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Biomedicine (Semester II) > 13. Nervous System I - Pathologies > Flashcards

13. Nervous System I - Pathologies Flashcards

1
Q

Carpal Tunnel Syndrome: definition

A

Compression of the median nerve in the carpal tunnel

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2
Q

What does the median nerve do?

A

Provides sensory information to the hand

Controls movements in the hand and fingers

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3
Q

Carpal Tunnel Syndrome: aetiology

A

Fluid retention - pregnancy
Overuse - vibrating tools, desk posture
Other pathologies - RA, hypothyroidism, acromegaly
Trauma (swelling), tumour or fracture in wrist

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4
Q

Carpal Tunnel Syndrome: signs and symptoms

A

Tingling, numbness, pain in median nerve distribution
Worse at night
Weakness of grip and weak thumb opposition

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5
Q

Carpal Tunnel Syndrome: diagnostics

A

Tinel’s test
Phalen’s test
Nerve conduction studies

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6
Q

Carpal Tunnel Syndrome: complications

A

In chronic/untreated cases, muscles around base of thumb may degenerate

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7
Q

Carpal Tunnel Syndrome: allopathic treatment

A 
Anti-inflammatory drugs
Corticosteroid injection
Physiotherapy
Wrist splinting
Surgery
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8
Q

Bell’s Palsy: definition

A

Inflammation or compression of the facial nerve

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9
Q

Bell’s Palsy: aetiology

A

Viral - herpes simplex
Surgery
Injury

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10
Q

Bell’s Palsy: signs and symptoms

A

Sudden, unilateral weakness or paralysis of the facial muscles
Cannot close affected eye
Loss of taste
Intolerance to loud noise

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11
Q

Bell’s Palsy: allopathic treatment

A

Acyclovir

Cortisone

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12
Q

Guillain-Barre Syndrome: definition

A

Acute, ascending, progressive inflammation and demyelination of peripheral nerves

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13
Q

Guillain-Barre Syndrome: aetiology

A

Autoimmune - 75% triggered by a recent infection (1-3 wks after respiratory/GIT or post-vaccination

Antibodies formed against virus cross-react with lipids in myelin - molecular mimicry

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14
Q

Guillain-Barre Syndrome: signs and symptoms

A

Sudden, progressive, bilateral, ascending paralysis
Paraesthesia and sensory changes
Neuropathic pain into legs

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15
Q

Guillain-Barre Syndrome: complications

A

Death by heart or respiratory failure

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16
Q

Guillain-Barre Syndrome: diagnostics

A

Nerve conduction studies

Lumbar puncture

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17
Q

Guillain-Barre Syndrome: allopathic treatment

A

Emergency care - respirator, intensive care
Plasma exchange
Intravenous antibodies
Corticosteroids

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18
Q

Multiple Sclerosis (MS): definition

A

Autoimmune inflammatory diseases causing demyelination of axons in CNS neurons

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19
Q

Multiple Sclerosis (MS): pathophysiology

A

T-lymphocytes attack myelin antigens

Multiple areas of sclerosis (scar tissue) along axons disrupts conduction

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20
Q

Multiple Sclerosis (MS): aetiology

A 
Vit D deficiency
Vit B12 deficiency
Genetic susceptibility
Environmental triggers
Dietary risk factors
Viruses - EBV, measles etc
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21
Q

Multiple Sclerosis (MS): signs and symptoms

A 
Blindness, loss of vision in one eye and occasional pain
Double vision and nystagmus (jerking of eyeball)
Deafness
Loss of balance
Burning, pulling sensations
Tingling, loss of sensation
Bladder urgency, incontinence
Cognitive changes, depression
Weakness
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22
Q

Multiple Sclerosis (MS): diagnostics

A

No definite test - based on clinical findings
MRI ophthalmoscopy
CSF analysis

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23
Q

Multiple Sclerosis (MS): allopathic treatment

A

Immunomodulatory therapies - corticosteroids, interferon-beta
Physiotherapy
Symptom management

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24
Q

At what age is multiple sclerosis likely to occur?

A

Between 20-50 years

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25
Q

Who is more likely to be affected by multiple sclerosis?

A

Women (2:1 to men)

26
Q

What pattern does MS follow?

A

Relapsing-remitting pattern (85%)

Other patterns are progressive

27
Q

What is the prognosis for MS?

A

Depends on disease pattern - 15% only suffer one episode

Progressive types have a poor prognosis

28
Q

Motor Neuron Disease (MND): definition

A

Progressive degeneration of motor neurons in the spinal cord, motor cortex and brain stem

29
Q

At what age does MND usually occur?

A

> 40 yrs (50-70 yrs)

30
Q

Who does MND usually affect?

