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Flashcards in Neuropathy Deck (69)
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1
Q

Refers to lesions affecting the peripheral nervous system

A

Peripheral neuropathy

2
Q

Depends on whether myelin or axons are affected, which axons, and where they are affected

A

Symptoms of Neuropathy

3
Q

Symptoms may include weakness and muscle atrophy, loss of reflexes, and loss of sensation

A

Neuropathy

4
Q

Peripheral nerve neuropathy affecting all fibers would cause

A

Sensory, motor, and autonomic symptoms

5
Q

Peripheral nerve neuropathy affecting only small fibers would cause

A

Pain, temperature, and autonomic loss

6
Q

Peripheral nerve neuropathy affecting myelin (large fibers) would cause

A

Vibration and position sense loss, with motor loss

7
Q

Peripheral nerve neuropathy affecting only sensory ganglia would cause only

A

Sensory symptoms

8
Q

Tissue may be damaged, but nerves and nervous system are intact with

A

Nociceptive pain

9
Q

Arises from lesions in the peripheral and central nervous system

A

Neuropathic pain

10
Q

May include burning, shooting, stinging pain mixed with areas of numbness

A

Neuropathic pain

11
Q

A common feature of chronic pain is

A

Depression

12
Q

What are the primary drugs used to treat neuropathic pain?

A

Antidepressants and anti-epileptic drugs

13
Q

When symptoms follow a nerve root pattern, it is referred to as

A

Radiculopathy

14
Q

Often caused by compression of nerve roots from protruding discs

A

Radiculopathy

15
Q

When symptoms follow a peripheral nerve, it is referred to as

-Often caused by injuries

A

Mononeuropathy

16
Q

Involves nerve roots and the pattern of loss is along a dermatome or myotome

A

Radiculopathies

17
Q

In contrast to radiculopathies, are lesions or specific nerves or plexuses

A

Mononeuropathies and plexopathies

18
Q

A herpes zoster infection arising in the sensory neurons of the dorsal root ganglion of T1 spinal nerves

-May produce just sensory symptoms at the T1 dermatome (usually unilateral)

A

Radiculopathy

19
Q

A carpal tunnel syndrome may affect all sensory, motor, and autonomic components of the median nerve, distal to the wrist. This is an example of a

A

Mononeuropathy

20
Q

Caused by a generalized process affecting peripheral nerves

A

Polyneuropathy

21
Q

May show a distal and symetrical sensorimotor (and possibly autonomic) distribution

A

Polyneuropathy

22
Q

Polyneuropathy is sometimes called a

A

Glove and sock pattern

23
Q

The most common causes of polyneuropathy are

A

Diabetes, alcohol, hypothyroidism, and Vitamin B12 deficiency

24
Q

May result from damage or injury to cell bodies, axons, or myelin sheaths

A

Peripheral neuropathy

25
Q

Axonal damage produces

A

Wallerian Degeneration (Or dying forward)

26
Q

Distal axonal degeneration, chromatolysius, and recruitment of macrophages

A

Wallerian degeneration

27
Q

The proximal stump after a neuron lesion can recover at a rate of

A

1-2 mm/day

28
Q

Conditions that affect the health of the neuron such as metabolic diseases causes the

A

Dying of back axons

29
Q

Longer axons are affected first, resulting in the

A

Distal extremities being affected first

30
Q

Occurs when myelin sheaths are damaged by trauma or disease

A

Segmental demyelination

31
Q

May be affected secondarily to axonal death

A

Myelin

32
Q

Symptoms of demyelination are detected by nerve conduction tests which detect

A

Conduction block and slowed CV

33
Q

Myelin and conduction can return in

A

Days to weeks

34
Q

Trauma affecting myelin can be thought of as a

A

Nerve “concussion”

35
Q

Note that it is only when the axon is interrupted that you will see

A

Muscle atrophy

36
Q

What are two causative disorders/agents that result in nutritional/metabolic causes of peripheral neuropathy

A

Diabetes Mellitus and Vitamin B12 deficiency

37
Q

An autoimmune disease that can result in non-traumatic peripheral neuropathy

A

Guillain-Barre Syndrome

38
Q

What is an inherited disorder that causes non-traumatic peripheral neuropathy?

