Module 2 - Chronic Neurological Conditions

Question 1

What are some modifiable risk factors for Alzheimers?

Answer 1

social isolation
low educational attainment
cognitive inactivity
mid-life depression.

Question 2

What is the pharmacological management of Alzheimers

Answer 2

• Cholinesterase inhibitors to treat the cognitive symptoms

- Medications may also be required if the patient is experiencing depression or behaviour/sleep changes, hallucinations

Question 3

What is delirium

Answer 3

Delirium (or acute confusion) is a serious acute medical
condition whereby a person’s mental ability is affected.
It develops over a short period of time (usually within
hours or days) and symptoms tend to fluctuate
throughout the day.

Question 4

What is the pathophysiology of Parkinson’s Disease

Answer 4

• Co-ordinated voluntary body movements are a result of the balance between excitatory and inhibitory neurotransmitters. In Parkinson’s disease there is a disturbance to this balance.
• Normally, dopamine inhibits the excitatory cholinergic neurons in the basal nuclei. Degeneration of dopaminergic neurons causes a depletion of dopamine. The resulting excess cholinergic activity produces the motor symptoms of Parkinson’s disease.
• The failure to inhibit acetylcholine is the underlying basis for the manifestations of the disorder.

Question 5

What is multiple Sclerosis (MS)

Answer 5

Chronic neurological disorder
Characterised by inflammatory, demyelination and gliosis (scarring) of CNS
- formation of sclerotic plaques in brain and spinal cord

Question 6

At what age is MS most prevalent

Answer 6

Disease of young adulthood

70% of cases arise between 20 and 40 years of age

Question 7

Describe the pathophysiology of MS

Answer 7

The pathophysiology of MS is due to autoimmune processes that follow a viral illness in genetically susceptible individuals. There is inflammation and destruction of the myelin-producing oligodendrocytes within the CNS. This produces demyelination, with areas of scarring causing conduction problems that produce the symptoms. Exacerbations and remissions occur, but eventually, usually after many years, there is permanent disability.

Question 8

Explain how the immune system affects MS

Answer 8

The underlying pathophysiology is due to autoimmune processes that follows a viral illness in genetically susceptible individuals. Therefore, the immune system involvement occurs as the inappropriate response by the immune system in these cases leads to impairment of neurons, particularly in relation to the myelin. There is inflammation and destruction of the oligodendrocytes that produce myelin within the CNS. This produces demyelination, with areas of scarring causing conduction problems that produce the symptoms.