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21 Cards in this Set
- Front
- Back
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what are some signs of upper motor neuron lesion?
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- weakness
- increased reflexes - spasticity - positive babinski sign - pseudobulbar affect |
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what are some signs of lower motor neuron lesion?
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- weakness
- decreased reflexes - flaccidity - atrophy of muscle - fasciculations |
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T or F: fasciculations are always indicative of disease/disorder.
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false; fasciculations are common and occur in healthy people. they are only of concern when we see atrophy, weakness, or other neurological findings
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a 64 y/o man presents to your office with both upper and lower motor neuron symptoms, muscle atrophy and stiffness, and mood changes. what is the most likely diagnosis?
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amyotrophic lateral sclerosis (ALS)
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ALS
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a slowly progressing, idiopathic, asymmetric disorder of upper and lower motor neurons
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amyotrophic lateral sclerosis
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lou gehrig's disease
haha fuckers. |
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Myasthenia gravis
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- autoimmune disorder against Ach receptors at NMJ
- slightly more common in females - proximal weakness > distal weakness |
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a middle aged women presents to your office complaining of weakness that gets worse as the day goes. she says that resting will sometimes make the weakness better for a little bit. she has no pain or sensory problems. what is the most likely diagnosis?
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myasthenia gravis
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T or F: the antibody titer in myasthenia gravis directly correlates to the clinical severity.
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false; it has no correlation
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patient presents to your office complaining (they all fucking complain in my questions) of proximal weakness and fatiguability. he says the more activity he does the better his strength is. you find that he has decreased reflexes. what is your major concern?
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- that he has small cell lung carcinoma. he is showing signs consistent with Lambert-Eaton myasthenia syndrome which is a paraneoplastic disorder associated with small cell lung carcinoma
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what are the antibodies against in LEMS?
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voltage gated Ca channels
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how does botulinum toxin work?
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it disrupts Ach vesicle exocytosis
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a patient comes in with generalized weakness, dysphagia, diplopia, myadriasis, and is in respiratory distress. you suspect an infection (for some unknown reason) so you get a gram stain that reveals gram positive rods. what is the most likely diagnosis? what is the etiologic agent?
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- botulism
- clostridium botulinum |
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polymyositis
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- 40-60 y/o
- females > males - proximal weakness w/ mild myalgias - elevated CK levels - CD8 + cells are present - abnormal EMG - endomysial inflammation |
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a 60 y/o patient presents with an insidious onset of muscle pain and stiffness. CK levels, EMG, and biopsy are normal. what is the most likely diagnosis?
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polymyalgia rheumatica
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a 13 y/o presents with progressive proximal muscle weakness, a heliotrope rash and Gottron's sign. he has elevated CK levels and an abnormal EMG. what is the most likely diagnosis?
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dermatomyositis
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an X linked recessive disorder that has an onset at about 5 y/o and death by about 20 y/o. the person will not produce dystrophin, will have delayed motor milestones, a positive gower's sign and hypertrophy of the calf muscles. what do they most likely have?
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Douche nne's muscular dystrophy
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an autosomal dominant disorder carried on chromosome 19 that affects adults. will have muscle weakness, cataracts, frontal balding, cognitive difficulties, and cardiac conduction defects. what is the most likely diagnosis?
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myotonic dystrophy
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which myopathies will all symptoms get worse with exertion?
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metabolic myopathies
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which myopathies destroy type 2 muscle fibers?
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steroid myopathies
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a fat ass with high cholesterol comes in complaining of muscle weakness. he says it began about 2 months after the other doctor switched his cholesterol meds. what is the most likely diagnosis?
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statin myopathy
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