Neuro - Periph Nervous System

Front 1

Are cranial nerves part of central or periph nervous system?

Back 1

PERIPH

Front 2

Name for:

injure AXON/MYELIN--> DISTAL degen of axon/myelin

Back 2

Wallerian Degeneration

(PNS)

Contrast neuronal degen: inj body --> die

Front 3

Name for:

Damage periph neuron body --> distal dying of axon

Back 3

Neuronal/axonal degeneration

(contrast Wallerian: just lose distal axon)

Front 4

Difference b/w:

Wallerian degen & neuronal degen

Back 4

Wallerian: inj axon --> distal dying of axon

Neuronal: inj BODY --> distal die axon

Front 5

Small or large fiber:

Neuropathic pain

Back 5

Small

Front 6

Small or large fiber:

Aching/throbbing/burning

Back 6

Small

Front 7

Small or large fiber:

Temperature

Back 7

Small

Front 8

Small or large fiber:

Cardiac arryth

Back 8

Small

Front 9

Small or large fiber:

Orthostatic hypoT

Back 9

Small

Front 10

Small or large fiber:

Constipation

Back 10

Small

Front 11

Small or large fiber:

Loss of vibration

Back 11

Large

Front 12

Small or large fiber:

Lose of position sense

Back 12

Large

Front 13

Small or large fiber:

Weakness

Back 13

Large

Front 14

Small or large fiber:

Denervation --> fasciculations

Back 14

Large

Front 15

Small or large fiber:

Lose DTRs

Back 15

Large

Front 16

Acute, subacute or chronic peripheral neuropathy:

Guillan-Barre

Back 16

Acute

Front 17

Acute, subacute or chronic peripheral neuropathy:

Porphyria

Back 17

ACUTE

Front 18

Acute, subacute or chronic peripheral neuropathy:

Diphtheria

Back 18

ACUTE

Front 19

Acute, subacute or chronic peripheral neuropathy:

Polio

Back 19

Acute

Front 20

Acute, subacute or chronic peripheral neuropathy:

Thallium

Back 20

Acute

Front 21

Acute, subacute or chronic peripheral neuropathy:

-Lead
-Arsenic

Back 21

Both ACUTE

Front 22

Acute, subacute or chronic peripheral neuropathy:

Uremia

Back 22

Acute

Front 23

Acute, subacute or chronic peripheral neuropathy:

Vasculitis

Back 23

Acute

Front 24

Acute, subacute or chronic peripheral neuropathy:

B1, B12 def

Back 24

Subacute

Front 25

Acute, subacute or chronic peripheral neuropathy:

Sarcoidosis

Back 25

Subacute

Front 26

Name for:

Stocking-glove pattern

Back 26

Polyneuropathy

Front 27

Polyneuropathy: symm?

Back 27

YES

(stocking-glove)

Front 28

Name for pattern:

involvement of individ nerves in a multifocal distrib

Back 28

Mononeuropathy multiplex

Front 29

Name for pattern:

Involvement of nerve roots

Back 29

Radiculopathy

Front 30

Peripheral neuropathy:

#1 risk factor

Back 30

DM

(EtOH is #2)

Front 31

Guillain-Barre:

-symm?
-weak? prox or distal?
-sens loss?

Back 31

Sym
Prox AND distal weak
Sens loss

Front 32

Chronic inflamm demyelinating polyneuro:

-symm?
-weak? prox or distal?
-sens loss?

Back 32

SAME AS GBS:

Symm
Prox & distal weak
Sens loss

Front 33

Amyloidosis:

-symm?
-weak? prox or distal?
-sens loss?

Back 33

Symm
DISTAL WEAK (not prox; contrast GBS)
Sens loss

Front 34

Lyme disease neuropathy:

-symm?
-weak? prox or distal?
-sens loss?

Back 34

ASYMM

Distal weak

Sens loss

Front 35

Sarcoidosis neuropathy:

-symm?
-weak? prox or distal?
-sens loss?

Back 35

ASYMM (contrast amyloidosis)

Distal weak

Sens loss

Front 36

HIV:

-symm?
-weak? prox or distal?
-sens loss?

Back 36

ASYMM

Distal weak

Sens loss

Front 37

Hereditary neuropathy with liability to pressure palsy (HNPP):

-symm?
-weak? prox or distal?
-sens loss?

Back 37

ASYMM

Prox & Distal weak

Sens loss

Front 38

Another name for:

Acute Inflammatory Demyelinating Polyneuropathy

Back 38

Guillain Barre

Front 39

Another name for:

Guillan Barre

Back 39

Acute Inflammatory Demyelinating Polyneuropathy

Front 40

Guillain Barre:

-M or F?
-adults or children?
-what % die? what % excellent recovery?

Back 40

M=F
Adults > child
5% die, 85% recover

Front 41

Guillain Barre:

What % pts preceded by acute infxn? what type of infxn (SPECIFIC)?

