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The Windows Control Panel is the technician s toolbox It contains the tools you need to do everything from changing the mouse settings to installing new device drivers This lab exercise won t attempt to examine every tool in the Control Panel, but it will help you become familiar with many of them Some Control Panel programs known as applets are speci c to particular hardware, while others are used for software con guration Windows initially sets up defaults that work for most installations, but as a technician, you may need to tweak some of the settings Also, not all Windows features are enabled in a normal installation, so you may need to enable or disable features according to the needs of a particular user

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A small percentage of patients at the time of initial evaluation and a larger percentage subsequently will have an MCP associated with a secondary disorder Multiple myeloma, amyloidosis, lymphoma, cryoglobulinemia, or POEMS syndrome are noteworthy examples A lambda, rather than a kappa, light chain increases the probability of a secondary cause of an MCP Peripheral neuropathies associated with secondary causes of MCPs have, with the exception of the IgM kappa-related demyelinating sensory-predominant neuropathy, more distinctive phenotypes than MGUSrelated neuropathies For example, polyneuropathy, organomegaly, endocrinopathy, monoclonal protein and skin changes (POEMS) syndrome often associated with a motor-predominant, demyelinating, nonlength-dependent CIDP phenotype Amyloidosis may manifest as a small ber phenotype with prominent dysautonomia65 MCPs or light chains can be detected in these disorders in serum or urine by immunoelectrophoresis or immuno xation The latter is more sensitive but is also more labor intensive For these reasons, it is not used as a default screening procedure by many laboratories Diabetic neuropathy is common and is associated with multiple phenotypes It is estimated to be the cause of neuropathy in 15 30% of North American patients60,61,66 The diagnosis of diabetic neuropathy is dependent on the ful llment of criteria outlined by the American Diabetes Association in association with one or more of the characteristic clinical and EDX diabetic neuropathy phenotypes The diagnosis is made by association A direct causal relationship cannot be readily proven Although thickening of the basal membranes of the vaso nervorum demonstrable by nerve biopsy is characteristic of diabetes, it is unknown what role it plays, if any, in the pathogenesis of diabetic nerve injury Alternative causes of peripheral neuropathy should always be considered in diabetic patients, particularly if the phenotype is atypical in the diabetic population The American Diabetes Association criteria include either an elevated (fasting blood sugar) ( 124 mg/dL) or an abnormal 2-hour (glucose tolerance test) ( 200 mg/dL)67 Tests of glycosylated hemoglobin are usually employed for assessment of diabetic control rather than for initial detection of diabetes Traditionally, neuropathy was not readily attributed to diabetes unless the diagnosis of diabetes had been established for years More recently, a statistical association has been demonstrated between impaired glucose tolerance (FBS 110 125 mg/dL or GTT 140 199 mg/dL) and the SFN phenotype68 71 Measurement of serum creatine kinase (CK) is a valuable adjunct in the evaluation of patients with neuromuscular disease Although considered to be primarily a marker of muscle disease, increased serum CK levels commonly occur in ALS and other motor neuron diseases Conversely, elevated CK levels do not occur in all myopathies Normal CK levels vary with gender, race,.

The electrophysiologic presentation of acute organophosphate intoxication is rather unique230 232,408,409 414 Motor and sensory nerve conduction velocities are essentially normal within the rst 24 48 hours Mild conduction slowing may develop subsequently CMAP amplitudes are decreased in severe intoxication with limited effects in milder exposures In about 60% or more of patients, an afterdischarge(s) as described above may be seen (Fig 23 4) This is believed to be the most sensitive EDX indicator of early toxicity230 232 A rather unique feature of organophosphate toxicity is a decrement increment pattern to repetitive stimulation observed either early in the course of the disorder or in later stages of recovery Speci cally, there is an

For a refresher on the Windows Control Panel, refer to the Control Panel section in 13 of Mike Meyers A+ Guide to Managing and Troubleshooting PCs

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