Weakness

Question 1

gradual onset with progression of weakness sx in a child.

2 tumors:

Answer 1

1. astrocytoma

2. glioma

Question 2

Difference btw Duchenne and Becker’s M disorders

Answer 2

Duchenne: defective gene- absence of dystrophin

Becker’s: normal dystrophin

Question 3

x: c/c of double vision, difficulty swallowing, weakness in the arms/ jaws with repeated use

Answer 3

Myasthenia Gravis

female- NM transmission is blocked by autoantibodies that bind to AcH receptors

Question 4

CC:

• anhedonia: inability to feel pleasure
• difficulty sleeping
• sense of worthlessness

Answer 4

depression

Question 5

CC:
• incapacitating, decr ability to preform ADLs → not due to exertion only
• 6+ mo.

Answer 5

Chronic Fatigue sx

Question 6

x: child has difficulty rising from bent over position

Answer 6

duchenne muscular dystrophy

Question 7

X: pt's weakness gets worst when exposed to: 
carbs
alcohol
cold
stress 
rest after exercise

Answer 7

hypokalemia

affects the Cl channels

Question 8

x: defect of Na+ channel gene on chrom. 17

Answer 8

hyperkalemia

worst by: exercising for more than an hour

better by: glucose, insulin, Ca+ gluconate

Question 9

Which channels are defected in hyper/ vs hypokalemia

Answer 9

hyper: Na+ channel
hypo: Cl- channel

Question 10

dz’s that cause intention tremors and resting tremors

Answer 10

intention: MS

Resting: PD

Question 11

x: numbness, tingling or weakness that resolves in a few days

has a genetic link of HLA-DR2

Labs:

• incr lymphocytosis
• incr protein in CSF
• IgG’s
• oligoclonal bands in CSF

Answer 11

Multiple Sclerosis

Question 12

X: brief jerking motion in sleep

Answer 12

myoclonus

Question 13

causes of myoclonus (6)

Answer 13

1. uremia
2. alzheimers
3. epilepsy
4. creutzfeldt jakob dz
5. hypoxia
6. head trauma

Question 14

4 causes of chores (involuntary movemetns of distal ext. and face)

Answer 14

1. huntington’s
2. sydenham’s sequella (rheumatic Q)
3. SLE
4. Drug induced

Question 15

x: decr GABA, choreoform movements

Answer 15

Huntington’s dz

Question 16

x: writhing movements of the prox limb

due to dopamergic overactivity in the basal gg

Answer 16

athetosis

Question 17

x: violent movement disorder, arm or leg is flung about conti.

Cause:
• infarct or tumor irritating the contralateral subthalamic nucleus

Answer 17

hemiballismus

Question 18

x: bilateral leg weakness following a viral infection

Answer 18

Guillain- Barre sx

PE:

• motor signs
• absent DTR
• flucatuating in BP
• Diaphoresis

Question 19

x: repeated head trauma in football player

combo of UMNL and LMNL
- atrophy, fasciculations and brisk DTRS (norm: sensory)

Answer 19

Amyotrophic lateral sclerosis (ALS)

Question 20

x: lesion involving the schwann cells and N fibroblasts

- cafe- au- lait lesions

Answer 20

Neuroflibromatosis

type 1: hyperpigmentation nodules
type 2: prob with hearing and seeing