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79 Cards in this Set
- Front
- Back
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pelvic tilt indicates weakness of ___ muscles,
especially___ |
hip girdle
gluteus medius |
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as hip extensor weakness progresses ___ occurs
this is characteristic of ___ |
increased lumbar lordosis
MD |
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myotonia can be detected by ___ on exam, which triggers ___
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percussion of thenar eminence
sustained contraction |
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4 kinds of neuromuscular disorders
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motor neuron disease (MND)
peripheral neuropathy (PN) neuromuscular junction (NMJ) myopathy |
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MNDs have ___ bulk,
___ tone ___ strength ___ sensation ___ reflexes ___ babinski, and ___ pattern |
low
high low normal high or low positive asymmetric |
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PNs have ___ bulk,
___ tone ___ strength ___ sensation ___ reflexes ___ babinski, and ___ pattern |
low
low low low low negative symmetric or asymmetric |
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MNDs have ___ bulk,
___ tone ___ strength ___ sensation ___ reflexes ___ babinski, and ___ pattern |
normal
normal low normal normal negative symmetric |
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MNDs have ___ bulk,
___ tone ___ strength ___ sensation ___ reflexes ___ babinski, and ___ pattern |
low
normal low normal normal or low negative symmetric |
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3 kinds of MND
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UMN only
LMN only UMN and LMN |
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MND affecting UMNs only
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PLS
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2 kinds of LMN-only MNDs
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SMAs
polio-like syndromes |
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6 kinds of SMA
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infantile
juvenile kennedy's distal scapuloperoneal segmental |
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infantile SMA is aka
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Werdnig-Hoffman
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juvenile SMA is aka
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Kugelberg-Welander
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distal SMA is aka
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neuronal CMT
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6 polio-like syndromes
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polio
other viruses post-radiation MND paraneoplastic MND toxin-induced MND idiopathic LMND |
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MND affecting upper and lower motor neurons
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ALS
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T/F: most ALS is sporadic
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true (90%)
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2 criteria for ALS dx
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UMN + LMN involvement
progression over time |
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in addition to spasticity and hyperreflexia, ___ is a sign of UMN dysfunction
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loss of dexterity
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main prognostic factor for ALS
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age at onset (older is worse)
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typical survival time for ALS
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2--3 years
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appearance of ___ or ___ with suspected ALS should suggest other diagnoses
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sensory sx
autonomic sx |
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___ is the main study used to support dx of ALS
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needle EMG
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___ is present in 70% of sporadic ALS cases
this may cause ___ |
Glu transporter defect
excitotoxicity |
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___ is a drug approved for ALS
it works by ___ing survival benefit from its use is ___ |
riluzole
inhibiting Glu release 2--3 months |
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2 kinds of neuropathic disorders
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neuronopathy
peripheral neuropathy (PN) |
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neuronopathies affect ___
PNs affect ___ |
cell body
distal process |
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2 kinds of PN
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myelinopathy
axonopathy |
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MCC of neuropathy in industrialized countries
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DM
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5 key diagnostic questions for PNs
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what systems are involved
what is the distribution of weakness what is the nature of the sensory involvement what is the temporal evoluation |
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7 neuropathic disorders which may present with motor dysfunction only
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MNDs
multifocal motor neuropathy GBS CIDP Pb intoxication porphyria CMT |
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4 neuropathic disorders which may present with motor dysfunction only,
but commonly present WITH sensory sx |
GBS
Pb intoxication porphyria CMT |
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neuropathic disorders which commonly have dysautonomia
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PNs
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4 kinds of dysautonomia
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orthostasis
heat intolerance bowel/bladder dysfunction sexual dysfunction |
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7 PNs which commonly cause dysautonomia
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DM
amyloidosis GBS vincristine-induced porphyria HIV dysautonomia idiopathic pandysautonomia |
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PNs often associated with pain
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cryptogenic sensory PN (CSPN)
DM vasculitis GBS amyloidosis |
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pain from CSPN and DM is ___ (2)
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symmetric
worse in feet |
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pain in vasculitis is ___ (2)
