Polyneuropathy

Question 1

How fast do autonomic nerves conduct?

Answer 1

Slow due to lack of myelin!

Question 2

4 mechanisms of nerve injury

Answer 2

1) Disrupted axon transport
2) Nerve infarction
3) Nerve inflammation
4) compression/direct trauma

Question 3

MOST common mechanism of nerve injury

Answer 3

disrupted axonal transport

Question 4

Properties of nerve fibers that have the highest chance of being disrupted

Answer 4

Longest ones! toes! and sensory (largest diameter) fibers!

Question 5

Polyneuropathy picture has to be

Answer 5

Symmetrical!

Question 6

2 clinical features of peripheral neuropathy showing negative symptoms

Answer 6

1) numbness

2) weakness

Question 7

4 common etiologies of polyneuropathies

Answer 7

• Diabetic neuropathy
• B12 deficiency
• monoclonal gammopathy
• Syphillis/HIV

Question 8

Most common type of hereditary neuropathy

Answer 8

Charcot marie tooth

Question 9

Key lab tests to evaluate a distal symmetric polyneuropathy

Answer 9

serum B12 with metabolites
serum protein immunofixation
2hr glucose tolerance test (if fasting blood sugar Hemoglobin A1C normal)

Question 10

Multiple single nerves affected suggests

Answer 10

Mononeuropathy multiplex -

Question 11

3 possible etiologies of multiplex neuropathy

Answer 11

vasculitis
amyloidosis
Mimics: leprosy, diabetes

Question 12

symptomatic treatment of neuropathic pain

Answer 12

pregabalin
amytriptiline
duloxetine