Degenerative Diseases

Question 1

Multiple Sclerosis

Answer 1

Affects: lesions develop in CNS.
Cause: Unknown; viral and autoimmune possible
Factors: precipitated by stress/ infections/ trauma, worsened by heat, dehydration, fatigue

Question 2

Most common type of MS

Answer 2

Relapsing-remtting: 85%. Characterized by attacks then full or partial recovery for weeks or months.

Question 3

Difference between primary and secondary progressive MS?

Answer 3

Primary progressive is progressive from the start with no episode of remitting. Secondary progressive starts as relapse-remitting.

Question 4

Parkinson’s Disease

Answer 4

Affects: CNS, degeneration of dopaminergic neurons at substantial nivea basal ganglia. Loss of inhibitory dopamine leads to excessive excitatory output of acetylcholine
Cause: infection, atherosclerosis, idiopathic, toxic, drug-induced
Factors: rigidity, bradykinesia, resting tremor, impaired postural reflexes

Question 5

Parkinson’s Stages (Hoehn and Yahr)

Answer 5

I. Minimal or absent disability, unilateral symptoms
II. Minimal bilateral involvement.
III. Balance is involved, some activity restrictions.
IV. All symptoms present and severe, stands and walks with assistance.
V. Confined to bed or wheelchair.

Question 6

Sinemet

Answer 6

Levodopa/ carbidopa: provides dopamine

Lasts about 2-3 years until deterioration occurs and dyskinesias may develop.

Question 7

Anticholinergic drugs

Answer 7

Control tremor associated with PD

Question 8

What drug is used early to slow progressions of PD?

Answer 8

MOI, increase dopamine

Question 9

Myasthenia Gravis

Answer 9

Affects: PNS, acetylcholine receptors at NM junction
Causes: autoimmune antibody mediated
Factors: usually attacks bulbar (extra ocular, facial and mastication) and proximal limb-girdle muscles. worsens with continued mm contraction

Question 10

What is the myasthenia crisis?

Answer 10

MG with respiratory failure; medical emergency