A

Charcot-Marie-Tooth Neuropathy

39
Q

Affects 1.9% of the population

-most common complication in this population

A

Diabetic Neuropathy

40
Q

The greatest source of morbidity and mortality in diabetes patients

A

Diabetic neuropathy

41
Q

Accounts for greater than 80% of patients with diabetic neuropathy

A

Length-dependent diabetic neuropathy

42
Q

Length dependent polyneuropathy gives a

-Produced by most nutritional, metabolic, and toxic diseases

A

Glove and stocking pattern of sensory loss

43
Q

Symptoms include parethesias, dyesthesias, numbness, tingling, and burning

-Motor weakness of the distal limbs is also present

A

Length dependent polyneuropathy

44
Q

Length dependent polyneuropathy can lead to trophic changes like

A

Calluses and plantar ulcers

45
Q

More affects in ALL distal neuropathies

A

Sensory neurons

46
Q

The most common metabolic neuropathy

-May affect peripheral nerves, optic nerves, spinal cord, and brain

A

B12 deficiency

47
Q

Symptoms of neuropathy from B12 deficiency include the distal limbs, beginning more commonly in the

A

Upper Limb

48
Q

The most common feature of peripheral neuropathy from B12 deficiency is

A

Loss of vibration sense

49
Q

Vitamin B12 neuropathy may primarily or secondarily affect lateral and dorsal columns of the spinal cord. This is called

A

Subacute combined degeneration

50
Q

Therefore, ataxia and spasticity can occur together with the symptoms of

A

Peripheral neuropathy

51
Q

Can see in vegetarians or people with gluten sensitivity or malabsorption syndromes

A

B12 deficiency

52
Q

Without B12, is abnormal

-NCV will decrease

A

Myelin production

53
Q

Needs to be differentiated from MS

A

B12 deficiency

54
Q

The most common cause of acute paralysis seen in clinical practice

-Also called Acute Inflammatory Demyelinating polyneuropathy (AIDP)

A

Guillain Barre

55
Q

The most rapidly progressing and potentially fatal form of neuropathy

A

Guillain Barre

56
Q

Primarily motor with ascending symmetric paralysis

A

Guillain Barre

57
Q

May begin with paresthesias in toes and fingers and aching in the thighs and back

A

Guillain Barre

58
Q

What are two major features of Guillain Barre?

A

Nerve conduciton velocity is decreased and there is increased protein in CSF w/ normal cell count

59
Q

60% of the time, Guillain Barre begins how long after an infection or vaccination?

A

1-3 weeks

60
Q

Widespread inflammatory process that affects myelin sheaths

A

Guillain Barre

61
Q

The 2 most important diagnostic tests for Guillain Barre are

A

CSF analysis and Nerve Conduction Tests

62
Q

The results of these tests are

A

Increased protein in CSF and decreased NCV

63
Q

Classified s hereditary motor and sensory neuropathy

A

Charcot-Marie-Tooth Disease

64
Q

Which form of Charcot-Marie-Tooth (CMT) disease affects

  1. ) Myelin
  2. ) Axons
A
  1. ) CMT1

2. ) CMT2

65
Q

The most common form of CMT: produces a combined motor sensory neuropathy

A

CMT1

66
Q

CMT1 primarily affects distal muscle, particularly affecting the

A

Peroneal nerve

67
Q

Because of the demyelination, are not affected by CMT1

A

Small fiber types carrying pain and temperature

68
Q

The typical onset of CMT1 is in

A

Late childhood

69
Q

Identifiable by the slowly progressive nature and by the reduced conduction velocity in all nerves

A

CMT1,