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Pathopharm Exam 3 > Module 6: Part 3 (53-78) > Flashcards

Module 6: Part 3 (53-78) Flashcards

1
Q

what kind of IgG antibodies are produced against Myasthenia Gravis

A

acetylcholine receptors (antiacetylcholine receptor antibodies)

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2
Q

T/F
Myasthenia Gravis causes contractions of the eye muscles

A

False
It causes weakness and fatigue of eye muscles

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3
Q

what visual changes happen with MG?

A

diplopia

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4
Q

MG causes weakness and fatigue of: (SATA)
A. eye muscles
B. throat
C. Respiratory paralysis

A

✅A. eye muscles
✅B. throat

❌C. Respiratory paralysis- Occurs only in Myasthenia crisis!

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5
Q

T/F
MG signs in neonates, can be seen 4-6 days after birth

A

False
Can be seen 1-3 days after birth

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6
Q

Classification’s of MG (5)

A

Neonatal myasthenia
Congenital myasthenia
Juvenile myasthenia
Ocular myasthenia
Generalized autoimmune myasthenia

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7
Q

Myasthenia crisis major symptoms (2)

A

Severe weakness
respiratory paralysis

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8
Q

Cholinergic crisis can be d/t

A

Acetylcholinesterase drug toxicity (OD)

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9
Q

T/F
MG pt’s can experience cholinergic crisis

A

True

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10
Q

Arousal vs. awareness

A

Arousal mediated by the reticular activating system
awareness is a state of wakefulness

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11
Q

T/F
Awareness is mediated by the reticular activating system

A

False

Arousal mediated by the reticular activating system
awareness is a state of wakefulness

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12
Q

Is content of thought arousal or awareness?

A

awareness

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13
Q

How are coma’s produced? (2)

A

Bilateral hemisphere damage or suppression
Brainstem lesions or metabolic derangement that damages or suppresses the reticular activating system

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14
Q

Structural alterations in arousal:
above the tentorium cerebelli-membrane

A

supratentorial

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15
Q

Structural alterations in arousal:
subtentorial, below the tentorium cerebelli-membrane

A

infratentorial

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16
Q

Structural alterations in arousal:
outside the brain tissue

A

extracerebral

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17
Q

Disorders within brain substance (intracerebral) can cause
(4)

A

bleeding, infarcts, emboli and tumors

fxn primarily as masses

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18
Q

Causes of structural alteration in arousal (9)

A

infection, vascular alterations, neoplasms, traumatic injury, congenital alterations, degenerative changes, polygenic traits, and metabolic disorders

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19
Q

metabolic alterations in arousal produce a decline in arousal by alterations in delivery of energy substrates as occurs with: (4)

A

hypoxia
electrolyte disturbances
hypoglycemia
or hyperglycemia

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20
Q

psychogenic alterations in arousal (unresponsiveness) may signal

A

general psych d/o’s
*uncommon occurrence

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21
Q

T/F
in metabolic alterations, despite apparent unconsciousness, pt is physiologically awake and neuro exam reflects normal responses

A

False

Psychogenic alterations causes this to occur

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22
Q

Patterns of neuro fxn are critical to evaluation process of alterations of arousal (5)

A

(1) level of consciousness
(2) pattern of breathing
(3) pupillary reaction
(4) oculomotor responses
(5) motor responses.

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23
Q

______ changes indicate the presence and level of brainstem dysfxn

A

Pupillary

24
Q

Why do pupillary changes indicate presence/level of dsyfxn

A

because brainstem areas that control arousal are adjacent to areas that control the pupils

25
Q

Severe ischemia and hypoxia usually produce ___, ____ pupils

A

dilated, fixed

26
Q

what does atropine do to pupils?

A

dilated and fixed pupils

27
Q

Test for Oculocephalic Reflex Response also called

A

Doll’s Eyes Phenomenon

28
Q

a normal oculocephalic reflex response

A

eyes turn together to side opposite from turn of head

29
Q

an abnormal oculocephalic reflex response

A

eyes do not turn in conjugate manner

30
Q

an absent response in oculocephalic reflex response

A

eyes do not turn as head position changes

31
Q

body can’t maintain internal homeostasis

A

brain death (brainstem death)

32
Q

brain death criteria (6)

A

Completion of all appropriate, therapeutic procedures
Unresponsive coma (absence of motor and reflex responses)
No spontaneous respirations (apnea)
No cephalic (ocular or caloric) reflexes
Isoelectric EEG
Persistence for 1 hour and 6 hours after onset

33
Q

death of the cerebral hemispheres exclusive of the brainstem and cerebellum is known as _____.

A

Cerebral death (irreversible coma)

34
Q

Patients with cerebral death, their brain can continue to maintain which normal fucntions?

A

brain can continue to maintain normal resp. and CV fxns, temp control, and GI fxn

35
Q

survivors of cerebral death (3)

A

Remain in coma
Emerge into a vegetative state (“wakeful unconscious state”)
Progress into a minimal conscious state

36
Q

T/F
survivors of cerebral death can return to pre-injury status with extensive physical therapy

A

False

37
Q

Eyes open spontaneously; normal sleep-wake cycle; arousal level is normal. little speech or movement.

A

Akinetic mutism

38
Q

Full arousal; sleep-wake cycle present; quadriplegic; Can’t speak or move muscles except vertical eye movement/blinking

A

Locked-in syndrome

39
Q

Sudden, transient alteration of brain fxn caused by abrupt explosive, disorderly discharge of cerebral neurons

A

seizures

40
Q

Disruption in balance of excitation and inhibition

A

seizures

41
Q

Tonic-clonic (jerky, contract-relax) movements a/w some seizures is known as ____.

A

convulsion

42
Q

Seizures originating in both sides of the brain simultaneously w/LOC

A

Generalized seizures

43
Q

Secondary generalization (progression of partial to generalized seizure)

A

Partial (focal) seizures

44
Q

Experience of a 2nd seizure before pt has fully regained consciousness from the preceding seizure/single seizure lasting more than 30 min

A

Status epilepticus

45
Q

follows an epileptic seizure

A

Postictal state

46
Q

A state of alternating contraction and relaxation of muscles

A

Clonic phase

47
Q

A state of muscle contraction in which there is excessive muscle tone

A

Tonic phase

48
Q

Bursts of action potentials

A

hypersynchronization

49
Q

Group of neurons that appear to be hypersensitive to paroxysmal depolarization

A

Epileptogenic focus

50
Q

seizure consequences (4)

A

250% increase in adenosine triphosphate (ATP)
Cerebral oxygen consumption increased by 60%
Cerebral blood flow also increases approximately 250%
Available glucose and oxygen are depleted

51
Q

With severe seizures the brain tissue may require more ___ than can be produced

A

ATP

52
Q

with seizures _____ accumulates in the brain tissues

A

Lactate

53
Q

seizures may produce secondary ____, _____, and ____ accumulation

A

hypoxia
acidosis
lactate

54
Q

May result in progressive brain tissue injury and destruction

A

seizures

55
Q

Cellular exhaustion and destruction

A

consequences of seizures

Pathopharm Exam 3 (18 decks)

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