neurologic system disorders Flashcards
1
Q
MC neuropathy dx in western hemisphere
A
diabetic neuropathy
2
Q
what is diabetic neuropathy a complication of
A
diabetes
3
Q
what is diabetic neuropathy characterized by
A
mixed polyneuropathy: sensory (mostly), motor, and autonomic
4
Q
sometimes diabetic neuropathy presents as mononeuropathy and affects what
A
peripheral or cranial nerves individually
5
Q
what may be the presenting symptom of occult diabetes
A
diabetic neuropathy
6
Q
what is diabetic neuropathy related to
A
duration and severity of hyperglycemia
7
Q
hallmarks of diabetic neuropathy?
A
increased nerve fiber damage and reduced nerve fiber repair capacity
8
Q
what fibers are affected in diabetic neuropathy
A
distal sensory and autonomic
9
Q
what does reduced nerve fiber repair capacity lead to
A
progressive loss of sensation
10
Q
where are symptoms most common in in diabetic neuropathy
A
lower extremities and consists of numbness, pain, burning, and paresthesis
11
Q
what type of neuropathy is bells palsy?
A
mononeuropathy
12
Q
what CN is involved in bells palsy?
A
7/facial
13
Q
what happens to the facial nerve in bells palsy?
A
axonal degeneration
14
Q
etiology of facial nerve geneneration in bells palsy?
A
unknown; maybe HSV activation
15
Q
who is bells palsy seen in?
A
all ages; more commonly in pregnant women and diabetics
16
Q
do many people recover from bells palsy?
A
yes! 80% recover spontaneously
17
Q
what occurs in bells palsy
A
unilateral weakness of facial muscles that occurs abruptly, ipsilateral ear pain, impaired taste, lacrimation, hyperacusis
18
Q
what type of disorder is MS
A
demyelinating
19
Q
mc inflammatory disorder of CNS?
A
MS
20
Q
what is MS
A
progressive, inflammatory, demyelinating, autoimmune disorder of the CNS
21
Q
what is degenerated in MS
A
myelin sheath in CNS neurons
22
Q
3 types of MS degeneration in nerves
A
mixed (general), spinal, cerebellar
23
Q
what marker has an inc risk for developing MS
A
HLA DR2
24
Q
are more males or females affected in MS
A
females 3:2
25
2 types of MS?
relapsing/remitting and chronic progressive
26
pathologic hallmark of MS?
CNS plaque with loss of myelin and depletion of oligodendrocytes with or without axon loss
27
when is the onset of MS
women of childbearing yrs or men over 40y/o
28
symptoms of MS?
impaired vision/optic neuritis, ataxia, spasticity, bladder dysfunction, weakness/paralysis in one or more limbs, sensitivity to temp, cognitive impairment
29
3 different clinical manifestations of MS?
opticospinal multiple sclerosis (OSMS), spinal multiple sclerosis, and cerebellar multiple sclerosis
30
what does spinal multiple sclerosis involve
spinal tract and dorsal column
31
symptoms of spinal multiple sclerosis
weakness, numbness, or both in one or more limbs, bladder problems
32
what does cerebellar multiple sclerosis affect
all 4 limbs
33
symptoms of cerebellar multiple sclerosis
nystagmus, ataxia, weakness
34
pathogenesis of MS
T cell mediated autoimmune disease, macrophage and microglial cell involvement in myelin degradation
35
what does Damage to/loss of myelin impair
nerve conduction
36
what is guillain barre syndrome (GBS)
autoimmune mediated attack causing demyelination of the peripheral nerves and sparing of axons
37
is GBS acute or chronic onset
acute
38
what kind of paralysis is in GBS
ascending motor
39
do most ppl with GBS have myelin loss or myelin and axonal loss
mlyelin loss only
40
is there CNS damage in GBS
no
41
MCC acute flaccid paralysis
GBS
42
if someone gets GBS, when do they typically get it
after a specific medical event like infection, vaccination, childbirth, surgery, immunosuppression
43
what does als stand for
amyotrophic lateral sclerosis
44
what does ALS affect in the body
upper and lower motor neurons of the cerebral cortex, brainstem, and spinal cord (corticospinal tracts and anterior roots)
45
what symptoms does als cause
Progressive weakness leading to respiratory failure and death but has normal intellectual and sensory function until death
46
what is classic als called
lou gehrig disease
47
what type of disease is Myasthenia gravis
chronic autoimmune
| postsynaptic neuromuscular junction disease
48
what causes Myasthenia in the body
