Muscles, Nerves, Psychiatric disorders

CK-MM

• Creatine kinase

• Mainly skeletal muscle

CK-MB

• Cardiac muscle contains 30%

• High plasma CKMB = cardiac damage

• can also be due to skeletal muscle injury

CK-BB

Confined mainly to the brain

Increased CK

• Rhabdomyolysis

• Extreme excercise

• African american descent

• MI

• Hypothyroidism

Myoglobinemia

• Extreme exertion

• Myoglobin percipitates = cause kidney damage

• Coca-cola urine

• Hyperkalemia

• Hypocalcemia

• Hyperphosphatemia

• Hyperuricemia

Genetic muscle disease

• Muscular dystrophy

• Duchenne MD = severe

• Dystrophin gene = abnormal / undetectable

• Beck MD = milder

Acquired Metabolic Muscle disease

1. Secondary ehtanol, statin abuse

2. Secondary endocrine disorder

3. Hypo/hyperthyroidism

4. Cushings syndrome

5. Vit D deficiency

Genetic Metabolic Muscle disease

• defect in carb metabolism

• Disorder of fatty acid oxidation = LDL build up

Coma

• decreased consciousness

• Nervous system

• Ethanol, glucose, sodium, ABG

• Wenicke-Korsakogg syndrome

  • congenital Vit B1 deficiency

  • alcoholics, refeeding syndrome, gastri bypass

Dementia

• Loss of intellectual function

• Alzheimers

• Vascular

• Lewy body

  • Parkinson's disease

• Frontal-temporal 

• Huntington

• metabolic or endocrine disorder

Metabolic / Endocrine dementia disorder

1. Hypothyroidism

2. Liver, Kidney failure

3. Ethanol abuse

4. Heavy metal poisoning

5. Vitamine deficiency

Movement disorder

• Basal ganglia

• Hypokinetic

  • Parkinsons

  • Wilson disease

• Hyperkinetic

  • Huntington

• Ataxia

Parkinson disease

caused by degeneration of dopaminergic neurons

Dopamine

Wilson disease

mutation of ATP7B, copper build up

Ataxia

• Disordered control of movement

• Tay-Sach's disease

• Ataxia telangiectasia/Louis Bar syndrome

  • small dilated blood vessels

  • 90% increase fetoprotein, AFP

Depression

• Psychiatric

• Cortisol levels

• Hypothyroidism

• Cushing disease

• risk factor for CVD

• Diabetes mellitus

• Poly cystic ovarian syndrome

Bipolar disorder

• Treated with lithium

• Mimics calcium

• lead to hypothyroidism

• Continued use damages renal function

  • nephrogenic diabetes insipidus