Back 41

75% pts with resp or GI infxn

25% CAMPYLOBACTER JEJUNI

25% CMV or EBV

Front 42

What periph neuropathy:

s/p Camplyobacter jejuni

Back 42

Guillain Barre

Front 43

What periph neuropathy:

autoimmune against GANGLIOSIDES

Back 43

Guillain Barre

Front 44

What dz:

anti-GM1, antiGD1a, antiGQ1b

Back 44

Guillain Barre

Front 45

Guillain Barre:

Abs against what neuron component?

Back 45

Gangliosides

Front 46

Guillain Barre:

most common Ab detected

Back 46

Anti-GM1

(m for most common)

Front 47

What dz:

rapid, ascending areflexic motor paralysis +/- sensory loss

Back 47

GBS

Front 48

Guillain Barre:

Weakness starts what body part? Reaches worst in how many days?

Back 48

Feet --> LBP

Worst within 30d (usu 14d)

Front 49

Guillain Barre:

See bulbar weakness? resp muscle weak?

Back 49

YES

Front 50

Guillain Barre:

DTRs increase or decrease? W/in how many days?

Back 50

Disappear after 3d

Front 51

Guillain Barre:

-Pain common?
-Autonomic s/sx?

Back 51

Pain common

ANS inv: ortho hypo, transient HTN, arrryth

Front 52

What dz:

Miller-Fischer variant

Back 52

Guillain Barre

(Gait ataxia, areflexia, external ophthalmoplegia; no limb weakness)

Front 53

Guillain Barre: what syndrome?

Gait ataxia, areflexia, external ophthalmoplegia; no limb weakness

Back 53

Miller-fisher variant

Front 54

Miller-Fisher variant of GBS:

-how appear nerve conduction studies
-see which Abs?

Back 54

NORMAL NCS

anti-GQ1b Abs

Front 55

What dz:

CSF: albumino-cytologic dissociation (high protein, no cells)

Back 55

GBS

Front 56

Guillain Barre:

-what is an early EMG change?

Back 56

Decrease motor unit recruitment

Front 57

If suspect GBS --> order which labs?

Back 57

1. CBC
2. ESR
3. HIV
4. LFTs

Front 58

GBS: req hosp? when transfer to ICU?

Back 58

YES

monitor FVC, negative insp pressure

FVC <15 --> ICU & likely intubate

Front 59

GBS: what med txs?

Back 59

IVIg & plasmapheresis (equally effective)

NOT STEROIDS

Front 60

GBS: give steroids to tx?

Back 60

No proven benefit

Front 61

Which ROOT SYNDROME:

Pain lateral shoulder; deltoid sens loss; paralyzed deltoid, supraspinatus, biceps

Back 61

C5

Front 62

C5 root syndrome:

-where is pain?
-which muscles paralyzed?

Back 62

Pain: lateral shoulder

Paralyzed biceps, supraspinatus, deltoid

Front 63

Which ROOT SYNDROME:

Impaired biceps reflex

Back 63

C5 or C6

Front 64

Which ROOT SYNDROME:

Pain radial side of arm (to thumb); paralyzed biceps & brachioradialis

Back 64

C6

Front 65

C6 root synd:

-where is pain?
-which muscles paralyzed?
-lose what reflex?

Back 65

Pain: radial arm to thumb
Paralyzed biceps & brachiorad

Lose biceps (same as C5)

Front 66

Which ROOT SYNDROME:

Pain b/w 2nd & 4th fingers; paralyzed triceps, extensors, flexors, pec major

Back 66

C7

Front 67

C7 root synd:

-where is pain?
-what muscles paralyzed?
-lose what reflex?

Back 67

Pain 2nd-4th fingers
Paralyzed triceps, extensors & flexors and pec major

Lose Triceps

Front 68

Which ROOT SYNDROME:

Lose triceps reflex

Back 68

C7

Front 69

Which ROOT SYNDROME:

Lose knee jerk

Back 69

L3 or L4

Front 70

Which ROOT SYNDROME:

Lose adductor thigh reflex

Back 70

L3

(also lose knee jerk()

Front 71

Which ROOT SYNDROME:

No sens loss; paralyzed quadriceps & ant tibial muscles

Back 71

L3

(contrast L4: medial leg sens loss)

Front 72

Which ROOT SYNDROME:

Lose sensation medial leg (below knee) to medial malleolus

Back 72

L4

Front 73

Which ROOT SYNDROME:

Invert foot

Back 73

L4

Front 74

Which ROOT SYNDROME:

Lose sensation dorsum of foot to great toe; paralyzed extensor hallucis longus

Back 74

L5

Front 75

L5 root synd: lose what reflex?

Back 75

Trick - none

Front 76

Which ROOT SYNDROME:

Lose ankle jerk

Back 76

S1

Front 77

Which ROOT SYNDROME:

Lose sens lateral border of foot; evert foot

Back 77

S1

Front 78

Another name for:

Chronic GBS

Back 78

Chronic Inflammatory Demyelinating Polyneuropathy

Front 79

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP):

-what ages?
-preceding events?

Back 79

40-60yo

NO KNOWN ANTECEDENTS (contrast GBS - C jejuni)

Front 80

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP):

-slow or rapid onset?
-painful?
-how affect reflexes?

