Neurological and Endocrine Disorders Flashcards
Neurological & Endocrine Disorders
A type of ischemic stroke that occurs when a blood clot forms in an artery that supplies blood to the brain
thrombotic stroke
Neurological & Endocrine Disorders
Idris is in a serious car accident that causes a traumatic brain injury. After regaining consciousness in the hospital, Idris has anterograde amnesia and retrograde amnesia that affects memories for the ten months prior to the accident. When Idris’s long-term memories begin to return, he’s most likely to recall which types of memories first?
longer-term memories
Neurological & Endocrine Disorders
Migraine headaches have been linked to abnormal levels of:
serotonin
Neurological & Endocrine Disorders
Which is not a characteristic of hypothyroidism?
a) decreased libido
b) heat intolerance
c) confusion
d) unexplained weight gain
b) heat intolerance
Neurological & Endocrine Disorders
A client with __________ tells her therapist that, since her traumatic brain injury, she has had trouble disciplining her children because, when she tells them she’s angry about what they’ve done, she doesn’t sound angry and, as a result, they don’t listen to her. As the client describes the problems she has with her children, she speaks in a monotone.
aprosodia
Neurological & Endocrine Disorders
an MRI-based technique that is used to detect abnormalities in the brain’s white matter by measuring the spreading of water molecules in the tissues
diffusion tensor imaging
Neurological & Endocrine Disorders
a type of seizure that causes a very brief loss of consciousness, often without being noticed, typically lasting 10-20 seocnds and characterized by a blank stare
generalized onset non-motor
Neurological & Endocrine Disorders
levodopa is most effective for which symptom(s) of Parkinson’s?
bradykinesia
Neurological & Endocrine Disorders
Parkinson’s disease has been linked to a degeneration of dopamine-producing cells in which area of the brain
substantia nigra
Neurological & Endocrine Disorders
medical term for a stroke that is caused by an interruption of blood flow to the brain that causes brain cells to die / a loss in neurological functioning.
cerebrovascular accident (CVA)
Neurological & Endocrine Disorders
all of the following are risk factors for stroke except (and which is the largest risk factor?)
a) obesity
b) agranulocytosis
c) hypertension
d) male gender
e) AA race
b) agranulocytosis
c) hypertension
other risk factors: heart disease, diabetes, cigarette smoking, older age, family hx of stroke, heavy alcohol consumption
Neurological & Endocrine Disorders
what are the 2 main types of stroke and what causes each of them
1) ischemic stroke: caused by a blood clot blocking blood flow
2) hemorrhagic stroke: caused by bleeding in the brain (these are further categorized by where the bleeding occurs)
Neurological & Endocrine Disorders
this is most common type of stroke, which is caused by a blood clot blocking an atery in the brain
ischemic
Neurological & Endocrine Disorders
this is a less common type of stroke caused by bleeding in the brain
hemorrhagic
Neurological & Endocrine Disorders
this type of stroke is caused by a blood clot in a cerebral artery that supplies blood to the brain
thrombotic stroke
Neurological & Endocrine Disorders
this type of stroke is caused by blockage in a cerebral artery due to a blood clot developing in the heart or elsewhere in the body and then traveling through the bloodstream to the brain
embolic stroke
Neurological & Endocrine Disorders
this type of stroke is also known as a “mini-stroke,” is caused by temporary blockage of bloodflow to the brain, and is usually a warning sign that a more severe stoke may occur in the future
transient ischemic stroke (TIA)
Neurological & Endocrine Disorders
this type of stroke is due to bleeding in the brain and occurs when there is a rupture in a cerebral artery within the brain or in the space between the brain and the membrane that covers the brain
hemorrhagic stroke
Neurological & Endocrine Disorders
this type of hemorrhage occurs a cerebral artery ruptures in the brain and bleeds into the brain tissue
intracerebral hemorrage
Neurological & Endocrine Disorders
this type of hemorrhage occurs in the space between the brain and the membrane that covers the brain
subarachnoid hemorrhage
Neurological & Endocrine Disorders
symptoms of a stroke depend on which ____ is involved.
