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KCSU17 Patho/Pharm Submodule 1 > Neuro Abnormal Physiology > Flashcards

Neuro Abnormal Physiology Flashcards

1
Q

types of primary headaches

A

tension

migrane

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2
Q

tension headache

A

mild-moderate

bilateral

band-like

associated with pericardial muscle tenderness (sore neck)

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3
Q

tension headache

pathophysiology

A

not well understoon

overstimulation of nociceptive (pain) receptors from sustained tension in scalp and neck muscles

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4
Q

tension headache

treatment

A

OTC meds (decrease sensitivity)

NSAIDS, acetaminophen PRN

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5
Q

Migrane

A

recurrent

unilateral

throbbing HA that occurs with associated SXS

may be preceded by aura (classic) or no (common)

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6
Q

migrane pathophysiology

A

cortical spreading depression

flow of neuronal activity spreading across cerebral cortex chasing the meninges (dura) to cause headache

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7
Q

migrane treatment

A

depends on acuity v. chronicity

abortive (stop the headache)

may try to go for symptoms

not much

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8
Q

most common reason for malignancy in brain

A

metastases from other cancer sites that travel to brain

mostly secondary metastases

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9
Q

primary brain tumors

A

benign or malignant (both have serious consequences bc major impact on basic fx)

grow and develop in the brain

seldom metastasize outside CNS

able to grow for a while unnoticed bc the brain is pain free so won’t give symptoms

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10
Q

types of primary brain tumors

A

neuroglial tumors

  1. astrocytomas as
  2. oligodendrogliomas
  3. ependyomas
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11
Q

astrocytomas

A

infiltrating or non infiltration

MC in 40s-60s

most agressive: Glioblastoma

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12
Q

oligodendrogliomas

A

MC 40s-50s

MC in white matter of cerebral hemisphere

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13
Q

ependyomas

A

MC in first two decades
pediatric/adolescent cancer

MC in 4th ventricle or spinal cord

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14
Q

Intracranial pressure

A

fixed amount of space in head due to skull

increase in cerebral volume (i.e. growth of abnormal cancer tumor) will increase the ICP

for a while the ventricles can compensate but after a while it is too much

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15
Q

s/s of intracranial pressure

A

HA
vision changes
N/v
papilledema (swelling of optic disk)

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16
Q

Headaches and brain tumors

A

caused by eventual compression of dura mater or vascular structures

diffuse by may be ipsilateral to tumor

early stages: only in morning, improves with head elevation

later: more constant, exacerbated by anything to increase cranial pressure

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17
Q

meningitis

pathophysiology

A

acquisition of a pathogen via ear infection or sore threat, etc. that then invades and survives in blood and cross BBB to get into CSF

eventually Cytokines are relied in CSF and inflammation results to cause damage to CSF (edema of brain, loss of cerebrovascular auto regulation and increase ICP

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18
Q

swelling in meningitis caused by

A

immune response to presence of pathogen in CSF

BBB is loosened so it is permeable to fluid without being able to relieve pressure

also lets in WBCs and medications to fight infection

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19
Q

how is meningitis diagnosed?

A

lumbar puncture

puncture occurs b/t L4 and L5

check for increased pressure and color

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20
Q

meningitis treatment

A

can use stereos (dexamethasone) where inflammation is more significant than worsening outcome

steroids decrease inflammation, so controversial bc inflammation is also what heals it but can be dangerous

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21
Q

normal lumbar puncture/csf analysis:

pressure

A

50-200 mmHg

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22
Q

normal lumbar puncture/csf analysis:

appearance

A

clear, colorless

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23
Q

normal lumbar puncture/csf analysis:

protein

A

10-50 mg/dL

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24
Q

normal lumbar puncture/csf analysis:

