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Pathophysiology > neurologic system disorders > Flashcards

neurologic system disorders Flashcards

1
Q

MC neuropathy dx in western hemisphere

A

diabetic neuropathy

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2
Q

what is diabetic neuropathy a complication of

A

diabetes

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3
Q

what is diabetic neuropathy characterized by

A

mixed polyneuropathy: sensory (mostly), motor, and autonomic

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4
Q

sometimes diabetic neuropathy presents as mononeuropathy and affects what

A

peripheral or cranial nerves individually

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5
Q

what may be the presenting symptom of occult diabetes

A

diabetic neuropathy

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6
Q

what is diabetic neuropathy related to

A

duration and severity of hyperglycemia

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7
Q

hallmarks of diabetic neuropathy?

A

increased nerve fiber damage and reduced nerve fiber repair capacity

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8
Q

what fibers are affected in diabetic neuropathy

A

distal sensory and autonomic

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9
Q

what does reduced nerve fiber repair capacity lead to

A

progressive loss of sensation

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10
Q

where are symptoms most common in in diabetic neuropathy

A

lower extremities and consists of numbness, pain, burning, and paresthesis

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11
Q

what type of neuropathy is bells palsy?

A

mononeuropathy

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12
Q

what CN is involved in bells palsy?

A

7/facial

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13
Q

what happens to the facial nerve in bells palsy?

A

axonal degeneration

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14
Q

etiology of facial nerve geneneration in bells palsy?

A

unknown; maybe HSV activation

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15
Q

who is bells palsy seen in?

A

all ages; more commonly in pregnant women and diabetics

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16
Q

do many people recover from bells palsy?

A

yes! 80% recover spontaneously

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17
Q

what occurs in bells palsy

A

unilateral weakness of facial muscles that occurs abruptly, ipsilateral ear pain, impaired taste, lacrimation, hyperacusis

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18
Q

what type of disorder is MS

A

demyelinating

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19
Q

mc inflammatory disorder of CNS?

A

MS

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20
Q

what is MS

A

progressive, inflammatory, demyelinating, autoimmune disorder of the CNS

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21
Q

what is degenerated in MS

A

myelin sheath in CNS neurons

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22
Q

3 types of MS degeneration in nerves

A

mixed (general), spinal, cerebellar

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23
Q

what marker has an inc risk for developing MS

A

HLA DR2

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24
Q

are more males or females affected in MS

A

females 3:2

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25
Q

2 types of MS?

A

relapsing/remitting and chronic progressive

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26
Q

pathologic hallmark of MS?

A

CNS plaque with loss of myelin and depletion of oligodendrocytes with or without axon loss

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27
Q

when is the onset of MS

A

women of childbearing yrs or men over 40y/o

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28
Q

symptoms of MS?

A

impaired vision/optic neuritis, ataxia, spasticity, bladder dysfunction, weakness/paralysis in one or more limbs, sensitivity to temp, cognitive impairment

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29
Q

3 different clinical manifestations of MS?

A

opticospinal multiple sclerosis (OSMS), spinal multiple sclerosis, and cerebellar multiple sclerosis

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30
Q

what does spinal multiple sclerosis involve

A

spinal tract and dorsal column

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31
Q

symptoms of spinal multiple sclerosis

A

weakness, numbness, or both in one or more limbs, bladder problems

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32
Q

what does cerebellar multiple sclerosis affect

A

all 4 limbs

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33
Q

symptoms of cerebellar multiple sclerosis

A

nystagmus, ataxia, weakness

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34
Q

pathogenesis of MS

A

T cell mediated autoimmune disease, macrophage and microglial cell involvement in myelin degradation

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35
Q

what does Damage to/loss of myelin impair

A

nerve conduction

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36
Q

what is guillain barre syndrome (GBS)

A

autoimmune mediated attack causing demyelination of the peripheral nerves and sparing of axons

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37
Q

is GBS acute or chronic onset

A

acute

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38
Q

what kind of paralysis is in GBS

A

ascending motor

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39
Q

do most ppl with GBS have myelin loss or myelin and axonal loss

A

mlyelin loss only

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40
Q

is there CNS damage in GBS

A

no

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41
Q

MCC acute flaccid paralysis

A

GBS

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42
Q

if someone gets GBS, when do they typically get it

A

after a specific medical event like infection, vaccination, childbirth, surgery, immunosuppression

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43
Q

what does als stand for

A

amyotrophic lateral sclerosis

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44
Q

what does ALS affect in the body

A

upper and lower motor neurons of the cerebral cortex, brainstem, and spinal cord (corticospinal tracts and anterior roots)

