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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
Who is more likely to be affected by multiple sclerosis?
Women (2:1 to men)
26
What pattern does MS follow?
Relapsing-remitting pattern (85%) | Other patterns are progressive
27
What is the prognosis for MS?
Depends on disease pattern - 15% only suffer one episode | Progressive types have a poor prognosis
28
Motor Neuron Disease (MND): definition
Progressive degeneration of motor neurons in the spinal cord, motor cortex and brain stem
29
At what age does MND usually occur?
>40 yrs (50-70 yrs)
30
Who does MND usually affect?
More commonly affects men
31
Motor Neuron Disease (MND): pathophysiology
Abnormal mitochondrial function causing oxidative stress in motor neurons
32
Motor Neuron Disease (MND): aetiology
Unknown - suspected link with genetics, environmental toxins, oxidative stress
33
Motor Neuron Disease (MND): signs and symptoms
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
Motor Neuron Disease (MND): complications
Death by respiratory failure - typically 3-5 yrs | Stephen Hawking exception
35
Motor Neuron Disease (MND): allopathic treatment
No cure | Specialist care
36
Dementia: definition
Syndrome caused by a number of brain disorders which cause memory loss, decline in other aspects of cognition, difficulty performing daily activities
37
What is the prevalence of dementia?
Prevalence of dementia rises with age
38
What are the two main categories of dementia?
``` Alzheimer's disease (50%) Vascular dementia (25%) ```
39
What is vascular dementia?
Due to cerebrovascular disease e.g. stroke/strokes and poor oxygen delivery
40
Alzheimer's Disease: definition
Neurodegenerative disease of the cerebral cortex
41
Alzheimer's Disease: pathophysiology
Abnormal protein deposition (beta amyloid) Atrophy of neurons Less acetylcholine
42
Which area of the brain is usually first affected by Alzheimer's?
Hippocampus
43
What is the hippocampus important for developing?
Memories
44
Which area of the brain is usually affected later by Alzheimer's?
Amygdala
45
What is the amygdala important for?
Emotions | Memories
46
Alzheimer's Disease: aetiology
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
Alzheimer's Disease: signs and symptoms - early stages
Slight memory loss (especially short term - forgetting recent conversations) Repeated questions and confusion Decreased initiative - reduction in hobbies/hygiene
48
Alzheimer's Disease: signs and symptoms - later stages
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
Alzheimer's Disease: diagnostics
Mini mental stage exam | MRI/CT scans
50
Alzheimer's Disease: allopathic treatment
Drugs - acetylcholinesterase inhibitors (to encourage Ach to increase) - ineffective Psychological treatments - cognitive behavioural therapy
51
What is the prognosis for Alzheimer's?
People typically live for anywhere between 5 and 20 yrs after the onset of symptoms
52
What is the most common cause of death in people with Alzheimer's?
Infection
53
Parkinson's Disease: definition
Progressive neurological disorder affecting movement
54
What is the prevalence of Parkinson's
Affects 1% of individuals over 60
55
Parkinson's Disease: pathophysiology
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
Parkinson's Disease: aetiology
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
Parkinson's Disease: signs and symptoms
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
Parkinson's Disease: allopathic treatment
Dopamine replacement - levodopa/L-dopa | Deep brain stimulation - electrodes in brain
59
Huntington's Disease: definition
Inherited neurodegenerative disorder affecting the basal ganglia
60
Huntington's Disease: pathophysiology
A genetic (autosomal dominant) disease with a defect on chromosome 4
61
Huntington's Disease: signs and symptoms
``` Loss of muscle co-ordination Cognitive impairment Loss of intellect Depression Aggression ```
62
What are the involuntary jerky movements seen in Huntington's disease called?
Chorea

Biomedicine (Semester II) (20 decks)

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