glucose

A

50-80

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25
normal lumbar puncture/csf analysis: gram stain
negative/normal
26
normal lumbar puncture/csf analysis: glucose csf:serum ratio
0.6
27
normal lumbar puncture/csf analysis: WBC
<5 - all mononuclear
28
normal lumbar puncture/csf analysis: other
no RBCs unless you have a traumatic tap usually appear in first vile but not 4th
29
infection and inflammation of the brain parenchyma
encephalitis can co-occur with meningitis
30
encephalitis is caused by
most often caused by virus ex. HSV, West Nile, HIV, Arbovirus, Polio, Rabies
31
encephalitis
local necrotizing hemorrhage and prominent cerebral edema caused by virus, treat with acyclovir (antiviral medications)
32
encephalitis treatment
antiviral medication like acyclovir sometimes also put in antibiotics, bc it can be meningitis too
33
epilepsy
disordered characterized by recurrent seizures that are not provoked by anything else display a known pattern
34
seizure
discharge of neurons in an abnormal way abrupt, excitatory, lasts about 1 minute not a disease itself but a symptom of some other complication could be motor, sensory, autonomic or psychic
35
types of seizures
partial/focal generalized
36
partial seizures
originate in small collection of neurons in one hemisphere and spread elsewhere either simple or complex
37
complex partial sezires
seizure beings in a localized area and then spreads to both hemispheres involves loss of conciousness
38
simple partial sizures
seizures that are confined to one hemisphere don't involve loss of consciousness
39
generalized sizures
abnormal discharge of widespread electrical activity across both hemispheres impaired consciousness (generally) may or may not b`e convulsive -- must be bilateral for motor
40
how are seizures diagnosed?
use of EEG evaluates electrical activity of the brain even if normal, doesn't rule out epilepsy
41
dementia
progressive deterioration of cognitive function interferes with social performance many forms
42
forms of dementia (6)
1. alzheimers disease 2. vascular (ischemic or hemorrhagic damage) 3. frontotemporal 4. CJD 5. Wernicke-korsakoff syndrome (liver toxicity) 6. huntington disease
43
alzheimer's disease
atrophy of cerebral cortex with subsequent enlargement of ventricles neurotic plaques and neurofibrillary tangles due to inability to synthesize acetylcholine follows predictable course
44
neurotic plaques
areas of degenerated nerve terminals around an amyloid core
45
neurofibrillary tangles
abnormally found in cytoplasm of neurons resist breakdown, even if neuron dies
46
how is Alzheimer's diagnosed?
very extensive process that is a diagnosis of exclusion can't diagnose directly, just make sure it isn't anything else
47
management/treatment of Alzheimer's
no cure, treat both patient and family with support groups and respite care prescribe medication that slows the progression of the disease (cholinesterase inhibitors and memantine)
48
medications prescribed for Alzheimer's and their function
cholinesterase inhibitors (good for mild, allows for more acetylcholine to be available) memantine :works with cholinesterase inhibitors to modify the glutamate receptor (NMDA)
49
common age of presentation of Huntington disease
typically appears in the 4th-5th decade (40s-50s) -- after people have had children, so it gets passed on (autosomal dominant)
50
pathophysiology of Huntington disease
causes neuronal death starts in Basal ganglia (coordinate motor output) no cure
51
symptoms of Huntington disease
choreiform movements memory loss results in personality changes: depression, impulse behavior, mood lability (swings)
52
Parkinson disease
progressive degenerative disorder of the basal ganglia specifically degeneration of substantial nigra -- dopamine degeneration
53
neurotransmitter associated with Parkinson disease
dopamine
54
symptoms of Parkinson disease
results in tremor (esp. in fine movements such as writing), rigidity, bradykinesia (slow movements)
55
medication management of Parkinson disease 3 medications used and their fxn
typically prescriptions are focused on improving dopamine system and levels to increase levels: Levodopa + Cardopa agonist of dopamine receptors: Bromocriptine inhibit the breakdown of dopamine: Selegine
56
medical term for a stroke
cerebrovascular accident (CVA)
57
stroke
acute, focal loss of oxygenated blood in the brain that leads to neuronal death two main types: ischemic stroke, hemorrhagic stroke also transient ischemic attacks
58
transient ischemic attacks (TIA)
mild, self limited episodes of neurologic dysfunction without acute infarction (no death of nerve cells) symptoms typically resolve in 24hrs so often not diagnosed
59
most common type of stroke?
ischemic stroke
60
ischemic CVA
caused by thrombi or emboli characterized by a prenumbra goal of treatment is to restore blood flow to area (try to get it quickly and minimized long term sequelae) use thrombolytics to restore blood flow
61
Hemorrhagic CVA
less common, higher mortality spontaneous intracerebral hemorrhage usually due to rupture of a blood vessel or an existing aneurysm
62
increased risk for hemorrhagic CVA: (why)
hypertension (thins the walls of the blood vessels so more likely to rupture) anticoagulation (slightest trauma will cause a major blood rush to the head)
63
hemorrhagic cva work up
preform non contrast CT first blood will appear bright white (if you use contrast you won't see the blood -- obscured blood)
64
treatment of hemorrhagic cva
management fr pressure, blood pressure, and mechanical ventilation neurosurgical team consult to get in and stop the bleeding/repair the vessel
65
prenumbra
ischemic cva central core of dead cells that are surrounded by cells that are minimally perfused/ischemic

KCSU17 Patho/Pharm Submodule 1 (12 decks)

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