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45
Q

what symptoms does als cause

A

Progressive weakness leading to respiratory failure and death but has normal intellectual and sensory function until death

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46
Q

what is classic als called

A

lou gehrig disease

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47
Q

what type of disease is Myasthenia gravis

A

chronic autoimmune

postsynaptic neuromuscular junction disease

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48
Q

what causes Myasthenia in the body

A

IgG antibody produced against acetylcholine receptors (antiacetylcholine receptor antibodies)

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49
Q

symptoms of myasthenia gravis

A

Weakness and fatigue of muscles of the eyes and the throat, diplopia, difficulty chewing, talking, swallowing

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50
Q

when does myasthenia gravis occur? who is it more common in

A

Can occur at any age and is more common in younger women and older men

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51
Q

what organ plays an important role in the pathogenesis of myasthenia gravis

A

thymus

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52
Q

what does ACh do

A

stimulates muscles

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53
Q

In most patients with myasthenia gravis, what does they thymus look like

A

hyperplastic

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54
Q

what happens if a thymoma is suspected in myasthenia gravis

A

thymectomy

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55
Q

what are epilepsies

A

group of disorders characterized by recurrent seizures

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56
Q

what are seizures

A

Transient disturbances of cerebral function caused by abnormal paroxysmal neuronal discharges in the brain

57
Q

what is eliptogenic focus

A

group of neurons that are hypersensitive to paroxysmal depolarization

58
Q

what is hypersyncronization

A

bursts of action potentials

59
Q

how are seizures characterized

A

generalized or partial

60
Q

what do generalized seizures affect

A

whole brain

61
Q

what do partial seizures affect

A

portion of the brain

62
Q

are are idiopathic seizures

A

seizures with no specific cause that begin ages 5-20

63
Q

why do elderly ppl usually have seizures

A

caused by strokes or tumors

64
Q

what are secondary seizured caused by

A

Congenital abnormalities or perinatal injury, infection, trauma, metabolic disease, vascular disease, tumors, neurodegenerative disease

65
Q

what are general seizures characterized by and what are the types

A

Characterized by a sudden loss of consciousness; convulsive and absence

66
Q

2 types of convulsive seizures

A

gran mal or tonic clonic

67
Q

what happens in a generalized tonic clonic seizure

A

loss of consciousness, tonic contractions of muscles, limb jerking, unconscious for minutes, postictal state

68
Q

what is a postictical state

A

period of confusion lasting several minutes after consciousness is regained

69
Q

what happens in tonic contractions

A

slow continuous contractions of muscles caused by limb extension and arching of the back

70
Q

how long does the tonic phase last

A

10-30 sec

71
Q

what is the clonic phase

A

limb jerking that builds in frequency to a peak after 15–30 seconds and then slows gradually over another 15–30 seconds

72
Q

when in a persons life do absence seizures usually occur

A

begin in childhood and remit by adulthood

73
Q

what are absence seizures characterized by

A

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
Q

how is the pt after a absence seizure

A

they are fully alert

75
Q

how often do absence seizures occur

A

can occur several times throughout the day

76
Q

how are absence seizures transmitted

A

autosomal dominant with incomplete penetrance

77
Q

what should patients with simple or complex partial seizures should be investigated for

A

underlying brain lesions in specific areas

78
Q

what are partial seizures caused by

A

focal brain disease

79
Q

2 types of partial seizures

A

simple and complex

80
Q

what do simple partial seizures begin with

A

motor, sensory, visual, psychic, or autonomic phenomena depending on location of seizure

81
Q

is the person aware during a simple partial seizure

A

yes

82
Q

is a person conscious during a simple partial seizure

A

yes unless the seizure spreads to another area and produces a tonic clonic seizure

83
Q

what are automatisms

A

stereotyped, coordinated, involuntary movements

84
Q

is a person conscious in a complex partial seizure

A

no, they have impaired consciousness

85
Q

what happens in a complex partial seizure before impairment of consciousness

A

Olfactory or sensory hallucinations, unexplained fear, or aura consisting of unusual abdominal sensationsillusions of familiarity (déjà vu)

86
Q

how long do Complex Partial Seizures last

A

2-5 min

87
Q

what are Complex Partial Seizures followed by

A

postictal confusion

88
Q

where is the seizure focus in a Complex Partial Seizure

A

temporal or frontal lobe

89
Q

what is Status epilepticus

A

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
Q

what type of seizure may resemble simple repetitive tics or are a sequence of natural looking mvmts

