Neuro 3 Clinical App Flashcards
hippocampal amnesia
bilateral lesions of hippocampi def in anterograde mem (can't learn new) def in spared procedural and working mem
korsakoff’s syndrome
thiamine def, alcoholism
degen of mammillary bodies, hippocampal complex and dorsomedial thalamic nuc
can’t retain new mem, no short to long mem
hard to understand written material and meaning convos
confabulate (frag mem into ones that didn’t occur)
anosmia
loss of smell
from viral infection of mucose, obstruction of nasal passages, congenital, chear of cn1 or tumors of floor ant cranial fossa
phantosmia
olf hallucination
smell when no odor present
lesion of ant/medial temporal lobe
hippocampus, amygdala, or medial dorsal thalamic nuc
kluver-bucy syndrome
bilat temporal lobe lesions in amygdala
visual agnosia, hyperorality, hypermetamorphosis(intensively explore enviro or overreact to visual stim), placidity (no showing of anger/fear), hyperphagia (eat lots), hypersexuality
uncal herniation
Uncus and parahippocampal gyrus over the tentorium cerebelli edge, through tentorial notch
compress: midbrain
dilated pupil, slowly (shows side 90%), abnormal eye movements (cniii)
weak m oppo of dilated pupil
respiration affected/abnormal reflexes
conduction deafness
def to obstruction/altered transformation of sound to tympanic mem or through ossicle chain (wax buildup, middle ear infection, stapes)
sensorineural deafness
dam to cochlea, cnviii, or cochlear nuc (ipsi deaf)
central deafness
dam to central pathways
bc of crossing - NOT DEAF
past the cochlear nucleus it is hard to follow conversions (can’t make out voices from background noise)
aica occlusion
monaural hearing loss (ipsi)
ispi facial paralysis and inability to look to the side of the lesion (pontine gaze center - horizontal)
auditory agnosia
perceive sound, but can’t identify it
unimodal sensory association cortex bilaterally (primary/secondary auditory cortex)
wernicke’s area lesion
w. aphasia, receptive or fluent aphasia
can’t understand/comprehend said or written
alexia, agraphia, can talk but has no meaning
in gen - can’t get/know whats going on, isn’t aware something is wrong
broca’s area lesion
b. aphasia, expressive or non-fluent aphasia
loss of ability to speak fluently, written grammer issues, can understand spoken and written lang, know whats going on = depressed
can have mutism (severe)
less severe - limited speech, slow, telegraphic speech (nonessential words omitted)
“no if ans or buts” can start to say but struggle to finish
global aphasia
non-fluent
lesion of lateral sulcus
brocas and wernickes (mixed transcortical aphasia)
receptive and expressive deficits, reading and writing impaired
transcortical lesion
sensory (sim to wern)- fluent, impaired comprehension and naming, mca-pca border zone
motor (sim to brocas)-nonfluent, aca-mca border zone
gigantism
excessive levels of GH before puberty
stim epiphyseal plates
acromegaly
gh-secreting pituitary adenoma
increased organ, hand, foot, tongue, coarsening facial feat, insulin resistance, glucose intolerance
graves disease
hyperthyroidism
increased levels of of Thyroid stim immunoglobulins stim t3/4 syn
TSH low, TH high
hyperthyroidism
hyperexcitiability, hyperreflexia, irritability
increased BMR and heat production, sweat- lose weight
increased HH, RR (SOB), tremor, m weak, goiter
EXOPHTHALMOS
graves/thyroid neoplasm - tsh low
secondary or third disorder - tsh high
treat w PTU, thyroidectomy
hypothyroidism
bone age is less that chronologic age
babies: mental retardation
adults: slow, impaired mem/decreased mental capacity, drowsiness, lack of effort
decreased bmr, heat production, hr, weight gain, cold, hypoventilation, growth and mental retardation
caused by thyroiditis - tsh high = thyroidectomy
secondary or third disorder - tsh low
cretinism
mental and growth retardation
hypothyroidism in perinatal period
goiter
high tsh or ts immunoglobulins
thyroidistis
hypothyroidism
high tsh, low th
autoimmune, antibodies to peroxidase, decrease t3 and t4
addisons disease
primary adrenocortical insufficiency
low bg, anorexia/weight loss. n/v, weak, low bp, high k, metabolic acidosis, decreased hair, HYPERPIGAMENTATION
INCREASED ACTH, decreased cortisol
cushing syndrome
primary adrenal hyperplasia
high bg, m wasting, obesity in trunk, round face, buffalo hump, osteoporosis, straie, virilization and menstral disorders, high bp
low ACTH, high cortisol
secondary adrenocortical insufficiency
acth low, cortisol low, aldosterone levels norm
cushing disease
secondary, high cortiosal and acth
excess, increased acth and cortisol (pituatary adenoma)
high bg, m wasting, obesity in trunk, round face, buffalo hump, osteoporosis, straie, virilization and menstral disorders, high bp
conn syndrome
aldosterone secreting tumor
primary hyperaldosteronism
na resorption, k and h secretion
high bp, low k, metabolic alkalosis, low renin
21b hydroxylase def
virilzation, early puberty, def of glucocorticoids and mineralcorticoids
increased acth
adrenogenital syndrome and hyperplagsia
17a hydroxylase def
lack of secondary hair
def in glucocorticoids and androgens, excess mineralcorticoids
high acth
secondary hyperparathyroidism
chronic hypocalcemia (renal fail or vit d def)
increase PTH and hyperplasia of PT glands
ca blood levels are low or normal
severe hypomagnesemia
sim to ca on pth except in severe cases
inhibits pth syn/storage/secretion
alcoholism
primary hyperparathyroidism
caused by PT adenomas
high pth, high ca, low p
stones, bones (resorption), and groans (constipation)
ca-phosphate or oxalate stones
hypoparathyroidism
from removal of PT or T or autoimmune/congential
low pth, low ca, high p
pseudohypoparathyroidism
high, pth, low ca, high p
Gs protein in kidney is defective
short stature, neck, obesity, subcutaneous calcification, short metatarsals/metacarpals
albright hereditary osteodystrophy
humoral hypercalcemia of malignancy
malignant tumors secrete PTH-rp
high ca, low p, PTH low
rickets
vit d def
not enough ca and p for new bone formation in kids
skeletal deformaties and fail to grow
osteomalacia
adults
vit d def where new bone fails to mineralize = bending and softening of weight bearing bones
can involve chronic renal failure
hashimoto thyroiditis
hypothyroidism, primary
high tsh, low th
autoimmune, antibodies to peroxidase, decrease t3 and t4
sheehan syndrom
necrosis of pituatary postpartum
low tsh, th, lh, fsh
no period or lactation
hypocalcemia
hyperreflexia, spontaneous m twitch, tingle/numb, (+) Trousseau and Chvostek (twitch of hand w bp cuff)
hypercalcemia
decrease QT interval, faster heart contraction
hyporeflexic, constipation, anorexic, lack of appetite, coma, lethargic
causes of hypopituitarism
brain damage, pituitary tumor
pheochromocytoma
adrenal gland tumor of chromaffin tissue increased catecholamines Hypertension Orthostatic hypotension Headaches Sweating Palpitations Chest pain Flushing Anxiety
Secondary Hyperaldosteronism
o A kidney problem
o Hypersecretion of renin
o Excess renin from juxtaglomerular cells of the kidney
pedrin deficiency
sensorineural hearing loss
SLC26A4 gene
hypothyroidism with goiter
