Weakness

Question 1

If the brain is injured and the patient is presenting with weakness, the deficit will be?

Answer 1

lateral

Question 2

If the spinal cord is injured and the patient is presenting with weakness, where will the deficit be?

Answer 2

bilateral

Question 3

What are some causes of brain injury leading to weakness?

Answer 3

• stroke (cerebrovascular event)
• bleeding (hemorrhage in the brain)
• cancer
• Progressive multifocal leukoencephalopathy (PML)

Question 4

Which two diagnoses can cause brain and spinal cord injury?

Answer 4

• Multiple Sclerosis

- transverse myelitis

Question 5

If a patient is presenting with weakness and the spinal cord is injured, what are some possible causes?

Answer 5

• trauma
• spinal stenosis
• spinal abscess
• Polio
• West Nile Virus

Question 6

An overall fatigue and global weakness may be due to an impairment in the delivery of oxygen to the body. This can be caused by what two main diagnoses?

Answer 6

• anemia

- heart failure

Question 7

An overall weakness mneumonic can be remembered using DANG THE RAPIST. What does it stand for?

Answer 7

D- diabetes
A- alcohol
N- nutrition
G- guillan-bare *ascending paralysis after viral infxn

T- trauma/radiculopathy
H- hereditary *like charcot marie tooth syndrome
E- environmental, like lead

R- remote cancer
A- autoimmune
P- porphyria
I- Inflammatory
S- syphilis
T- TB

Question 8

If a patient is weak, a BMP should be checked for which levels?

Answer 8

Magnesium and Potassium

Question 9

Explain the pathophysiology behind Myasthenia Gravis

Answer 9

• Autoantibodies attack the ach receptors at the post-synaptic neurons. This causes ach to not reach the post-synaptic neurons. As a result, the more that a muscle is used with repeated contraction, the weaker it becomes.
• extraocular eye muscles, swallowing–> use them a lot, and the ACH becomes depleted faster… then they become weak

Question 10

Explain the pathophysiology behind Lambert-Eaton disease

Answer 10

• Autoantibodies attack the calcium channels at the pre-synaptic neuron, causing the calcium to not be able to depolarize the membrane.
• As a result, muscles that require the depolarization to move will be weak. The muscles affected are the proximal muscles.

Question 11

List some types of myositis

*ultimately leading to muscle weakness

Answer 11

• dermatomyositis
• inclusion body myositis
• polymyositis
• statin induced myositis