artery
Neurological & Endocrine Disorders
this artery is the largest branch of the internal carotid artery, supplies a large area of the brain, and is the most commonly affected artery in a stroke
middle cerebral artery
Neurological & Endocrine Disorders
a stroke involving the middle cerebral artery would damage what area of the brain & result in these symptoms
- frontal, parietal, & temporal lobes
-
symptoms
aphasia (speech difficulties; due to damage in the dominant hemisphere)
contralateral neglect (neglecting one side of visual field; non-dominant hemisphere affected)
other sxs: facial weakness, arm paralysis, & sensory loss
Neurological & Endocrine Disorders
a stroke involving the posterior cerebral artery would result in these symptoms…
- headache
- nausea & vomiting
- memory loss
- speech difficulties (Dysarthria)
- ataxia
Neurological & Endocrine Disorders
A stroke involving the anterior cerebral artery would result in these symptoms…
- executive dysfunction (e.g., impaired insight & judgment)
- mutism
- urinary incontinence
- confusion
Neurological & Endocrine Disorders
these types of TBIs depend on the injury’s location and severity, while these types of TBIs usually cause more widespread damage
open; closed
Neurological & Endocrine Disorders
this type of head injury may produce a loss of consciousness; and, when individuals regain consciousness, they usually experience a variety of mental (e.g., emotional, cognitive, & behavioral) & physical symptoms
TBI
Neurological & Endocrine Disorders
cognitive symptoms of a TBI may include what symptoms associated with memory problems
anterograde & retrograde amnesia
Neurological & Endocrine Disorders
the duration of cognitive symptoms after TBI is a good predictor of what
recovery
Neurological & Endocrine Disorders
when retrograde amnesia occurs after a TBI, which memories are affected more? when lost memories begin to return, those from the most ____ past are recovered first
recent long-term; distant
Neurological & Endocrine Disorders
physical symptoms of a TBI include all of the following except:
a) nausea and vomiting
b) headaches
c) strokes
d) seizures
c) strokes
physical sxs also include: fatigue, loss of consciousness, pupil dilation, weakness or numbness in limbs, & difficulty w/ balance & coordination
Neurological & Endocrine Disorders
which of the following is the term for a neurological condition that affects the ability to express or understand prosody (i.e., variations in the rhythm, pitch, timing, & loudness of speech that are used to convey emotional info)
a) ataxia
b) aprosodia
c) anasognosia
d) asomatognosia
b) aprosodia (the inability to produce or comprehend affective components of language)
Neurological & Endocrine Disorders
post-traumatic seizues can occur within what timeframe following a TBI and can often be successfully treated with anti-seizure meds
1 week
Neurological & Endocrine Disorders
this symptom of a TBI can occur more than 1 week after and is typically harder to treat
post-traumatic epilepsy (PTE)
Neurological & Endocrine Disorders
the following are alternative treatments used when medication is ineffective to treat this neurological disorder
a) vagus nerve stimulation
b) responsiveness neurostimulation (RNS)
c) surgery
post-traumatic epilepsy (PTE)
Neurological & Endocrine Disorders
some evidence suggests that seizures following TBI are linked to atrophy in what brain areas
temporal lobe & hippocampus
Neurological & Endocrine Disorders
describe the typical prognosis for a TBI
at 3 months, 1 year, lifetime
- most recover within first 3 months with substantial improvement during the 1st year
- many people continue to have symptoms indefinitely, especially with moderate to severe injury
Neurological & Endocrine Disorders
this disease is an incurable neurodegenerative disorder that is mostly inherited and involves a general lack of coordination & an unsteady gait
Huntington’s
Neurological & Endocrine Disorders
this autosomal dominant gene on chromosome 4 is responsible for Huntington’s disease
huntington (HTT) gene
Neurological & Endocrine Disorders
Offspring of a 1 person with the huntington (HTT) gene have a ____% chance of inheriting Huntington’s, while offspring of 2 people with this gene have a ____% change of inheriting Huntington’s
50%; 75%
Neurological & Endocrine Disorders
Huntington’s is primarily associated with neurodegeneration in these brain areas
basal ganglia (specifically the striatum)
Neurological & Endocrine Disorders
neuroimaging studies of Huntington’s have found that atrophy in these 2 brain areas is apparent years before the onset of symptoms
caudate nucleus & putamen
Neurological & Endocrine Disorders
Huntington’s is associated with abnormal levels of this neurotransmitter
dopamine
also, GABA & glutamate
Neurological & Endocrine Disorders
symptoms of Huntington’s most often appear between these ages and life expectancy is usually this many years after onset of symptoms
- 30 to 50 years
- 10 to 30 years
Neurological & Endocrine Disorders
progression of Huntington’s disease varies, but typically these symptoms precede cognitive & motor symptoms. List these symptoms.
