Clinical

Question 1

Rhabdomyolysis after exertion, fasting or in association with a viral illness raises the suspicion for what group of disorders?

Answer 1

Metabolic myopathies

Question 2

Strength and CK levels of metabolic myopathies

Answer 2

Normal inbetween episodes

Question 3

What is the most common metabolic cause of repeated myoglobinuria?

Answer 3

CTPII deficiency

Question 4

Myoadenylate deaminase deficiency shows what on ischemic exercise testing?

Answer 4

Failure to generate ammonia

Question 5

What is the most proximal abnormal posterior interosseous innervated muscle possible?

Answer 5

Extensor digitorum communis (C7-C8)

Question 6

What cervical nerve roots are most commonly affect in cervical radiculopathy?

Answer 6

• C7 (1st)
• C6 (2nd)

Question 7

What is the most common form of CMT peripheral neuropathy?

Answer 7

CMT 1A: duplication of chromosome 17p11.2-12 region containing the peripheral myelin protein 22 gene

Question 8

What are the limitations in Erb’s palsy and where is the potential lesion?

Answer 8

• Trouble supinating forearm, extending wrist, flexing elbow, abducting shoulder and externally rotating shoulder
• Traction injury to the upper trunk or C5/C6 nerve roots

Question 9

What are the 3 levels of nerve injury from least to worst?

Answer 9

1. Neuropraxia: (mild)
   
   1. Disruption of the myelin shealth (conduction block)
   2. No Wallerian degeneration
   3. Conduction block causes Sensory loss
2. Axonotmesis: (moderate)
   
   1. Demyelination causes axonal damage
   2. Wallerian degeneration
   3. Endoneurium and schwann cells intact
   4. Motor and sensory loss
3. Neurotmesis
   
   1. Complete loss of axon, schwann cells and endoneurium
   2. Complete motor and sensory loss
   3. No spontaneous recovery

Question 10

What percent of patients with MGUS will go on to develop a malignant plasma cell dyscrasia?

Answer 10

19%

Question 11

What kind of neuropathy is associated with amyloidosis?

Answer 11

Small fiber neuropathy

Question 12

What monoclonal protein is usually seen with amyloidosis?

Answer 12

IgG or IgA