Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
CM Neuropathies
Neurology Neuropathies
| Question | Answer |
|---|---|
| Neurological exam consists of: | motor (strength, bulk, tone), sensation (vibration, position, temperature, pin prick), reflexes |
| mononeuropathy | single nerve involved; such as the median nerve in carpal tunnel syndrome |
| Polyneuropathy | multiple diffuse; such as metabolic neuropathies like diabetic or uremic neuropathy |
| Many isolated single nerves | mononeuritis multiplex |
| Motor involvement signs | Atrophy, fasiculations, weakness, cramps |
| Signs of sensory involvement | numbness, pain |
| Signs of autonomic involvement | dizziness, tachycardia, gastroparesis, impotence, loss of sweating |
| Tinnel's and Phalen's signs in Carpel Tunnel | Percussion over median nerve at wrist (tinnel's), flexion of the wrist for 30-60 seconds (Phalen's). |
| Location of sx in Carpel Tunnel | Fingers supplied by the median nerve: thumb, index, middle and medial half of the ring finger |
| Hypothyroidism, DM, RA, Pregnancy, Obesity and repetitive use are associated with higher risk of | Carpal tunnel syndrome |
| Areas of entrapment in ulnar nerve lesions | cubital tunnel, elbow, wrist. Injury may occur years after a malunited suprabondylar fracture of the humerus with bony overgrowth. |
| Signs of ulnar nerve palsy | Contrary to findings in carpal tunnel syndrome, muscle weakness and atrophy characteristically predominate over sensory sx. Atrophy of first dorsal interosseus muscle and difficulty with fine manipulations |
| Wrist drop and finger drop are motor deficits seen in | radial mononeuropathy |
| Reflexes to test radial nerve | triceps and brachioradialis |
| Humerus fx, crutches, and lead toxicity are all causes of | radial nerve lesions |
| _______ is the most common pure sensory mononeuropathy | Meralgia paresthetica; compression of the lateral cutaneous nerve of the thigh as it passes under or through the inguinal ligament. Pain on lateral thigh |
| Weakness of hip flexion and knee extension may suggest | femoral neuropathy. Sensory loss on the anterior thigh and medial suface of the lower leg |
| Habitual leg crossing can damage | the common peroneal nerve. |
| For motor deficit caused by sciatic neuroapathy, what must be affected? | Peroneal AND Tibial muscles |
| Numbness of 4th and 5th finger | Ulnar mononeuropathy |
| Obese, diabetic with prickly pain on anterior thigh | Meralgia Paresthetica (lateral femoral cutaneous) |
| Guillain-Barre Syndrome AIDP Pneumonic | Acute, Inflammatory, Demyelinating, Polyradiculoneuropathy |
| Which neuropathy is frequently associated with antecedent GI illness or URI? | Buillain-Barre Syndrome |
| Characteristics of GBS: | Rapidly ascending weakness, motor affected more than sensory, may start with deep achy pain, hypo or areflexia, facial droop, dipolopia, dysphagia |
| Diagnostic testing for GBS | Lumbar puncture (cytoalbuminological dissociation), Nerve conduction studies |
| What is the recovery time for GBS? | Recovery is generally complete in month to 1-2 years. Tx: plasmapheresis and infusion of high doses of human Ig |
| cytoalbuminological dissociation on an LP is associated with | GBS |
| Which fibers (A or C) are associated with burning, cold, sharp, shooting pain? | C- small fibers: discomfort |
| Which fibers (A or C) are associated with tingling and decreased position sensation | A- large fibers |
| Onset of polyneuropathies | insidious (sudden and asymmetric pain may suggest non-neuropathic origin) |
| In a polyneuropathy were motor deficit is greater than sensory, and there is rarely burning, or tingling, it is more likely | genetic. Most genetic neuropathies are autosomal dominant |
| In which CMT do you find: demyelination, NCS=slow velocity, and areflexia? | CMT I |
| In which CMT do you find: axon loss, NCS=low amplitude and reflexes are less affected? | CMT II |
| Foot deformity with high arches (pes cavus ) and hammer toes, reflecting long-standing muscle imbalance in the feet typically is present in | CMT |
| What percentage of Diabetics will have peripheral neuropathy after 20 years of diabetes? | 15%. Primary axonal with secondary demyelination |
| _______ is the most frequent cause of peripheral neuropathy worldwide | Diabetes |
| Signs of diabetic polyneuropathy | symmetric, usually begins distally with sensory loss in the feet |
| Pain and atrophy of proximal leg muscles in diabetics | Diabetic Amyotrophy; Tx with high dose IVIg |
| What is the screening tool for monoclonal gammopathies? | SPEP |
| What percentage of patients with idiopathic PN have monoclonal gammopathy? | 10% |
| POEMS pneumonic in Osteosclerotic Myeloma | Polyneuropathy, Organomegaly (spleen, liver), Endocrinopathy (thyroid, DM, hirsutism, testicular atrophy, M protein, Skin (hyperpigmentation). |
| Distal symmetric sensorimotor polyneuropathy (with primaily axonal features). Burning, numb feet with atrophy = | Alcohol-Nutritional Neuropathy (diabetic is symmetric, distal and SENSORY) |
| Differential Diagnosis for Common Peroneal MonoNeuropathy | L5 radiculopathy, ALS |
| distal muscle atrophy and weakness indicate | Motor impairment |
| If you see hammer toes and pes cavus in a 20 year old, think | hereditary neuropathy |
Created by:
ltm12