Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology RIA > Weakness > Flashcards

Weakness Flashcards

1
Q

isolated progressive weakness, involving a number of limbs progressively, with muscle wasting

A

ALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

name 3 causes of subacute/acute onset of weakness

A
  • Guillian Barre syndrome
  • Cauda equina
  • Transverse myelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

condition that can present with both peripheral weakness + loss of peripheral sensation

A

GBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

investigations for a patient presenting with peripheral weakness + loss of sensation

A

FBC, U+E, Ca, LFTs, Phosphate, Magnesium, CRP, ESR, CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can GBS affect breathing?

A

by causing neuromuscular ventilatory failure by causing muscular weakness of diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what position makes neuromuscular ventilatory failure worse?

A

lying down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

examination signs of worsening GBS

A
  • worsening neck weakness
  • SoB worse on lying flat
  • reduced chest excursion on deep inspiration
  • CO2 retention flap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

signs of GBS related autonomic instability

A

tachycardia

BP changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

investigation for GBS

A

LP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

landmarks for LP

A

between lateral aspects of iliac crest at L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

complications of LP

A
  • cerebellar herniation
  • pain
  • headache
  • bleeding
  • infection
  • CSF leakage
  • subarachnoid epidermal cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CSF finding in GBS

A

normal cell count + elevated protein level

= cytoalbuminologic dissociation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Presentation of transverse myelitis

A

rapid onset of weakness, bladder/bowel and sensory alterations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

frequency of FVC measurements in GBS

A

4-hourly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

GBS is…

A

immune mediated demyelination of the peripheral nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

antibody found in 25% patients with GBS

A

Anti-GM1 antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

autonomic involvement in GBS

A 
urinary retention
\+ 
labile BP 
\+ 
constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Poss CN involvement in GBS

A
  • diplopia
  • ophthalmoplegia
  • facial weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

triggers of GBS

A
  • EBV, HIV, CMV,
  • Campylobacter jejuni
  • E. Coli
  • Hodgkin’s disease
  • Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

examination findings in GBS

A
  • ascending weakness
  • areflexia
  • distal paraesthesia
  • slurred speech (if oropharyngeal muscle weakness)
21
Q

Investigations for ascending weakness:

A
  • Nerve conduction studies
  • LP
  • LFTs
  • Spirometry
  • Antibody
22
Q

Management of GBS

A
  • Thromboprophylaxis
  • IVIG or Plasma exchange
  • FVC monitoring
  • Neurorehabilitation
23
Q

Triad in Miller fisher syndrome

A
  • ophthalmoplegia
  • ataxia
  • areflexia
24
Q

CIDP is …

A

chronic, progressive relapsing remitting course of GBS; if the symptoms progress after 6 weeks

25
Q

when do symptoms in GBS peak?

A

1-4 weeks after starting

26
Q

how does plasma exchange hep to treat GBS?

A

In GBS your plasma contains harmful proteins, this treatment removes your blood, separates out the plasma and combines your remaining blood with a donors plasma which is then put back into you

27
Q

majority fully recover by how long?

A

6-12 months

28
Q

Myasthenia Gravis is …

A

chronic autoimmune disorder of the post-synaptic membrane at the NMJ in skeletal muscle

29
Q

MG antibodies ?

A

antibodies to Acetylcholine receptors

30
Q

Differentials of weakness?

A
  • Lambert-Eaton syndrome
  • GBS
  • Transverse Myelitis
31
Q

often the first symptoms to appear in MG are?

A

ocular symptoms

32
Q

Muscle weakness in MG is dependant on what?

A

fatiguability

33
Q

what is muscle fatiguability?

A

muscles become progressively weaker through periods of activity
+
diurnal variation

34
Q

Levator palpebrae superioris weakness in MG causes

A

ptosis/dopping eyelids

35
Q

double vision in MG is caused by>

A

extraocular muscle weakness

36
Q

speech changes in MG and why?

A

nasal speech: dysarthria; due to bulbar muscle weakness

37
Q

transverse smile in MG caused by

A

facial muscle weakness

38
Q

difficulty getting out a chair in MG caused by

A

proximal muscle weakness

39
Q

specific examination tests in MG (2)

A

asking patient to count to 50 and listen to voice become quiter (positive finding)
+
ask patient to stare at your finger held above their forehead

40
Q

investigations for MG

A
  • CT thorax (thyoma)
  • EMG
  • autoantibodies
  • Pulmonary function tests
41
Q

symptomatic treatment of MG

A

pyridostigmine

42
Q

1st line treatment of MG

A
  • Pyridostigmine
  • Thymectomy
    +/- Immunosuppressants: corticosteroids, rituximab
43
Q

Pyridostigmine is a…

A

anticholinesterase

44
Q

Myasthenic crisis is…

A

complication of MG: characterised by worsening muscle weakness resulting in respiratory failure requiring intubation + mechanical ventilation

45
Q

management of Myasthenic Crisis

A

IVIG or plasmaphoresis

46
Q

indication for mechanical ventilation

A

FVC < 15 ml/kg

47
Q

complications of MG

A
  • respiratory failure
  • impaired swallowing (following mechanical ventilation)
  • acute aspiration
  • secondary pneumonia
  • plasma exchange induced adverse reactions
48
Q

Cauda equina examination findings

A
  • reduced perianal sensation
  • reduced anal tone
  • urinary retention
  • bilateral leg weakness
  • areflexia
49
Q

what FVC is an indication for intubation>

A

< 15 ml/kg

Neurology RIA (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions