Systemic and Metabolic Disorders Flashcards
What are the effects of B1 deficiency?
- Cardiomyopathy
- Peripheral neuropathy
- Wernicke-Korsakoff
What is classic triad for Wernicke’s syndrome?
- Delirium
- Ataxia
- Ophthalmoplegia
What area of the brain is affected with Wernicke-Korsakoff syndrome?
Mamillary bodies
What are the neurological s/sx of B12 deficiency?
Distal symmetric sensory loss with UMN and MS changes
What are the s/sx of B6 deficiencies?
- Sensory ataxia
- Neuropathy
- Seborrhoeic dermatitis
- atrophic glossitis
- angular cheilitis
What drug can cause a B6 deficiency?
Isoniazid
What are the s/sx of niacin (B3) deficiency?
Pellagra:
Dermatitis, diarrhea, dementia, and death
Neuropathy
What are the s/sx of vitamin A deficiency?
- Night blindness
- Xerophthalmia
What are the ss/x of vitamin D deficiency?
Weakness
What are the s/sx of vitamin E deficiency?
- Neuropathy
- Spinocerebellar ataxia
What are the s/sx of vitamin K deficiency?
No neurological s/sx, but coagulopathy may result in ICH
What are the s/sx of hypernatremia?
- MS changes
- Szs
- Weakness
What are the s/sx of hyponatremia?
- MS changes
- Szs
Rapid correction of hyper or hyponatremia may result in osmotic demyelination? What is this called?
Hyponatremia–Central pontine myelinolysis
Which is usually more symptomatic: hyper or hyponatremia?
Hyponatremia
What are the s/sx of hypokalemia?
Weakness
What are the s/sx of hypercalcemia? Causes?
- MS changes, cramps, weakness
- malignancy, hyperparathyroidism
What are the s/sx of hypocalcemia?
- Hypoparathyroidism
- Renal failure
- Pancreatitis
Tetany
What is Chvostek’s sign? Trousseau’s sign?
Chvostek’s = facial nerve tapping
Trousseau’s sign = BP cuff
Both are from hypocalcemia
What are the s/sx of hypermagnesemia?
Hyporeflexia, lethargy
What usually causes hypomagnesemia?
IVF
Renal failure
Antacids
What do we treat with Mg that can cause hypermagnesemia?
Eclampsia
What are the s/sx of hypomagnesemia?
Like hypocalcemia
What are the s/sx of hypoglycemia?
- MS changes
- Seizures
- Focal cerebral dysfunction
What are the s/sx of hyperglycemia?
- DKA
- MS changes
True or false: hypoglycemia can cause focal neurological deficits
True
What is posterior reversible encephalopathy (PRES)? What are the s/sx of this?
HTN caused encephalopathy that occurs in the posterior aspect of the brain
- Accelerated HTN
- HA, seizures, MS changes
- Papilledema
What may an MRI show with PRES?
Parieto-occipital white matter changes
What are the neurological s/sx of hypoxia 2/2 pulmonary dz?
- HAs
- Lethargic
- MS changes
What are the s/sx of hepatic encephalopathy?
- Asterixis
- MS changes
- Encephalopathy
What are the EEG findings of hepatic encephalopathy?
Triphasic waves
What are the neurological s/sx of renal dz?
- MS changes
- Asterixis
- Seizures
- Myoclonus
- Polyneuropathy
CNS infection in renal disease = what infectious agent?
Listeria
Why hypocalcemia with pancreatic disease?
Pancreatitis enzymes use Ca
What are the s/sx of hashimoto’s encephalopathy?
- Relapsing progressive ms changes
- Periodic paralysis
What must always be checked with neurological s/sx 2/2 thyroid issues?
Anti-TPO antibodies
What is the treatment for dementia 2/2 thyroid dysfunction?
Steroids
What is the most common hematological disorder that can cause neurological s/sx?
Sickle cell anemia
What is TTP? What are the neuro s/sx of this?
-inhibition of the ADAMTS13 metalloprotease responsible for cleaving large numbers of vWF, causing an increase in the number of platelets adhering to sites of damage, and thrombocytopenia
- Hallucinations
- Delerium
- HAs
Neurosarcoidosis usually presents?
- Multiple different cranial neuropathies
- Aseptic meningitis
How do you definitively diagnose neurosarcoidosis?
Bx
Who usually gets Takayasu Arteritis?
Young adult asian women or children
What are the neurological disturbances with Takayasu arteritis?
Focal cerebral ischemia or subclavian steal
What is Takayasu arteritis? What vessels are usually affected?
Large vessel granulomatous vasculitis, usually affecting the aorta and pulmonary arteries, that usually causes diminished peripheral pulses
What is Kawasaki disease? What is the classic sign? What are the neuro s/sx? Who is usually affected?
- Autoimmune medium sized vasculitis. Can cause coronary aneurysms.
- Strawberry tongue
- Facial weakness, seizures, strokes
- Infants and children
What is polyarteritis nodosa? What are the neuro s/sx? Who is usually affected?
a systemic vasculitis of small- or medium-sized muscular arteries, causing ischemic damage to the skin, kidneys, nervous system. Can cause MI.
What is Wegener’s granulomatosis? What are the neuro s/sx? Who is usually affected?
a systemic disorder that involves both granulomatosis and polyangiitis. It is a form of vasculitis (inflammation of blood vessels) that affects small- and medium-size vessels in many organs. Damage to the lungs and kidneys (RPGN) can be fatal.
Mononeuritis multiplex
What is the ab that is elevated with Wegener’s granulomatosis?
c-ANCA
What are the renal problem of Wegener’s?
RPGN
What is primary CNS angiitis? S/sx?
-Idiopathic inflammation of blood vessels only in the CNS
- HA
- Sz
- MS change
What is neuroleptic malignant syndrome? S/sx?
- Life-threatening adverse reaction to neuroleptic or antipsychotics
- Fever, autonomic instability, MS change, rigidity
What is the treatment for NMS?
Dopaminergic antagonists or discontinuance of dopaminergic agents
What are the s/sx of serotonin syndrome? Treatment?
- MS change
- Fever
- Hemodynamic instability
What is the typical type of neurologic s/sx of thyroid dz?
Periodic paralysis
What are the neuro s/sx of sickle cell disease?
Strokes
Seizures
CNS infections