IgG antibody produced against acetylcholine receptors (antiacetylcholine receptor antibodies)
49
symptoms of myasthenia gravis
Weakness and fatigue of muscles of the eyes and the throat, diplopia, difficulty chewing, talking, swallowing
50
when does myasthenia gravis occur? who is it more common in
Can occur at any age and is more common in younger women and older men
51
what organ plays an important role in the pathogenesis of myasthenia gravis
thymus
52
what does ACh do
stimulates muscles
53
In most patients with myasthenia gravis, what does they thymus look like
hyperplastic
54
what happens if a thymoma is suspected in myasthenia gravis
thymectomy
55
what are epilepsies
group of disorders characterized by recurrent seizures
56
what are seizures
Transient disturbances of cerebral function caused by abnormal paroxysmal neuronal discharges in the brain
57
what is eliptogenic focus
group of neurons that are hypersensitive to paroxysmal depolarization
58
what is hypersyncronization
bursts of action potentials
59
how are seizures characterized
generalized or partial
60
what do generalized seizures affect
whole brain
61
what do partial seizures affect
portion of the brain
62
are are idiopathic seizures
seizures with no specific cause that begin ages 5-20
63
why do elderly ppl usually have seizures
caused by strokes or tumors
64
what are secondary seizured caused by
Congenital abnormalities or perinatal injury, infection, trauma, metabolic disease, vascular disease, tumors, neurodegenerative disease
65
what are general seizures characterized by and what are the types
Characterized by a sudden loss of consciousness; convulsive and absence
66
2 types of convulsive seizures
gran mal or tonic clonic
67
what happens in a generalized tonic clonic seizure
loss of consciousness, tonic contractions of muscles, limb jerking, unconscious for minutes, postictal state
68
what is a postictical state
period of confusion lasting several minutes after consciousness is regained
69
what happens in tonic contractions
slow continuous contractions of muscles caused by limb extension and arching of the back
70
how long does the tonic phase last
10-30 sec
71
what is the clonic phase
limb jerking that builds in frequency to a peak after 15–30 seconds and then slows gradually over another 15–30 seconds
72
when in a persons life do absence seizures usually occur
begin in childhood and remit by adulthood
73
what are absence seizures characterized by
brief lapses in consciousness lasting several seconds without loss of posture; may be associated with blinking, slight head mvmts, brief jerks of limb mvmt
74
how is the pt after a absence seizure
they are fully alert
75
how often do absence seizures occur
can occur several times throughout the day
76
how are absence seizures transmitted
autosomal dominant with incomplete penetrance
77
what should patients with simple or complex partial seizures should be investigated for
underlying brain lesions in specific areas
78
what are partial seizures caused by
focal brain disease
79
2 types of partial seizures
simple and complex
80
what do simple partial seizures begin with
motor, sensory, visual, psychic, or autonomic phenomena depending on location of seizure
81
is the person aware during a simple partial seizure
yes
82
is a person conscious during a simple partial seizure
yes unless the seizure spreads to another area and produces a tonic clonic seizure
83
what are automatisms
stereotyped, coordinated, involuntary movements
84
is a person conscious in a complex partial seizure
no, they have impaired consciousness
85
what happens in a complex partial seizure before impairment of consciousness
Olfactory or sensory hallucinations, unexplained fear, or aura consisting of unusual abdominal sensationsillusions of familiarity (déjà vu)
86
how long do Complex Partial Seizures last
2-5 min
87
what are Complex Partial Seizures followed by
postictal confusion
88
where is the seizure focus in a Complex Partial Seizure
temporal or frontal lobe
89
what is Status epilepticus
Experience of a second seizure before the person has fully regained consciousness from the preceding seizure OR a single seizure lasting more than 30 minutes
