Trigger - Misc Flashcards
unsuccessful attempts at remyelination results in plaques and scaring
MS
Hypovitaminosis D predisposes you to what diagnosis
MS
symptoms worsen with increasing body temp
uthoff phenomenon in MS
Shock like sensation down legs
Lhermittes symptoms in MS
increased risk of optic neuritis and relative afferent pupil defect
eye problems in MS, theres alot more, i just put theswez
what cranial nerves are effected in MS
5,7,9
detrusor muscle hyperreflexia
MS
what is clinically isolated MS syndrome
first MS attack, must last 24 hrs. doesnt have to meet all criteria
what kind of tremor can present in MS
intention tremor
deterioration in function separate from attacks
secondary MS
steady decline in function from onset of disease. no remission or relapse
primary MS
waves of remission and relapse in functional status.
RRMS
marked delay in latency during evoked potential testing
diagnostic of MS even in asymptomatic patients
oligoclonal bands and intrathecal IgG on CSF analysis
diagnostic study for MS patients with Isolated syndrome or atypical presentation.
also may see mild WBC elevation
acute tx of MS meds
methylprednisolone
Plasma exchange if needed
what must ptts be tested for prior to being given disease modifying agents
hep A
hep B
hep C
VZV
what are indications for disease modifying drugs in MS? what are the modifying drugs
CIS w rilsent lesions or relapsing RRMS or SPMS
- monoclonal abx (ocrevus)
- oral therapies
- platform injection therapies
BBW for irsk of progressive multifocal leukoencephalopathy. all pts MUST be tested for JC abx prior to therapy
Ocrevus (MAB) for MS
ampyra is used when
K+ channel blocker that is used in MS when LE weakness interferes with ambulation
magnesium, abx, corticosteroids are used as protective factors for what
cerebral palsy
leading cause of childhood disabiltiy
CP
hand preference before 12 months, gross motor delay in year 1.
Cerebral palsy
imaging can be cranial US, MRI of brain, or CT
Cerebral palsy
only do MRI if baby is >3 weeks
usually follows trauma and presents with patchy bone demineralization, skin changes.
complex regional pain syndrome
single limb prevented use via pain
Complex regional pain syndrome
pain made worse by loud noises, light touch, motion and stress
Chronic regional pain syndrome
acute phase
3 months
when does cyanosis/pallor and atrophy of subcutaneous tissue present. Joint fibrosis also present here
subacute stage of chronic regional pain syndrome
9 months
edema resolves, skin is dry/pale/cool/shiny. joint stiffness progresses and osteoporosis can happen
chornic stage of chronic regional pain syndrome
budapest criteria
chronic regional pain syndrome
first line treatment is OT and PT
Chronic regional pain syndrome
Fatal neurodegenetaive disease of both upper and lower motor neurons characterized by progressive loss of motor function
amyotrophic lateral sclerosisis
what is the MC type of ALS
sporadic
what is hte MCC of death in ALS
pneumonia
Impaired astrocytes increase glutamate => increased Ca2+ uptake
too much ca = mitochonrial oxidative stress
pathophys of ALS
drooling, amotional lability, involuntary laughing crying
bulbar dysfunction in ALS
involuntary laughing/crying = psuedobulbar affect syndrome
EMG will show both acute and chronic denervation and reinnervation.
Both upper and lower motor neuron lesion dysfunction
ALS
Only proven med that extends life in ALS patients
riluzole
inhibits release of glutamate (ALS = excess glutamate)
Only used for pts with a SOD1 gene mutation
tofersen
MC caused by sepsis
toxic metabolic encephalopathy
diagnosis of exclusion
toxic metabolic encephalopathy
asterixias, brisk DTRs , exagerated physiologic tremors
toxic-metabolic encephalopathy
Cafe au lait spots
Neurofibromatosis
soft, pea sized lesions that are nonpainful or tender
neurofibromas found in neurofibromatosis
bowing of the lower legs
scoliosis
NF type 1
compression of the pituitary, optic gliomas
NF type 1
ADHD common in this disorer
NF type 1
MCC of death in NF type 1
malignant tumor
MC lesion in NF type 2
Benign, slow-growing tumor of the vestibulocochlear nerve
CN 8
gradual hearing loss, tinnitus, ataxia, HA
NF type 2
Multiple, non-cutaneous schwannomas without vestibular involvement
schwannomatosis
Focal pain of neuropathic and nocipceptive nature
Focal numberness and weakness
Muscle atrophy
schwannomatosis
SOOOO PAINFULLLLLL
