Neuro 8

Front 1

Define Motor Neuron disease, give examples

Back 1

(Ant horn cell)
- disease within motor neurons cause secondary changes in motor axons and motor fibers
- ie. ALS, spinal muscular atrophy, polio, West-Nile

Front 2

Define motor neuropathy, give examples

Back 2

- disease that affects axons/myelin/both
- diabetes, renal insufficiency, lead

Front 3

Define NMJ disease, give examples

Back 3

- disease affecting pre or post synaptic areas of NMJ
- MG= post synaptic
- Eaton-Lambert- pre synaptic

Front 4

Define Paresthesiae

Back 4

- abnormal sensations (tingle, prick, pins, warm, cold, burn)

Front 5

Define hyperesthesia

Back 5

- loss of a larger sensory neurons that leads to the over activity in smaller axons
- mild stimuli = painful

Front 6

Define Anesthesia

Back 6

- no sensation 'numb'

Front 7

What are teh 2 most common causes of autonomic symptoms?

Back 7

1. diabetes
2. amyloid neuropathy (esp young patient)

Front 8

What are some autonomic symptoms?

Back 8

- dry skin, hair loss
- impotence, constipation/diarrhea, incontinence/urinary retention, postural hypotension

Front 9

What is Gower's manuver?

Back 9

- person has to climb up on themself in order to stand up
- hip weakness, weak thoracic muscles indicative of a myopathy

Front 10

What is hypertrophy/ pseudohypertrophy of a muscle and give an example

Back 10

- muscle bulk appears sufficient but is replaced by fat/connective tissue
- Duchenne muscular dystrophy in calves/deltoid

Front 11

What are the 4 general categories of muscle weakness?

Back 11

1. neuropathy
2. myopathy
3. motor neuron/ant horn
4. NMJ

Front 12

Which category of weakness is mainly distal? proximal?

Back 12

distal= neuropathy
proximal= myopathy

Front 13

Which categories of weakness are usually decreased? normal?

Back 13

Decreased= neuro/myo
Normal= ant horn/ NMJ

Front 14

Which is the only category of weakness that shows sensory loss and paresthesias?

Back 14

- neuropathy

Front 15

Fasciculations are present in which category? possible in which category?

Back 15

- present in Ant horn
- possible in neuropathy

Front 16

Atrophy is present in all categories of weakness except?

Back 16

- NMJ

Front 17

Which category of weakness has severe fatigue?

Back 17

- NMJ

Front 18

Which is the category that never involves pain?

Back 18

- NMJ

Front 19

Nerve conduction study is evaluated by what 2 ways and what do they indicate?

Back 19

1. amplitude (axonal damage)
2. velocity of response (demylination of nerve)

Front 20

How does electromyography differentiate between neuropathy and myopathy?

Back 20

N= not enough motor units firing to make a full view of the repeating unit
M= unit amplittude is smaller as it requires little stimulus to fire

Front 21

What does CK levels indicate? How does this differentiate between neuropathy and myopathy?

Back 21

- indicates muscle damage
N- normal CK
M= high CK

Front 22

What is carpal tunnel classified under?

Back 22

Compressive neuropathy (mononeuropathy)

Front 23

Carpal tunnel usually involves what nerve?

Back 23

Median

Front 24

What is polyneuropathy characterize by?

Back 24

- distal pain, paresthesia, weakness, neuro findings (ie motor impaired, hyporefleia)

Front 25

What is the 2 most common cause of Acute polyneuropathy?

Back 25

Guillain=Barre Syndrome (AIDP- ascending paralysis with weakness)
AIDS (severe and quick)

Front 26

What is the ost common causeof subacute polyneuropathy?

Back 26

Diabetic polyneuropathy

Front 27

What is the most common cause(s) of chronic polyneuropathy and what is unique about this category?

Back 27

- Charcot-Marie-Tooth
- HNPP
- Many of these are hereditary

Front 28

Describe Guillian-Barrer's course and treatment

Back 28

- 1/3 cases preceded by URI
- electrophysiological studies show demyelination
- Treat with IVIG (long)

Front 29

What is a common NMJ disorder?

Back 29

Myasthenia gravis

Front 30

Describe the course, testing, treatment of Myasthenia gravis

Back 30

- disease of post-synatpic NMJ, involves proximal and distal, curtain sign, fatiguable
- Tensilon test, electrodiagnositc
- Treat with steroids

Front 31

What are the 2 most common inflammatory myopathies?

Back 31

1. polymyositis
2. dermatomyositis

Front 32

Describe dermatomyositis; signs, tests, those susceptible

Back 32

- inflamed skin/muscle with minor clots at nail bed, rash on face
- muscular biopsy shows perifasicular atrophy
-females over 40

Front 33

What would a muscle biopsy look like in an individual with polymyositis?

Back 33

- wBC invasion into muscles

Front 34

What is most often used to treat neuropathies?

Back 34

- the anticonvulsant gabapentin

Front 35

What are possible causes of the Ant Horn disease, ALS?

Back 35

- sporadic (most and involves UMN/LMN)
- environment
- familial

Front 36

What is the pathology and related clinical signs of ALS?

Back 36

- CNS (brain and spine), dendrites atrophy, then axonal degeneration
- drool, foot drop, chocke, fingers weak, speech problems
- full cognition!