affective
* emotional changes: irritability, depression, aggression
Neurological & Endocrine Disorders
typical progression of symptoms with Huntington’s suggests that these symptoms are not just a reaction to the distress but instead a manifestation of what
underlying pathological changes
Neurological & Endocrine Disorders
what primary motor symptom is associated with onset of Huntington’s? Symptoms associated with later stages and criteria for mild or major neurocognitive disorder?
three C’s
Chorea (involuntary, jerky movements)
other symptoms:
Cognitive decline (memory problems, difficulty concentrating)
Changes in mood/behavior (irritability, depression, aggression)
Neurological & Endocrine Disorders
treatment goals for Huntington’s
- no cure
- relieve symptoms & improve quality of life
Neurological & Endocrine Disorders
this disease is an incurable neurodegenerative disorder that produces prominent motor symptoms and is the result of a combination of genetic & environmental factors
Parkinson’s
Neurological & Endocrine Disorders
neurotransmitters & low/high levels of each associated with Parkinson’s
D.A.N.G.
low levels
* dopamine
* acetylcholine
* norepinephrine deficiency
high levels
* glutamate
Neurological & Endocrine Disorders
the motor symptoms involved in Parkinson’s are associated with these 2 brain areas
- substantia nigra
- basal ganglia
Neurological & Endocrine Disorders
low levels of acetylcholine are associated with these symptoms of Parkinson’s
- impairments in gait & balance (physical)
- cognitive decline (cognitive)
Neurological & Endocrine Disorders
depression & anxiety, sleep disturbances, and other non-motor symptoms in Parkinson’s is associated with low levels of this neurotransmitter
norepinephrine
Neurological & Endocrine Disorders
this gene is associated with increased risk for neurocognitive disorder due to Parkinson’s, Alzheimer’s, & Lewy bodies
ApoE gene
Neurological & Endocrine Disorders
4 types of motor symptoms of Parkinson’s
T.R.A.P.
Tremor (when muscles are at rest that begins in hands & includes “pill-rolling”)
Rigidity in the face, limbs, & trunk (mask-like facial expression)
Akinesia (slowed voluntary movement [bradykinesia]
Postural instability (dificulty maintaining balance, increased risk of falls
Neurological & Endocrine Disorders
Up to ____% of people experience depression at some time during the Parkinson’s, with depressive symptoms preceding motor symptoms in about ____% of cases
50%; 20%
Neurological & Endocrine Disorders
Parkinson’s treatment & prognosis
- no cure
- temporarily alleviate symptoms with meds that increase dopamine levels
Neurological & Endocrine Disorders
first-line medication for Parkinson’s and how med works
Levodopa
* converted to dopamine in the brain
* most effective for “T.R.A.” - reducing tremor, rigidity in muscles, and bradykinesia
Neurological & Endocrine Disorders
alternative medications, med effects, & advantages for Parkinson’s when Levodopa isn’t effective
- dopamine agonists: mimick dopamine at receptor sites
- may delay progression & have fewer long-term side effects than levodopa (especially dyskinesias)
Neurological & Endocrine Disorders
what other conditions are treated by dopamine agonists (aside from treating motor symptoms of Parkinson’s)
- restless leg syndrome
- neuroleptic malignant syndrome
Neurological & Endocrine Disorders
treatment (not meds) for Parkinson’s when Levodopa and other dopamine agonist meds are not effective or are impairing quality of life
deep brain stimulation
Neurological & Endocrine Disorders
define & describe deep brain stimulation (DBS)
- a surgical treatment used to reduce motor symptoms of neurological disorders
- involves implanting electrodes in brain areas responsible for motor sxs & a pulse generator under the chest skin & sending electrical impulses to brain areas to alter brain activity
Neurological & Endocrine Disorders
what other conditions are treated by deep brain stimulation (DBS; aside from motor symptoms of Parkinson’s)
- essential tremor
- dystonia (neuro disorder causing involuntary muscle contractions)
- treatment-resistant epilepsy
- treatment-resistant OCD
Neurological & Endocrine Disorders
list the 2 types of seizures
1) focal onset
2) generalized onset
Neurological & Endocrine Disorders
characteristics of focal onset seizures
NOT symptoms
localized / focused in 1 area of the brain & affect 1 side of the body
Neurological & Endocrine Disorders
a type of seizure (also known as simple partial seizures) in which symptoms depend on location in the brain and consciousness in not affected