90
what type of seizure may resemble simple repetitive tics or are a sequence of natural looking mvmts
complex partial seizures
91
when do febrile seizures occur
sudden raise in temp; not uncommon
92
what is parkinson's
degeneration of basal ganglia (corpus striatum) involving the dopaminergic nigrostriatal pathway
93
3 characteristics of parkinsons
rigidity, bradykinesia (slowness of mvmt), tremor
94
50% of ppl have depression that is part of the pathologic state and NOT a situational response in these diseases
parkinsons and dementia
95
what is punding
stereotypic motor behavior where there is intense fascination with repetitive handling and examination of mechanical objects
96
etiology of parkinsons
unknown; maybe dopamine depletion
97
where is there degeneration in parkinsons
dopaminergic neurons in substantia nigra
98
what 2 hormones is there an imbalance in in parkinsons
dopamine and Ach
99
lewy bodies are commonly in
parkinsons
100
Tx of parkinsons
block effects of Ach and replace it with DOPA
101
essential tremor
uncontrollable shaking in different parts and sides of the body
102
where do essential tremors affect on the body
hands, arms, heads, larynx, tongue, chin
103
these tremors only cause minimal disability
essential
104
when are essential tremors onset
late, usually teen and early adult yrs
105
inheritance pattern for essential tremors
autosomal dominant
106
these are enhanced by emotional stress
essential tremors
107
dementia
progressive impairment intellectual functioning with a compromise in 2 of the following: language, memory, visuospatial skills, emotional behavior, personality, cognition
108
MCC/form of chronic progressive dementia
Alzheimers
109
life expectancy once alzheimers symptoms hit
5-10 years
110
how do ppl with alzheimers usually die
infection or inanition (lack of nourishment)
111
causes of alzheimers
familial or nonhereditary
112
primary markers of AD
neurofibrillary tangles
113
besides neurofibrillary tangles, what else is on alzheimers disease pathology
extracellular neuritic plaques
114
theories for AD causes
mutations for encoding amyloid precursor proteins, changes in apolipoprotein E, and activation of N methyl D aspartate (NMDA)
115
clinical manifestations: forgetfulness, emotional upset, disorientation, confusion, lack of concentration, decline in abstraction, problem solving, judgement
AD
116
how is the diagnosis made for AD
ruling out other causes of dementia
117
MC benign headache disorder
tension headache
118
etiology of tension headache
unknown
119
what can tension headaches be triggered or brought on by
stress, depression, hunger, muscle strain
120
do tension headaches come on suddenly or slowly
either
121
what are migraine headache?
painful headaches accompanied by nausea, vomiting, and sensitivity to light
122
unilateral; throbbing or pulsating discomfort
migraine headache
123
are migraine headaches more common in men or women
women
124
what is the onset of migraine headaches
early; puberty-30yo
125
typical pattern of migraine headache in women
follow menstrual pattern
126
is a positive family hx common in migraine headache
yes
127
2 mc types of migraine headaches
migraine w/o aura
| migraine w/ aura
128
classic migraine is called
migraine with aura
129
this is related to intracranial vasoconstriction and extracranial vasodilation
migraine with aura
130
aura?
Visual - flashing lights, wavy lines, or dots, blurry vision or blind spots
Sensory – tingling and numbness in the hand and mouth
131
Severe, unilateral, periorbital headaches
cluster headache
132
Last for 30 to 90 minutes and occur several times a day over a period of weeks to months
cluster headache
133
are cluster headaches in more males or females? what age?
middle age males
134
is family hx common in cluster headaches
NO
135
Nocturnal attacks can be more severe
cluster headache
136
etiology of cluster headaches
possibly vascular, serotonergic mechanisms
137
Patients with cluster headaches often pace incessantly around the room because pain is severe and not relieved by rest
cluster headaches
138
which is more intense: migraine or cluster headache
cluster
139
Least common type of headache
cluster headache
