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Behaviour > Peripheral Neuropathy > Flashcards

Peripheral Neuropathy Flashcards

1
Q

list 5 conditions associated with carpal tunnel syndrome

A

1) hypothyroidism
2) pregnancy in the third trimester
3) rheumatoid disease
4) acromegaly
5) amyloid (inc in dialysis patients)

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2
Q

treatment of MG

A

acetylcholine esterase inhibitors (pyridostigmine)
IV Ig plasma exchange
Immunosuppressants

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3
Q

name 3 autoimmune disorders of the nueromusclar junction

A

LEMS
neuromyotonia
Myasthenia Gravis

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4
Q

Lambert Eaton Myasthenic syndrome is associated with which type of cancer

A

60% is associated with small cell lung cancer and infact may precede diagnosis by 4 years

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5
Q

presentation of LEMS

A

very rare
causes hyporeflexia and weakness that can be transiently imroved through exercise
caused by antibodies against voltage gated calcium channels

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6
Q

presentation of neuromyotonia

A 
very rare
hypertonic stiffness in muscles
cramps
myokymia
caused by antibodies against voltage gated potassium channel which prevents the swithc off of ACh release
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7
Q

presentation of myasthenia gravis

A

uncommon
fatiguable weakness
EYE - diplopia and weakness of eye closure
BULBAR - speech swallowing chewing difficulty smiling
NECK- extension weakness
proximal limb muscle weakness
caused by antibodies against around 80% ACh receptors preventing adequate end plate potentials

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8
Q

what is early onset myasthenia graves associated wtih

A 
young women (menarche - 40)
Thymic hyperplasia
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9
Q

what is later onset MG associated with

A

older men

atrophic thymus

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10
Q

which tumour is myasthenia graves associated wtih

A

thymoma at any age

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11
Q

sensory signs of nerve dysfunction

A 
numbness 
buring
ataxia
allodynia
reduced proprioception
areflexia
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12
Q

motor signs of dysfunction

A

weakness
wasting
fasciulation
areflexia

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13
Q

what is mononeuropathy multiplex

A

nerve damage involving one or more nerve trunks
usually asymmetrical
(eg in diabetes, leprosy, vasculitis)

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14
Q

what is Wallerian degeneration

A

degeneration of nerve fibres distal to axon separation from cell body

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15
Q

what is poly neuropathy

A

neuropathy involving multiple nerve trunks
symmetrical and usually starts distally

eg GBS sock and glove

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16
Q

what is mononeuropathy

A

single nerve involvement from a local cause

eg trauma or compression

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17
Q

what is neuropathy

A

a pathological process that damages a nerve producing signs and symptoms

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18
Q

symptoms of axonal degeneration

A

tingling
burning
weakness
loss of motor function

19
Q

give examples of acute and chronic demyelinating neuropathies

A

acute- GBS

chronic - Chronic inflammatory demyelinating polyneuropathy

20
Q

first presentation of GBS

A

sock and glove neuropathy

21
Q

Treatment of GBS

A 
IV Ig (decreases duration)
plasma exchange (eliminate pathogen)
supportive care
22
Q

most common precursor to GBS

A

Campylobacter pylori

23
Q

presentation of peripheral neuropathy

A 
tingling
numbness of digits
weakness of limbs
hyporeflexia
fatigue
abnormal sensation
24
Q

3 causes of axonal degeneration

A

diabetes
alcoholism
genetics (CMT, leprosy)

25
Q

what is Charcot Marie Tooth syndrome

A

a genetic condition where axonal degeneration is caused by multiple gene mutations for proteins in myelin schwann cells and axons

26
Q

name an anaesthetic which works by blocking sodium channels

A

lidocaine

27
Q

name an anticonvulsant which works by using sodium channels

A

carbamezine

28
Q

name 3 excitatory neurotransmitters

A

noradrenaline - used in the Symp ANS
adrenaline - NA agonist
Acetylcholine - post ganglionic para NS and in motor end plates

29
Q

signs and symptoms of autonomic neuropathy

A 
dry mouth/eyes
syncope
GI disturbance
bladder urgency/frequency
impotence
dry skin and excessive/inadequate sweating
pupil constriction
30
Q

what is “dying back” neuropathy

A

distal axonal degeneration often due to toxic/metabolic abnormalities of neuronal cell body (HIV/AIDS; alcohol etc)

starts peripherally and dies back towards the cell body

31
Q

aetiologies of chronic peripheral neuropathy

A

variable:

  • idiopathic
  • diabetes/impaired glucose tolerance
  • drugs (statins, cytotoxic drugs)
  • B12 deficiency
  • alcohol
  • inherited
32
Q

presentation of radial nerve compression neuropathy

A

wrist drop and weakness of brachoradialis

33
Q

presentation of ulnar nerve compression at the elbow

A

hypothenar wasting
weakness of finger abduction and opposition of little finger
sensory changes in medial 1.5 fingers

34
Q

presentation of carpal tunnel syndrome

A

numbness in lateral digits
waking at night
weakness of thumb abduction
wasting of thinner eminence

35
Q

presentation of malaria parasthetica

A

numbness/burning over anterolateral thigh following sudden increase in weight, surgery or injury

36
Q

presentation of compression neuropathy of the common perennial nerve around the fibula

A

foot drop and weakness of ankle eversion with preserved ankle jerk
numbness on anterolateral dormer of the dorsum of the foot
follows prolonged sitting/bed rest

37
Q

features of CIDP

A
  • slow onset and recovery
  • progressive/relapsing procimal and distal limbe weakness and sensory loss
  • CSF protein raised (>0.4)
38
Q

thiamine deficiency causes which syndrome

A

Wernicke-Korsakoff

  • abnormal eye movements (nystagmus, bilateral L rectus palsy, conjugate gaze palsies)
  • ataxia (broad based gait, cerebellum signs and vestibular paralysis)
  • cognitive change (acute stupor/coma followed by amnesic syndrome and confabulations)
39
Q

which vitamin deficiency neuropathy presents as:
tingling and numbness of fingers and toes
distal sensory loss (esp in dorsal column)
absent ankle jerks
exaggerated knee jerks and extensor plantear response

A

B12 Cobalamin

40
Q

what are the causes of peripheral neuropathy

A 
Diabetes
Alcoholism
Vitamin deficiency
Infective/inherited
Drugs (e.g. isoniazid)
41
Q

name 6 methods of peripheral nerve damage

A

demyelination
axonal degeneration (usually toxic neuropathies)
wallerian degeneration (crush injuries)
compression
infarction (polyarteritis nodosa, Churg-Strauss)
infiltration (leprosy, malignancy, inflammation, sarcoidosis)

42
Q

mixed upper and lower motor neurone signs is indicative of which group of conditions

A

motor neurone disease

75% have symmetrical weakness and wasting
usually painless
25% bulbar and pseudo bulbar features (eye movements usually spared)
there is NO sensory loss
sphincters are NOT affected

43
Q

which tracts are affected by ALS

A

lateral corticospinal tracts causing a spastic paraparesis

Behaviour (10 decks)

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