Neuropathy Autonomic Neuropathy 2

Question 1

Pure autonomic failure (Bradbury-Eggleston syndrome) is characterized by which pathological finding?

Accepted Answer

Lewy bodies in peripheral autonomic neurons

Answer

Pure autonomic failure is associated with Lewy body accumulation in peripheral autonomic neurons without central nervous system involvement.

Question 2

Gustatory sweating (Frey's syndrome) after eating is a form of autonomic neuropathy associated with damage to which nerve?

Accepted Answer

Auriculotemporal branch of trigeminal nerve

Answer

Frey's syndrome results from aberrant reinnervation of the auriculotemporal nerve, causing sweating during eating instead of salivation.

Question 3

Which medication class is first-line for symptomatic orthostatic hypotension in autonomic neuropathy?

Accepted Answer

Midodrine (alpha-1 agonist)

Answer

Midodrine, an alpha-1 adrenergic agonist, increases peripheral vascular resistance and is first-line for symptomatic orthostatic hypotension.

Question 4

Diabetic neurogenic bladder due to autonomic neuropathy first manifests as which urodynamic abnormality?

Accepted Answer

Impaired bladder sensation and increased capacity

Answer

Early diabetic neurogenic bladder shows impaired sensation, increased bladder capacity, and reduced detrusor contractility.

Question 5

Multiple system atrophy (MSA) is distinguished from pure autonomic failure by which feature?

Accepted Answer

Involvement of the central nervous system with cerebellar or parkinsonian features

Answer

MSA involves both autonomic failure and central nervous system degeneration (cerebellar ataxia or parkinsonism), unlike pure autonomic failure.

Neuropathy Practice Test