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MSK Exam 1 Spring 2015 > Skeletal Muscle and Peripheral Nerve Pathology I > Flashcards

Skeletal Muscle and Peripheral Nerve Pathology I Flashcards

1
Q

looking for what in CSF

A

protein

inflammation

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2
Q

types of peripheral nerve injury

A

1 - axonal - trauma
2 - demyelinating - MS/GB
3 - neuronopathies - kill nerve body - polio

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3
Q

MBP

A

myelin basic protein
-role in myelin compaction

mutant forms - charcot marie tooth disease

demyelinating neuropathy - slow conduction

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4
Q

atrophy of leg muscle

A

polio

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5
Q

acute axonal injury

A

degeneration of distal axon

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6
Q

reinnervation of myofibers

A

myelinated by proliferating schwann cells

new internodes shorter and myelin sheath thinner

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7
Q

axonal degeration

A

loosened myelin layers

lipid droplet vaculoles

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8
Q

what does nerve follow to regenerate

A

myelin

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9
Q

mononeuropathy

A

affect single nerve

trauma, entrapment, infection

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10
Q

polyneuropathy

A

affect multiple nerves

symmetric fashion

stocking and glove distribution

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11
Q

mononeuritis multiplex

A

disease process damaging several nerves in haphazard fashion

vasculitis common cause

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12
Q

polyradiculoneuropathy

A

affect nerve root as well as peripheral nerve

-diffuse symmetric sx prox and distal parts of body

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13
Q

acute inflammatory demyelinating polyneuropathy

A

guillan barre

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14
Q

paralysis and areflexia, DTR gone, nerve conduction slow, CSF protein high, preceding acute flu-like illness

A

guillan barre

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15
Q

guillan barre infections

A 
campylobacter jejuni
CMV
EBV
mycoplasma pneumonia
prior vaccination - no evidence
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16
Q

nerve biopsy

A

often lymphocytes

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17
Q

chronic guillan barre

A

2 months or more

doesn’t get better

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18
Q

onion bulb neuropathy

A

demyelinzation

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19
Q

myelin basic protein

A

stain for myelin

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20
Q

ulnar deviation

A

rheumatoid arthritis

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21
Q

systemic autoimmune diseases with neuropathy

A

rheumatoid arthritis
sjogren
SLE

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22
Q

vasculitis

A

non-infectious inflammation of blood vessels - can involve and damage peripheral nerves

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23
Q

fibrinoid necrosis of vessels

A

polyarteritis nodosum

24
Q

target lesion

A

lyme

25
Q

pseudomembrane

A

diptheria

toxin causes neuropathy

26
Q

most common cause of stocking glove peripheral neuropathy

A

diabetes

27
Q

thin myelinated nerve, thick endometrial vessel, nodular sclerosis of glomerulus

A

diabetes

28
Q

numbness, loss of pain sensation, difficulty with balance, paresthesia, dysthesia

A

distal symmetric diabetic polyneuropathy

leads to foot and ankle fractures, chronic skin ulcers

also - diabetics have autonomic dysfunction

postural hypotension, incomplete bladder emptying, sexual dysfunction

29
Q

peripheral neuropathy in diabetic

A

has variable presentation

30
Q

distal, symmetric neuropathy, asymptomatic or muscle cramp, distal dysesthesias, diminished DTRs

A

uremic neuropathy
-with chronic renal failure

axonal degeneration is primary event**

recovery after dialysis

31
Q

compression mononeuropathy with distal symmetric sensory polyneuropathy

A

thyroid dysfunction - hypothyroid

32
Q

vit B12 deficiency

A

pernicious anemia

-subacute combined degeneration with damage to long tracts in SC and peripheral nerves

33
Q

peripheral neuropathy deficiency

A 
B1 (thiamine)
B6 (pyridoxine)
folate
vit E
copper
zinc
34
Q

uremic frost

A

white froth around mouth

with neuropathies

35
Q

wernickes encephalopathy

A

image of brain lesion

-from thiamine deficiency**

36
Q

toxic neuropathies

A

alcohol
heavy metals - lead, mercury, arsenic, thallium
medications - vinca alkaloids, taxanes, cisplatin

37
Q

basophilic stippling on RBC

A

lead poisoning

can cause neuropathy

38
Q

dots on hands with neuropathy

A

arsenic

39
Q

direct infiltration of tumor to brachial plexus

A

pancoast tumor

40
Q

paraneoplastic sensorimotor neuropathy

A

with small cell lung cancer

41
Q

waldenstroms

A

B cell IgM immunoglobulins

-hyperviscosity an demyelinating peripheral neuropathy

42
Q

periphera nerve injury/entrapment

A

carpal tunnel

43
Q

2nd and 3rd toes neuropathy with trauma

-dancer

A

whartons neuroma

44
Q

charcot marie tooth disease

A

sensory AND motor neuropathy

inherited genetic disorder**

45
Q

distal muscle atrophy, sensory loss, foot deformity

A

CMT - charcot marie tooth disease

see bruising, cuts, abrasions - no symptoms - no sensation of pain**

46
Q

pes cavus foot

A

with CMT 1

high arch and prominent metatarsal heads

47
Q

painless weakness

A

with disorders of NMJ

48
Q

myasthenia gravis

A

painless weakness**

autoimmune - Abs against AChR

49
Q

associations with myasthenia gravis

A

thymoma / thymic hyperplasia

anti-AChR Abs

50
Q

weakness that worsens with exertion

A

myasthenia gravis

also see diplopia and ptosis

51
Q

tx of myasthenia gravis

A

acetylcholinesterase inhibitors

52
Q

lambert eaton myasthenic syndrome

A

autoimmune disorder causing Abs that block ACh release by inhibiting presynaptic Ca channel

gets better with exertion**

53
Q

myasthenia gravis vs. lambert eaton

A

MG - postsynaptic
LE - presynaptic

LE - better with exertion
MG - worse with exertion

54
Q

association with lambert eaton

A

neuroendocrine carcinoma of lung

-small cell

55
Q

CD8 T cells

A

polymyositis

56
Q

CD4 T cells

A

dermatomyositis

MSK Exam 1 Spring 2015 (21 decks)

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