NEURO 3: CNS DISORDERS Flashcards

(52 cards)

1
Q

Explain the development of a seizure disorder

A

Alteration in membrane potential in a small area (epileptogenic focus)

Neurons become hyperactive & hypersensitive

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2
Q

What are 2 classifications of seizure disorders based on brain involvement?

A
  1. Generalized onset: both hemispheres affected
  2. Focal onset: only one hemisphere affected
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3
Q

What are 2 kinds of generalized onset seizures?

A
  1. Motor seizures
  2. Nonmotor (absence) seizures
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4
Q

What are 4 types of motor seizures based on symptoms?

A
  1. Tonic: Loss of consciousness, muscle rigidity (stop breathing)
  2. Clonic: Involuntary rhythmic muscle contractions
  3. Myoclonic: Muscle twitching
  4. Atonic: Loss of muscle tone
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5
Q

What are 2 kinds of nonmotor absence seizures based on symptoms?

A
  1. Typical: staring spells in children
  2. Atypical: similar to typical but with some muscle involvement
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6
Q

What are 2 kinds of focal onset seizures based on LOC?

A
  1. Aware: no change in LOC (just a funny feeling)
  2. Unaware: altered LOC, automatisms
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7
Q

What is the term for the 5-30 minutes period after a seizure where the person may feel drowsy, confused, or weak?

A

Postictal state

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8
Q

What is the term for a prolonged seizure episode or continuing series of seizures without a period of recovery between episodes?

A

Status epilepticus

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9
Q

What are 3 priorities during a seizure episode?

A
  1. Maintain airway
  2. Protect from injury
  3. Document
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10
Q

What are 3 types of medications that can help control epilepsy?

A
  1. Sodium channel blockers
  2. GABA stimulation
  3. Glutamate receptor antagonists
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11
Q

What is the purpose of GABA?

A

Opens chloride channels, making cell membrane more negative and less likely to depolarize

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12
Q

What is the pathogenesis of cerebral palsy?

A

Damage in upper motor neurons that control voluntary and involuntary muscle movement

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13
Q

What is the term for brain damage due to accumulation of bilirubin in a baby’s blood?

A

Kernicterus

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14
Q

What determines the types of symptoms a person with cerebral palsy will experience?

A

Symptoms depend on function of damaged upper motor neuron

If neuron had inhibitory function, muscle relaxation becomes more difficult > rigidity

If neuron had excitatory function, muscle contraction becomes more difficult > ataxia

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15
Q

What is the term for rigidity due to continuous muscle contractions?

A

Spasticity

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16
Q

What is the term for uncoordinated movements and instability associated with cerebral palsy?

A

Ataxia

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17
Q

What is the term for abnormal involuntary movements associated with cerebral palsy?

A

Dyskinesia

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18
Q
A
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19
Q

What are 3 steps in the pathogenesis of multiple sclerosis?

A
  1. T and B cells damage myelin and oligodendrocytes (the cells that make myelin)
  2. Slowing or halting of nerve conduction
  3. Damage to underlying axons
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20
Q

What does it mean when they say that diagnosis of MS requires the disease to be “disseminated in space and time?”

A

Lesions must be present in at least 2 separate regions of the brain

Patient must experience at least 2 separate episodes of clinical symptoms

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21
Q

Around what age does the onset of MS occur, and how long do patients survive after diagnosis?

A

Onset: 30 yrs

Survival: 20-30 years

22
Q

What happens in amyotrophic lateral sclerosis?

A

Diffusely affects upper and lower motor neurons of cerebral cortex, brainstem, spinal cord

23
Q

In patients with ALS, what are 3 potential causes of death?

A
  1. Aspiration pneumonia
  2. Malnutrition
  3. Respiratory failure
24
Q

Which 2 medications are used in patients with ALS, and what are their functions?

A
  1. Riluzole: inhibits glutamate release
  2. Edaravone: free-radical scavenger
25
Around what age does the onset of ALS occur, and how long do patients survive after diagnosis?
Onset: 60-75 yrs Survival: 3-5 yrs
26
What causes Huntington's disease?
Autosomal dominant mutation in gene for huntingtin protein
27
Name 4 steps in the pathogenesis of Huntington's disease
1. Accumulation of mutant huntingtin protein in neurons 2. Damage to GABA inhibitory causes decreased ACH activity in corpus striatum 3. Striatal atrophy 4. Excessive dopamine activity in corpus striatum
28
What are 2 types of motor hyperkinesis seen in Huntington's disease?
1. Chorea: jerky involuntary movements 2. Athetosis: slow writhing movements of hands and feet
29
What is the term for impairment of willpower seen in Huntington's disease?
Abulia
30
What type of medication inhibits dopamine release to treat Huntington's disease?
VMAT2 inhibitors
31
Around what age does the onset of Huntington's occur, and how long do patients survive after diagnosis?
Onset: 40-50 years Survival: About 15 years
32
What happens in Parkinson's disease?
Loss of dopamine-releasing neurons in the substantia nigra (area of midbrain that modulates motor movement)
33
What is the result of dopamine depletion in Parkinson's disease?
Causes imbalance between direct & indirect motor pathways, which results in difficulty initiating/controlling movements
34
What is the surgical treatment used to treat Parkinson's?
Deep brain stimulation
35
What is the purpose of levodopa in treating Parkinson's?
Penetrates blood-brain barrier and then converted into dopamine
36
Why is carbidopa combined with levodopa in treating Parkinson's?
Prevents conversion of levodopa until after it crosses the BBB
37
Other than levodopa-carbidopa, what are 2 other types of medications used in treating Parkinson's?
1. Dopamine receptor agonists 2. MAO inhibitors
38
What forms the intracellular neurofibrillary tangles in Alzheimer's disease?
Hyperphosphorylated tau protein
39
What forms the plaques in Alzheimer's disease?
Amyloid beta protein
40
What are 3 kinds of medications used to treat Alzheimer's disease?
1. Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) 2. NMDA receptor antagonists (memantine) 3. Monoclonal antibody against amyloid beta protein (aducanumab)
41
What do MAO inhibitors do?
Inhibit breakdown of serotonin, norepinephrine, dopamine
42
What do tricyclic antidepressants do?
Inhibit reuptake of serotonin, norepinephrine, dopamine
43
What is the term for the theory that neurotransmitter imbalance is the cause of depression?
Monoamine hypothesis
44
Which hormone imbalance may lead to depression?
Increased cortisol causing neuronal atrophy
45
What is the difference between mania and hypomania?
Mania lasts at least one week Hypomania lasts at least 4 days
46
What does lithium do in treating bipolar disorder?
Increases serotonin activity Decreases norepinephrine and dopamine activity Inhibits adrenergic and cholinergic receptor signaling
47
What does valproic acid do in treating bipolar disorder?
Increases activity of GABA
48
What is the term for rigidity due to continuous muscle contractions associated with cerebral palsy?
Spasticity
48
What is the term for abnormal involuntary movements associated with cerebral palsy?
Dyskinesia
48
Which 2 medications are used in patients with ALS, and what are their functions?
1. Riluzole: inhibits glutamate release 2. Edaravone: free-radical scavenger
48
What is the action of carbamazepine?
Sodium channel blocker
48
What is the term for uncoordinated movements and instability associated with cerebral palsy?
Ataxia