CNS DIS Flashcards

1
Q

Progressive failure of cerebral functions that is not caused by an impaired level of consciousness is:

A

Dementia

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2
Q

T or F: Dementia frequently has an abrupt onset.

A

FALSE. Dementia never has an abrupt onset. If there is abrupt onset it is not dementia but another disease

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3
Q

What causes Alzheimer’s disease?

A

An abruption in the cholenergic system, decrease in ACE, decrease in number of cells in the brain

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4
Q

Alzheimer’s can cause an disturbances in:

A

Nerve cell communication, Decreased Metabolism, decreased Cell repair

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5
Q

What is the most common clinical manifestation of Alzheimer’s disease?

A

Gradual onset with a chronic progressive decline in cognitive functioning

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6
Q

Other cognitive manifestations of Alzheimer’s include:

A

Short term memory loss, Anxiety and agitation, Judgment, problem-solving and communication problems

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7
Q

On a day to day care basis, Alzheimer’s can cause

A

Loss of ability to complete ADLs

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8
Q

An end stage clinical manifestation of Alzheimer’s is:

A

Loss of bowel and bladder incontinence

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9
Q

The MMSE test is used to assess:

A

The stages of Alzheimer’s

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10
Q

A high MMSE score correlates with (beginning or end) stage of the disease, a low MMSE score correlates with (beginning or end) stage of the disease

A

Beginning; end

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11
Q

Compared to a healthy brain, a brain of a person with Alzheimer’s disease will have these key differences:

A

Cortical shrinkage, enlarged ventricles, shrinking of the hippocampus- the more severe the disease, the more shrinkage will occur

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12
Q

How is the decrease in ACE (associated with Alzheimer’s disease) managed?

A

*Increase ACETYLCHOLINE level by decrease its reuptake
*Pharmacologic agents that prevent Acetylcholine from breaking down.
[Acetylcholinesterase Inhibitors (AChEls)]

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13
Q

T or F: The purpose of Alzheimer’s treatments is to slow the progression of the disease.

A

FALSE. The progression cannot be stopped

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14
Q

What are the two main goals of Alzheimer’s drug treatments?

A

Improve cognitive function: memory, and Symptom control

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15
Q

T or F: Alzheimer’s drugs should be given in very small doses.

A

TRUE.

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16
Q

Seizures are:

A

Abnormal electrical activities within the NERVE CELLS in the brain

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17
Q

Seizures occur when:

A

A Synchronous, high frequency depolarization of a focus spreads to other parts of the brain

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18
Q

T or F: All seizures will manifest in generally the same way.

A

FALSE. Manifestations depend on location of focus and recruitment of other parts of the brain.

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19
Q

Congenital defects, Hypoxia at birth, Head Trauma, and cancer are all causes of:

A

Seizures

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20
Q

Hypokinesia causes:

A

paresis, paralysis

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21
Q

Define paresis:

A

Muscular weakness due to nerve damage

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22
Q

Hyperkinesia causes:

A

Chorea, tremors

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23
Q

Define chorea:

A

A neurological disorder characterized by jerky involuntary movements

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24
Q

flaccidity and floppiness is a result of:

A

Hypotonia

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25
Dysphagia, speech impairment, excitability, spasticity, and posturing are results of:
Hypertonia
26
Define dysphasia:
Difficulty swallowing as a symptom of disease
27
What are two types of posturing?
decerebrate, decorticate
28
A position in which the patient holds their upper arms at their sides with elbows, wrists, and fingers flexed while legs are extended and internally rotated, and feet are plantar flexed is _______________ posture.
Decorticate
29
A position in which jaws are clenched, neck is extended, arms are addicted and stiffly extended at the elbows with forearms probated, wrists and fingers flexed is____________posturing
Decerebrate
30
What are the two types of seizures?
Partial and generalized
31
What is the major difference between simple and complex partial seizures?
Level of consciousness: in complex you will see loss of consciousness
32
A seizure that only involves part of the brain is considered:
A partial seizure
33
A seizure that involves the whole brain in addition with loss of consciousness is:
A generalized seizure
34
A tonic seizure involves:
Contraction of the muscles
35
A clonic seizure involves
Relaxation of muscles
36
T or F: febrilE seizures are associated with epilepsy.
FALSE. They are a result of a fever.
37
What are the three seizure stages?
Aura, seizure, post-ictal
38
Visual or audio warning signs happen during the ____________ stage
Aura
39
T or F: The time block between the aura and seizure stage varies between person to person.
TRUE
40
Confusion, Disorientation, Weakness, and Hypoglycemia are common during the _____________seizure stage.
Post-ictal
41
What is a Status Epilepticus seizure?
A seizure that lasts >30 minutes
42
CNS depression during the post-ictal stage could lead to a patient:
Forgetting to breathe
43
A sign that a patient is hypoglycemic in the post-ictal stage is:
Tremors
44
What is the goal of anticonvulsant drugs?
To control or prevent recurrence of seizures
45
What is the action of anticonvulsant drugs?
stabilize cell membrane by affecting cation transport
46
Can a child with epilepsy ever be off of medication?
Possibly, but must be weaned off slowly
47
Cerebrospinal fluid (CSF) leakage from nose or ear may indicate:
A skull fracture
48
Increased ICP, amnesia, hypotension are common signs of
Concussion
49
A contusion will present as
Increased ICP
50
Increased ICP; nuchal rigidity; fixed dilated pupil on the affected side; papilledema; hemiparesis; hemiplegia; and leakage of CSF from ears or nose are all s/s of:
Hematoma
51
A patient presenting with no loss of consciousness, confused would be described as a Grade ______ concussion.
I
52
A patient presenting with No loss of consciousness, brief retrograde amnesia would be described as a Grade ______ concussion.
II
53
A patient presenting with confusion & amnesia @ impact would be described as a Grade ______ concussion.
III
54
A patient presenting with immediate loss of consciousness would be described as a Grade ______ concussion.
IV
55
What is Second Impact Syndrome?
After one concussion, 2nd blow causes catastrophic IICP, herniation, ischemia, and cell death
56
What is the difference between concussion and contusion?
Concussion is a bruised brain, contusion refers to a lesion in the brain
57
Epidural:
head strikes a surface
58
Epidural hematoma:
tearing of an artery & blood accumulates between inner skull & dura
59
Coup:
impact of head against something
60
Contrecoup:
impact within the skull (rebound effect)
61
What is an example of an epidural?
unrestrained MVA (head hits windshield)
62
Subdural:
violent motion of brain tissue in the skull
63
What is an example of a subdural injury?
Shaken baby syndrome
64
What are the most common s/s of acute brain injury?
acute alteration in LOC, change in respiratory patterns
65
Abrupt onset of persistent neurological signs and symptoms because of a decreased blood supply to the brain is defined as:
A stroke
66
Which neurological condition is the #3 cause of death in US, Hypertension is the major risk factor, responsible for 500,000/yr., 1/3 with neuro deficit
Stroke
67
T or F: Age, race, gender, predisposing conditions, and substance abuse are all risk factors for stroke.
TRUE
68
What are the two classifications for CVA?
Ischemic and Hemorrhagic
69
An ischemic CVA is due to
An interruption of blood flow
70
atherosclerosis, idiopathic are examples of:
thrombotic ischemic CVA
71
heart disease, carotid athero/art.pressure, and edema are examples of:
embolic ischemic CVA
72
Tissue damage as a result of IICP would be classified as:
An ischemic CVA
73
A Hemorrhagic stroke results in:
A hemorrhage in the brain
74
List 6 serious effects of a Hemorrhagic stroke
edema, hydrocephalus, re-bleeding, infarction, coma, death
75
Clinical manifestations of stroke are dependent on:
area affected and adequacy of collateral circulation
76
List 5 clinical manifestations of a hemorrhagic stroke:
1. LOC 2. aphasia: receptive, expressive, mixed 3. hemineglect syndrome 4. Cognitive and motor disorders 5. Long term; motor defects, language, speech, aphasia, Dysphagia
77
paralysis, gait, paresis, decision making, voluntary activity, thought process, affective responses, incontinence indicates a stroke in which region?
ant. cerebral
78
hemiplegia, sensory, aphasia, confusion/coma, neglect indicates a stroke in which region?
middle cerebral
79
visual defects, hallucinations, memory loss, and repetitive activity are clinical manifestations of a stroke in which region?
post cerebral
80
An injury in the thalamus manifests with:
sensory, pain, tremors, aphasia
81
A celebellar injury may be observed by:
brain stem; visual deficits
82
What is the most important factor in treatment of a CVA?
Salvage brain tissue within 3 hrs!
83
An acute or chronic inflammation of the pia mater & arachnoid membranes is:
Meningitis
84
headache, nuchal rigidity, low grade fever are s/s of:
Meningitis
85
leukocytosis in CSF via spinal tap confirms which type of meningitis?
Bacterial