Back 80

SLOW, PAINLESS weakness beginning in legs

Absent reflexes

Front 81

What dz:

slow-evolving, painless weakness beginning in legs --> widespread areflexia & loss of vibratory sense; weak neck flexors

Back 81

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

Front 82

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP):

-weak neck flexors and/or extensors?

Back 82

Flexors

Front 83

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP):

How tx?

Back 83

STEROIDS x many yrs

(contrast GBS - no role for steroids)

Some pts may respond to IVIg or plasmapharesis

Front 84

What dz:

Immune-mediated pure motor multiple mononeuropathy

Back 84

Multifocal Motor Neuropathy

Front 85

Multifocal Motor Neuropathy:

-pure motor or sens inv?
-what ages?
-M or F?
-underlying mxn?

Back 85

Pure motor
young adults; M>F (slight)
immune-mediated

Front 86

Multifocal Motor Neuropathy: begins in which limbs?

Back 86

ARMS

(contrast CIDP: legs)

Front 87

What dz:

Young adult with slow-evolving, ASYMM distal limb weakness beginning in arms

Back 87

Multifocal Motor Neuropathy

Front 88

Multifocal Motor Neuropathy: distal or proximal weak?

Back 88

Distal

Front 89

Multifocal Motor Neuropathy: weakness in muscle with decreased or normal bulk?

Back 89

Normal bulk

Front 90

Multifocal Motor Neuropathy: how affect reflexes?

Back 90

NORMAL REFLEXES

(decreased strength in muscles w/normal bulk)

Front 91

Multifocal Motor Neuropathy: how affect CSF?

Back 91

Normal

Front 92

Multifocal Motor Neuropathy: see what Ab?

Back 92

IgM anti-GM1

(IgM!!!!)

Front 93

What dz:

Very high IgM anti-GM1

Back 93

Multifocal Motor Neuropathy

Front 94

Multifocal Motor Neuropathy: how tx?

Back 94

Good response to IVIg or CYCLOPHOSPHAMIDE

(imp to identify this dz)

Front 95

What % periph neuropathies are assoc w/serum monoclonal gammopathy (M-protein)?

Back 95

10%!

Front 96

10% periph neuropathies assoc w/what protein?

Back 96

M-protein reacting w/myelin-assoc glycoprotein (MAG)

Front 97

M-protein: reacts w/what myelin protein?

Back 97

Myelin-assoc glycoprotein (MAG)

Front 98

Monoclonal gammopathies (M-protein assoc):

-sens? early or late?
-motor? early or late? which limbs?

Back 98

Sens early --> motor (esp legs) late

Front 99

Monoclonal gammopathies (M-protein assoc):

Small or large fiber?

Back 99

LARGE FIBER

Front 100

Monoclonal gammopathies (M-protein assoc):

Electrodiagnostic findigns?

Back 100

DEMYELINATION

Front 101

Monoclonal gammopathies (M-protein assoc):

How tx?

Back 101

1. Excise & radiate plasmacytoma (if can locate)
2. Plasmapharesis

Front 102

Most common & important diabetic neuropathy?

Back 102

Diabetic polyneuropathy

Front 103

Diabetic neuropathy:

-how many yrs after dz?
-common at presentation?

Back 103

5-10 yrs

Uncommon at presentation

Front 104

Diabetic neuropathy:

Is WEAKNESS early or late?

Back 104

LATE

usu p/w paresthesias first

Front 105

Diabetic neuropathy:


Small or large fibers?

Back 105

BOTH

Front 106

Diabetic neuropathy:

How tx? (classes of drugs)

Back 106

Glucose control

NSAIDs
TCAs
AEDs: gabapentin, carbamazepine

Front 107

Diabetic neuropathy:

Neuropathic pain responds to what drug class?

Back 107

AEDs! Gabapentin & carbamazepine

Front 108

Diabetic AMYOTROPHY:

-another name
-TM1 or 2?
-how present?

Back 108

Diabetic proximal motor neuropathy

TM2 (older pts)

thigh & LBP --> thigh weak w/atrophy

Front 109

Name for:

T2DM with severe thigh & back pain --> thigh muscle weakness w/atrophy

Back 109

Diabetic amyotrophy (aka diabetic prox motor neuropathy)

Front 110

T/F DM pts more susceptible to compression neuropathies

Back 110

T

Front 111

Uremic neuropathy:

-a/symm?
-distal or prox?
-motor or sens?
-CLASSIC FEATURES?

Back 111

Symm, distal, motor&sens

Foot drop, leg weak

Front 112

Porphyric neuropathy:

-assoc which disease?
-sens or motor?
-how affect reflexes?

Back 112

ACUTE intermitt porph

Acute sens loss --> rapid weakness & paralysis --> areflexia, abd pain

Front 113

What dz:

Abdominal pain + leg paresthesias --> leg paralysis --> asc

Back 113

AIP --> porphyric neuropathy

Front 114

Critical care neuropathies: develop after how long in ICU?

Back 114

2 weeks