Exam 2 CH. 22 KIdney Flashcards
What is Polycystic Kidney Disease
Enlarges kidneys, palpable mass, asymptomatic until 30s
Flank pain, headaches
75% develop HTN possible upper UTI
Polycystic kidney disease is autosomal ___________. And is caused by what gene
Dominant, PKD1 or 2 gene
Eventual renal failure
Saccular aneurysm mc occurs where
In anterior circulation, Anterior communicating artery is MC.
What results in worm like arteries and veins?
Ateriovenous Malformation
Is MC cerebrovascular malformation
Who’s most at risk for ateriovenous Malformation (AVM)
Males 2x, MC age 10-30 years old
Headaches in 50% of all cases
What is an occlusion of single artery
Lacunar infarct
It is silent and devastating
When a small cerebral vessel is ruptured and resorbed
Slit Hemorrhage
A “slit like cavity” remains
What occurs when diastolic BP>130 and sever ICP and global cerebral dysfunction
Hypertensive Encephalopathy
This is systemic autoimmune vasculitis, fibrinoid necrosis, small heart and arteries
Polyarteritis Nodosa
What is primary Angiitis of the CNS
chronic inflammation in the multiple parenchyma and subarachnoid vessels
Involves the brain and spinal cord
Who is most at risk for Primary Angiitis of the CNS
Males age 30-60
Injury from aneurysm, hemorrhage, ischemia
Treatment is Immunosuppression
Who is more at risk for CNS trauma
Males 2x more likely
The Assessment is ABCD
What is punch drunk?
Chronic Traumatic Encephalopathy CTE
What is most susceptible during a contusion
Gyri!!!!!!!!!
Coup injury- at impact site
Contrecoup injury- Opposite site of impact
What is it called when movement of one brain region relative to another
Diffuse Axonal Injury (DAI)
Severe dysfunction 50% of causes post traumatic comas
Disrupts white matter, shaking
How long does it take to recover from a Concussion
80% in 10 days without treatment
What is post concussive syndrome
When symptoms last for weeks to months
15-20% of all concussions
Fatigue/low energy= 37% MC
Whats so bad about second impact syndrome
Second concussion can occur and is LETHAL
This is dural ARTERY damage, compresses brain tissue, my be lucid during bleed
Epidural Hematoma
Rapid tear movements of VEIN, subdural bleed, compresses brain
Subdural Hematoma
WHich one has the dura still attached to the skull epidural or subdural
Subdural
What is the most common artery effected by an epidural hematoma
Middle meningeal artery
Very aggressive lethal within hours
What is more common subdural or epidural hematoma
Subdural
MC self limited but still an emergency
Clot lysis 1 week, Fibrosis 1-3 months
What is the MC CNS malformation
Neural tube defects 1/1000
Risks= decreased folate, previous child
Spina Bifida Occulta is
Bony defect, asymptomatic
Myelomeningocele is
Extension of CNS through vertebral defect (lumbosacral)
Anencephaly is
Absence of brain, roster all apsect
Encephalocele is
CNS diverticulum through cranium
Look at slide
80
What is Hydromyelia
Cavity, connected to 4th ventricle
Syringomyelia is
Aka (syrinx)
Is a cyst within cord in adults
Developmental or traumatic, Arnold Chiari Malf
What causes a “Shaw-like” distribution in the upper trunk/arms
Syringomyelia
Loss of pain/temp sensation
Possible tissue atrophy or areflexia
What is intraparenchymal hemorrhage
Prematurity, near ventricles, possible hydrocephalus
Infarct is
Prematurity, Supratentorial white matter, chalky plaques/necrosis, possible cysts
Whats cerebral Palsy
Non progressive motor neuron defects
Prematurity, hypoxia, infection damage during development
What are symptoms of cerebral palsy
Spasticity, dystonia, ataxia, tremors
1/3 have decreased cognition or seizures
What is the MC CNS infection
Hematogenous, direct implant or local infection
Retrograde from PNS
What is a Epidural Abscess
Infection in the epidural space
Occurs from adjacent infection aka osteomyelitis
Cord compression results is a Neurosurgical emergency
Whats a subdural Empyema
Infection in the subdural space
Pyrexia, HA, cervicalgia
Neurologic dysfunction, lethargy, coma
Whats meningitis
Subarachnoid inflammation of leptomeninges
CSF examination helps to distinguish the type
what is Acute pyogenic meningitis
Rapid onset, HA, NUCHAL RIGIDITY, PHOTOPHOBIA
CSF=bacteria, increased pressure, neutrophils, proteins (exudate)
Fatal if untreated
Whats Kernig sign
Pain when moving the legs due from Meningitis
Whats the Brudzinski sign
When patient lays down and knees are bent they have pain when the head is lifted
What causes meningitis is neonates
E. Coli
Group B Strep.
What causes meningitis in young children
Haemophilus INfluenzae
What causes meningitis in young adult
Neisseria meningitidis
What causes meningitis in older adult
Strep. Pneumoniae
Listeria monocytogenes
What is aseptic meningitis
Viral, relatively acute onset, pyrexia, decreased consciousness, unchallenged rigidity, edema
CSF= Increased Lymphocytes
Tuberculous meningitis is
“Tuberculoma”, HA, malaise, confusion, vomiting
CSF= Moderate increase in WBC’s and proteins
Whats spirochetal meningitis
3 degree of syphilis or Lyme disease
Neuronal loss, progressive loss of neuro function.
Ataxia, anesthesia, Encephalopathy