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distal
asymmetric |
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GBS pain is commonly in ___
it is ___ |
back
symmetric |
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if asymmetric loss of proprioception is present, consider ___ (2)
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neuronopathy
ganglionopathy |
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6 causes of neuronopathy + ganglionopathy
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cancer
sjogren's idiopathic sensory neuronopathy cisplatin B6 toxicity HIV sensory neuronopathy |
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symmetric weakness in proximal and distal muscles implicates ___
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demyelinating disorders (GBS, CIDP)
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symmetric but only distal weakness implicates
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axonal PN
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5 kinds of causes of asymmetric weakness
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MND
radiculopathy plexopathy mononeuropathy multiplex compressive mononeuropathy |
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given symmetric proximal and distal weakness
with sensory loss, consider ___ (2) |
GBS
CIDP |
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given symmetric distal weakness with sensory loss,
consider ___ (5) |
DM
drugs toxins CMT amyloidosis |
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given asymmetric distal weakness with sensory loss at MULTIPLE nerves,
consider ___ (4) |
vasculitis
infection sarcoid HNPP |
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3 infections causing asymmetric distal weakness with sensory loss at multiple nerves
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Lyme disease
HIV leprosy |
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given asymmetric distal weakness with sensory loss at SINGLE nerve/region,
consider ___ (2) |
compressive mononeuropathy
radiculopathy |
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given asymmetric distal weakness without sensory loss,
consider ___ (2) |
MND
multifocal motor neuropathy |
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given asymmetric proximal and distal weakness with sensory loss,
consider ___ (4) |
polyradiculopathy
plexopathy meningeal carcinomatosis HNPP |
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given symmetric sensory loss without weakness, consider ___ (4)
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DM
drugs toxin CSPN |
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treatment of choice for GBS
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plasmapheresis
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full recovery rate for GBS
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80%
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___% of ocular MG have anti-AChR___% of generalized MG have anti-AChR
overall, ___% of MG have anti-AChR |
50
90 75 |
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___% of ocular MG progresses to generalized
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65
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once MG dx is made, you must do ___
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CXR
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CXR in MG is to check for ___ (2)
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thymic hyperplasia
thymoma |
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thymectomy is indicated for MG if ___ or ___
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age < 60 and generalized
thymoma |
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5 nonsurgical interventions for MG
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anti-ChE
azathioprine CS plasmapheresis IVIg |
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3 kinds of MD
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X-linked
AD AR |
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3 X-linked MDs
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DMD
Becker's MD Emery-Dreifuss MD |
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5 AD MDs
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myotonic dystrophy
scioscapulohumeral d. scapulohumeral d. distal myopathy oculopharyngeal d. |
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4 AR MDs
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limb-girdle dystrophy
distal myopathy congenital MD scapulohumeral MD |
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lab study for DMD
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CPK
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___ is the most common dystrophy affecting adults
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myotonic d.
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incidence of myotonic d.
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1/10,000
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2 cortical sx of myotonic d.
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hypersomnia
intellectual decline |
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6 non-neurologic sx of myotonic d.
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heart block
cataracts gonadal atrophy respiratory insufficiency GI sx endocrine abnormalities |
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3 channelopathic myotonic disorders
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hyperkalemic periodic paralysis (HPP)
paramyotonia congenita myotonia congenita |
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HPP is a defect in a ___ channel
it is a ___ disorder |
Na+
AD |
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HPP presents as ___ which is triggered by ___ (5)
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tansient paralysis
rest exercise stress large meals K+ |
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HPP may be txed with ___
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acetazolamide (K+ wasting)
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paramyotonia congenita is a defect in a ___ channel
it is a ___ disorder |
Na+
AD |
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unlike myotonia, in paramyotonia sx ___
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get worse with repeated muscle use
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myotonia congenita is a defect in a ___ channel
it is a ___ disorder |
Cl-
AD or AR |
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AD form of myotonia congenita is aka
AR form of myotonia congenita is aka |
Thomsen's disease
Becker's myotonia congenita |
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3 myotonia tx
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quinine
procainamide phenytoin |