A

complex partial seizures

91
Q

when do febrile seizures occur

A

sudden raise in temp; not uncommon

92
Q

what is parkinson’s

A

degeneration of basal ganglia (corpus striatum) involving the dopaminergic nigrostriatal pathway

93
Q

3 characteristics of parkinsons

A

rigidity, bradykinesia (slowness of mvmt), tremor

94
Q

50% of ppl have depression that is part of the pathologic state and NOT a situational response in these diseases

A

parkinsons and dementia

95
Q

what is punding

A

stereotypic motor behavior where there is intense fascination with repetitive handling and examination of mechanical objects

96
Q

etiology of parkinsons

A

unknown; maybe dopamine depletion

97
Q

where is there degeneration in parkinsons

A

dopaminergic neurons in substantia nigra

98
Q

what 2 hormones is there an imbalance in in parkinsons

A

dopamine and Ach

99
Q

lewy bodies are commonly in

A

parkinsons

100
Q

Tx of parkinsons

A

block effects of Ach and replace it with DOPA

101
Q

essential tremor

A

uncontrollable shaking in different parts and sides of the body

102
Q

where do essential tremors affect on the body

A

hands, arms, heads, larynx, tongue, chin

103
Q

these tremors only cause minimal disability

A

essential

104
Q

when are essential tremors onset

A

late, usually teen and early adult yrs

105
Q

inheritance pattern for essential tremors

A

autosomal dominant

106
Q

these are enhanced by emotional stress

A

essential tremors

107
Q

dementia

A

progressive impairment intellectual functioning with a compromise in 2 of the following: language, memory, visuospatial skills, emotional behavior, personality, cognition

108
Q

MCC/form of chronic progressive dementia

A

Alzheimers

109
Q

life expectancy once alzheimers symptoms hit

A

5-10 years

110
Q

how do ppl with alzheimers usually die

A

infection or inanition (lack of nourishment)

111
Q

causes of alzheimers

A

familial or nonhereditary

112
Q

primary markers of AD

A

neurofibrillary tangles

113
Q

besides neurofibrillary tangles, what else is on alzheimers disease pathology

A

extracellular neuritic plaques

114
Q

theories for AD causes

A

mutations for encoding amyloid precursor proteins, changes in apolipoprotein E, and activation of N methyl D aspartate (NMDA)

115
Q

clinical manifestations: forgetfulness, emotional upset, disorientation, confusion, lack of concentration, decline in abstraction, problem solving, judgement

A

AD

116
Q

how is the diagnosis made for AD

A

ruling out other causes of dementia

117
Q

MC benign headache disorder

A

tension headache

118
Q

etiology of tension headache

A

unknown

119
Q

what can tension headaches be triggered or brought on by

A

stress, depression, hunger, muscle strain

120
Q

do tension headaches come on suddenly or slowly

A

either

121
Q

what are migraine headache?

A

painful headaches accompanied by nausea, vomiting, and sensitivity to light

122
Q

unilateral; throbbing or pulsating discomfort

A

migraine headache

123
Q

are migraine headaches more common in men or women

A

women

124
Q

what is the onset of migraine headaches

A

early; puberty-30yo

125
Q

typical pattern of migraine headache in women

A

follow menstrual pattern

126
Q

is a positive family hx common in migraine headache

A

yes

127
Q

2 mc types of migraine headaches

A

migraine w/o aura

migraine w/ aura

128
Q

classic migraine is called

A

migraine with aura

129
Q

this is related to intracranial vasoconstriction and extracranial vasodilation

A

migraine with aura

130
Q

aura?

A

Visual - flashing lights, wavy lines, or dots, blurry vision or blind spots

Sensory – tingling and numbness in the hand and mouth

131
Q

Severe, unilateral, periorbital headaches

A

cluster headache

132
Q

Last for 30 to 90 minutes and occur several times a day over a period of weeks to months

A

cluster headache

133
Q

are cluster headaches in more males or females? what age?

A

middle age males

134
Q

is family hx common in cluster headaches

A

NO

135
Q

Nocturnal attacks can be more severe

A

cluster headache

136
Q

etiology of cluster headaches

A

possibly vascular, serotonergic mechanisms

137
Q

Patients with cluster headaches often pace incessantly around the room because pain is severe and not relieved by rest

A

cluster headaches

138
Q

which is more intense: migraine or cluster headache

A

cluster

139
Q

Least common type of headache

A

cluster headache

Pathophysiology (17 decks)

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