A

More commonly affects men

31
Q

Motor Neuron Disease (MND): pathophysiology

A

Abnormal mitochondrial function causing oxidative stress in motor neurons

32
Q

Motor Neuron Disease (MND): aetiology

A

Unknown - suspected link with genetics, environmental toxins, oxidative stress

33
Q

Motor Neuron Disease (MND): signs and symptoms

A

Weakness in upper limbs - dropping objects or difficulty manipulating objects
Wasting of hand muscles
Tremor of limbs at rest
Later stages can affect legs (tripping), cause slurred speech, dyspnoea, difficulty swallowing

34
Q

Motor Neuron Disease (MND): complications

A

Death by respiratory failure - typically 3-5 yrs

Stephen Hawking exception

35
Q

Motor Neuron Disease (MND): allopathic treatment

A

No cure

Specialist care

36
Q

Dementia: definition

A

Syndrome caused by a number of brain disorders which cause memory loss, decline in other aspects of cognition, difficulty performing daily activities

37
Q

What is the prevalence of dementia?

A

Prevalence of dementia rises with age

38
Q

What are the two main categories of dementia?

A 
Alzheimer's disease (50%)
Vascular dementia (25%)
39
Q

What is vascular dementia?

A

Due to cerebrovascular disease e.g. stroke/strokes and poor oxygen delivery

40
Q

Alzheimer’s Disease: definition

A

Neurodegenerative disease of the cerebral cortex

41
Q

Alzheimer’s Disease: pathophysiology

A

Abnormal protein deposition (beta amyloid)
Atrophy of neurons
Less acetylcholine

42
Q

Which area of the brain is usually first affected by Alzheimer’s?

A

Hippocampus

43
Q

What is the hippocampus important for developing?

A

Memories

44
Q

Which area of the brain is usually affected later by Alzheimer’s?

A

Amygdala

45
Q

What is the amygdala important for?

A

Emotions

Memories

46
Q

Alzheimer’s Disease: aetiology

A

Heavy metal toxicity - aluminium, copper, mercury degenerate the blood brain barrier. High copper and

Genetic links (<1%) - ApoE4 gene

Chronic inflammation - sugar, insulin resistance, dairy, gluten, leaky gut (promoting inflammation)

Pathogens (micro-organisms) - oral bacteria e.g. P. gingivalis

Herpes simplex virus

High levels of oxidative stress

Nutritional deficiency - B1, B3, B6, B12, folate, omega 3 fatty acids

Hormonal deficiencies - oestrogen, testosterone, thyroid hormone
High cortisol

47
Q

Alzheimer’s Disease: signs and symptoms - early stages

A

Slight memory loss (especially short term - forgetting recent conversations)
Repeated questions and confusion
Decreased initiative - reduction in hobbies/hygiene

48
Q

Alzheimer’s Disease: signs and symptoms - later stages

A

Significant memory loss
Subtle changes in higher order functions i.e. understand jokes
Mood disturbances - agitation, aggression
Loss of sense of self
Difficulty with language
Unsteady
Depression

49
Q

Alzheimer’s Disease: diagnostics

A

Mini mental stage exam

MRI/CT scans

50
Q

Alzheimer’s Disease: allopathic treatment

A

Drugs - acetylcholinesterase inhibitors (to encourage Ach to increase) - ineffective

Psychological treatments - cognitive behavioural therapy

51
Q

What is the prognosis for Alzheimer’s?

A

People typically live for anywhere between 5 and 20 yrs after the onset of symptoms

52
Q

What is the most common cause of death in people with Alzheimer’s?

A

Infection

53
Q

Parkinson’s Disease: definition

A

Progressive neurological disorder affecting movement

54
Q

What is the prevalence of Parkinson’s

A

Affects 1% of individuals over 60

55
Q

Parkinson’s Disease: pathophysiology

A

Degeneration of the dopaminergic neurons in the substantia nigra (area of brain that regulates movement)

Causes dopamine deficiency leaving patients less able to direct or control their movement

Accumulation of abnormal proteins (Lewy bodies) within neurons

56
Q

Parkinson’s Disease: aetiology

A

Mitochondrial dysfunction (oxidative stress)

Constipation and diet low in polyunsaturated fats

Genetics

Toxic environmental factors - carbon monoxide, manganese poisoning, exposure to pesticides and herbicides

57
Q

Parkinson’s Disease: signs and symptoms

A

Bradykinesia - short shuffling steps, difficulty stopping/starting

Resting tremor (pill rolling)

Stopped/flexed posture

Lack of normal subconscious movements - swinging arms

Muscle rigidity, mask like face, low voice

58
Q

Parkinson’s Disease: allopathic treatment

A

Dopamine replacement - levodopa/L-dopa

Deep brain stimulation - electrodes in brain

59
Q

Huntington’s Disease: definition

A

Inherited neurodegenerative disorder affecting the basal ganglia

60
Q

Huntington’s Disease: pathophysiology

A

A genetic (autosomal dominant) disease with a defect on chromosome 4

61
Q

Huntington’s Disease: signs and symptoms

A 
Loss of muscle co-ordination
Cognitive impairment
Loss of intellect
Depression
Aggression
62
Q

What are the involuntary jerky movements seen in Huntington’s disease called?

A

Chorea

Biomedicine (Semester II) (20 decks)

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