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Path midterm 2 > degenerative disorders 17 > Flashcards

degenerative disorders 17 Flashcards

1
Q

what are some examples of degenerative disorders?

A

Parkinson’s disease

  • Delirium / Dementia
  • Multiple sclerosis
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2
Q

what is Parkinson’s?

A

-severe degeneration of teh substantia nigra (part of the basal nuceli) resulting in decrease in neurotransmitter dopamine

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3
Q

what is secondary parkinsonism?

A

-similar to Parkinson’s disease but caused by trauma, infection, drugs (antipsychotics, antiemetics, etc). this is not “true Parkinson’s.

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4
Q

what is TRAP?

A
  • Tremor (at rest, unilateral bilateral)
  • Rigidity (stiffness)
  • Akinesia or bradykinesia
  • postural disturbances
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5
Q

what occurs with Parkinson Disease?

A
  • postural changes

- shuffling’s type of gait, usually have delay in beginning to walk and trouble starting to move

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6
Q

other symptoms of Parkinson’s

A
  • motor movement disorder
  • constipation, inappropriate sweating, and orthostatic hypotension (these ppl are at risk for fall because they have tremors that they cant control)
  • low levels of dopamine
  • low levels of sleep
  • depression
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7
Q

Onset of Parkinson’s disease?

A
  • onset after age 40
  • peak between 58-62
  • slightly more than women
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8
Q

Diagnosis of Parkinson’s disease?

A
  • history and physical examination
  • drug trial (if medication helps them, it confirms diagnosis)
  • rule out other causes
  • positron emission tomography (PET) in selected cases-not widely available
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9
Q

treatment of Parkinson’s?

A

Drug therapy to decrease symptoms

  • increased dopamine levels and or block ACH
  • newer strategic is to balance dopamine and ACH
  • deep brain stimulation
  • stem cell transplantation-helpful with some ppl
  • goal of these two is to re-stimulate cell in brain that stimulate dopamine
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10
Q

what is a delirium?

A
  • Acute confustional state
  • is reversible
  • functional in nature- due to drug and or alcohol withdrawl, medication adverse effects, sepsis, fever, pain
  • develops in 2-3 days-can be treated and is reversed
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11
Q

what is dementia?

A
  • progressive and irreversible (medication to only slow process)
  • impaired memory, reasoning, judgement, language
  • behavioural changes
  • supportive tx only
  • associated with parkinsons disease, CNS infection, atherosclerosis
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12
Q

what are the types of dementia?

A
  • Alzheimer’s disease
  • fronto-temporal dementia
  • dementia with lewy bodies
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13
Q

what is the most common type of dementia?

A
  • Alzheimer’s disease
  • 4th leading cause of death in Canada
  • affects 15% of general pop over age 65
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14
Q

pathophysiology of alzheimers?

A
  • degeneration of cholinergic neurons
  • these neurons release ACH-linked to memory
  • atrophy
  • loss of ACH
  • cerebral atrophy
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15
Q

early manifestations of AD?

A 
forgetfulness
memory loss 
missing appointments 
getting lost 
personality changes
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16
Q

later manifestations of AD?

A 
language 
disorientation 
confusion
lack of concentration 
decline in abstraction, problem solving 
lack of judgement
- neglects hygiene
wandering
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17
Q

what is sundown syndrome?

A

manifestations that get worse in the evening

18
Q

what is end stage AD?

A

-incontinence
apathy
loss of interest in food
cant recognize family and friends

19
Q

diagnosis of AD?

A
  • made by ruling out other causes of dementia
  • ppl with AD cant “track back” to figure out where they left something, they dont know where they have been
  • inability to form short term memory, and wont remember if they forgot something
20
Q

what Is delirium often a sign of in the older generation?

A

infection

21
Q

what is the pathophysiology of Multiple sclerosis?

A
  • is an autoimmune disorder
  • T cells and B cells cross the BB and start to attack myelin
  • causes problems with transmission of impulses and eventually cerebral atrophy
  • inflammation induced loss of oligodendrocytes
  • disrupted nerve conduction with death of neurons and brain atrophy
22
Q

manifestations of MS?

A
  • multiple and vary
  • depends on where in the brain this process is happening
  • common to have vision changes in clarity, depth and perception
  • relapse episodes (caused by stress and fatigue)
  • sometimes are misdiagnosed with MS but actually have lyme disease
23
Q

diagnosis of MS?

A
  • history and physical exam
  • MRI
  • Evoked response studies
24
Q

Tx of MS?

A
  • medications to reduce relapse
  • symptom managment therapies (bladder, bowel, fatigue, pain)
  • txs in development:
  • repair tc such as stem cells
25
Q

difference between women and men in MS?

A
  • men: more quicker and aggressive, steady decline

- women: more relapses

26
Q

what are the top 3 causes of blindness in Canada in order?

A

1) diabetic retinopathy
2) glaucoma
3) cataracts

27
Q

hearing loss is either.,

A

conductive or sensory

28
Q

what is glaucoma?

A
  • pressure build-up that compresses optic nerve and its blood suppy
  • peripheral vision is lost first, then moves in
  • nerve is deprived of O2
29
Q

risk factors for glaucoma?

A
  • age
  • ethnicity
  • diabetes
  • previous eye injury
  • far sightedness
30
Q

what are the two types of glaucoma?

A

open angle and closed angle

-both are failure of the aqueous humor to drain properly

31
Q

what is open angle glaucoma?

A
  • onset is slow, chronic
  • slow because the drain is partially blocked with “sludge”
  • slows down drainage of fluid, due to eye infection
32
Q

what is closed angle glaucoma?

A

short, acute onset

  • angle by canal of schemm is not closed off
  • blocks off drainage port, hence by onset is fast
33
Q

with both types of glaucoma, what vision is lost first?

A

peripheral

34
Q

managment of glaucoma?

A
  • regular screening (tests pressure, puff of air test)
  • medications to decrease fluid
  • surgery
35
Q

what are cataracts?

A

-cloudy from protein build up

36
Q

causes of cataracts?

A
  • age
  • diabeties
  • genetics
  • glaucoma
  • sun exposure- sun can cause damage to lens of eye over time
37
Q

what is conductive hearing loss?

A

-changes in outer and middle ear affects ability of sound to travel to inner ear

38
Q

causes of conductive hearing loss?

A
  • ear infection
  • foreign bodies
  • tumors
39
Q

manifestations of conductive hearing loss?

A

decreased hearing

soft voice- they speak louder because they can hear themselves more

40
Q

what is sensorineural hearing loss?

A

impairment of part of the inner ear, or auditory nerve (cranial nerve 8)

41
Q

causes of sensorineural hearing loss?

A

age
loud noises
drugs - some antibiotics can cause hearing loss
congential

42
Q

manifestations of sensorineural hearing loss?

A

high-tone hearing loss- loose this first

tinnitus

Path midterm 2 (13 decks)

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