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Neuropath - Feb 14th

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taylormaloney's version from 2017-02-14 17:47

Section 1

Question Answer
Define Nutritional neuropathy'Pernicious Anemia'
What causes it?Vit B12 deficiency- due to lack of B12 or Lack of Intrinsic Factor needed to absorb B12.
Where are the intrinsic factor (needed for absorption), produced?Parietal Cells of Gastric Mucosa.
What is the pathophysiology of Pernicious Anemia?Deficiencies in stomach acid production, or auto immune attack of acid secreting cells causes insufficient levels of B12/Intrinsic Factors.
How does B12 affect the peripheral neuropathy?Unknown connection, though it seems to involve an abnormal/lack of myelination in the PNS/CNS.
What are the S+S of Pernicious Anemia?Symmetrical sensory neuropathy, loss of fine motor control in hands, moderate Pain and sensory abnormalities, difficult ambulation, and rarely involving CNS. (Only in the case of severe disease).
Where is the symmetrical sensory neuropathy most often seen?Lower extremities.
How is Pernicious Anemia treated?Vitamin B12 supplementation parenterally.
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Section 2

Question Answer
Define Lead NeuropathyA Toxic neuropathy caused by the exposure to lead- leading to demyelination of both CNS + PNS axons.
What are the specific characteristics found in lead neuropathy?Typically found in 3rd world countries, found in those who have been drinking water sourced from lead pipes, those who work with car batteries/gasoline/paint.
What are the S+S of Lead Neuropathy?Gradual onset, mainly motor neuropathy, CNS effects including delerium/irritability/poor appetite/mental retardation.
What motor symptoms are often seen in those with Lead Neuropathy?Radial (Wrist Drop), and Peroneal (Foot drop) nerve dysfunctions.
How is Lead neuropathy diagnosed?XRays (looking for 'lead lines' at metaphysis), and Blood tests/Toxicology.
How is it treated?Removal of lead from environment, Anti-toxin Agent IV. (binds to lead and aids in removal from system).
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Section 3

Question Answer
What is Guillain- Barre Syndrome?Pathology causing rapid motor paresis/paralysis and sensory deficit potentially causing the inability to breathe actively.
What are the characteristics of GBS?Occurring at any age, rapidly progressing (peak of muscle weakness usually reached within 2-3 weeks), taking weeks to months to recover.
What is the most common type of GBS?Acute Inflammatory Demyelinating Polyradiculoneuropathy.
Etiology of GBS?Typically occurring after an infection, is also an immune-mediated disorder,
What causes GBS?Bacterial Infection (Campylobacter Jejui), Viral Infections, Surgery, Vaccinations.
90% of those with GBS report a history of..Illnesses (resp/GI) within preceding 30 days.
Involving predominantly _______ symptoms.Motor.
The more severe form involves..?Both motor and sensory nerve fibre degeneration.
Pathophysiology of GBS?Current theory is that it is an antibody-mediated demyelination.
Infection (often campylobacter) causes..Immune response, antibodies bind to myelin. Inflammation of nerve roots + peripheral nerves.
What takes place after the inflammation of nerve roots?The Macrophages strip the myelin from nerves, and potentially the loss of the axon in severe cases.
GBS is the most common cause of....Acute Flaccid Paralysis.
What are the S+S of GBS?Rapidly ascending motor weakness, moving in distal to proximal direction. Distal Sensory impairments, usually sphincters are spared.
Where is the most common first neurological symptom?Paresthesia in the toes.
What are the potential complications seen in severe cases?Intercostal N / Phrenic N damage.
What ANS symptoms may be present in GBS?Tachycardia, Cardiac Dysrhythmias, BP changes.
How is GBS diagnosed?Clinical and neurophysical exams, blood test (presence of immune cells/antibodies).
What is the prognosis of GBS?50%- 2 weeks. 90% - 4 weeks. Up to 20% - lasting neurological defects. Recovery possibly taking months/years.
What is the mortality rate of GBS?2-12%.
How is GBS treated?Protect Airway/Mechanical Respiration (If respiratory system paralysis). Plasmapheresis (removal of antibodies from blood), IV immunoglobulins.
How would massage therapy be utilized in cases of GBS?Contraindicated until fully healed.
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