focal onset aware seizure
Neurological & Endocrine Disorders
a type of seizure (also known as complex partial seizures) that does affect consciousness and may begin with an aura
focal onset impaired awareness seizure
Neurological & Endocrine Disorders
the most common type of focal onset impaired awareness seizures occur in this brain area, are categorized by sensory disturbances, & may begin with an aura, strange taste or odor, sudden intense emotion (e.g., fear), jamais vu (unfamiliarity) or deja vu
temporal lobe
Neurological & Endocrine Disorders
characteristic symptoms of temporal lobe seizures
- impaired awareness
- aura
- staring; dilated pupils
- autonomic sxs: lip smacking, repeated chewing or swallowing, fidgeting, picking at clothing
- speech difficulties
Neurological & Endocrine Disorders
causes and triggers of temporal lobe seizures
causes
* brain trauma: TBI, infections, tumors CVAs
* genetics: hereditary & mutations
triggers
* psychological stress
* mentruation
* alchohol
* diet (high caffeine & sugar)
Neurological & Endocrine Disorders
focal onset impaired awareness seizures that occur in this brain area are the second-most common type of focal onset impaired awareness seizure, symptoms are categorized as complex motor behaviors and often occur during sleep, lasting less than 30 seconds. List common symptoms.
- frontal lobe
symptoms
* movement: repetitive, rocking, pedaling
* behavior: explosive screams, laughter, speech difficulties
* other: urinary incontinence & personality changes
Neurological & Endocrine Disorders
focal onset impaired awareness seizures that occur in this brain area involve sensosry disturbances in the limbs, such as tingling, numbness, and pain and distortions in body image (e.g., feeling that a body part is enlarged, shrunken, or absent or feeling like you’re floating)
parietal lobe
Neurological & Endocrine Disorders
focal onset impaired awareness seizures that occur in this brain area are characterized by visual hallucinations, rapid eye blinking, eyelid flutter, and involuntary eye movements; flashing or stationary bright lights, multi-colored circular patterns, as well as partial blindness, impaired visual acuity, or other visual impairment
occipital lobe
Neurological & Endocrine Disorders
this type of seizure affects the whole brain (e.g., both hemispheres)
generalized onset
list the 2 types of generalized onset seizures
1) generalized onset MOTOR seizures
2) generalized onset NON-MOTOR seizures
Neurological & Endocrine Disorders
generalized onset motor seizures are also known as these 2 terms
tonic-clonic seizures & grand mal
Neurological & Endocrine Disorders
these types of generalized onset seizures cause a change in consciousness and include a tonic and clonic phase
generalized onset motor seizures
Neurological & Endocrine Disorders
list & describe the different phases of generalized onset motor seizures
T.C.A.M.
Tonic: stiffening muscles
Clonic: jerking movements
Myoclonic: suddent muscle jerks
Absense: staring spells
after consciousness is regained following a generalized onset motor seizure, the person may experience what feel… and may have no memory for the events that occurred ____ the seizure.
- depressed, confused, and/or fatigued
- during
Neurological & Endocrine Disorders
these types of generalized onset non-motor seizures are also known as petit mal seizures and involve a very brief loss of consciousness with a blank stare that may be accompanied by rapid blinking
T.C.A.M.
Absense: staring spells w/ brief loss of awareness
Neurological & Endocrine Disorders
a single, continuous seizure (e.g., 5 minutes or more) or multiple recurrent seizures without a return to consciousness / enough time to recover between them
status epilepticus (SE)
Neurological & Endocrine Disorders
list & describe the 2 main types of status epilepticus (SE)
- convulsive: most common type, characterized by physical convulsions, limb jerking & stiffening, & altered awareness
- nonconvulsive: not physically obvious, characterized by altered awareness, minor muscle movements (e.g., small twitches or slow, repetitive motions
Neurological & Endocrine Disorders
possible causes of status epilepticus (SE)?
- brain trauma: TBIs, infection, CVAs
- drug toxicity
- autoimmune disorders
- non-compliance w/ seizure meds
Neurological & Endocrine Disorders
first-line treatment for status epilepticus (SE)? second-line meds when first-line meds aren’t effective?
1) Benzos
2) anti-seizure meds
Neurological & Endocrine Disorders
list the 2 types of migraine headaches and typical triggers
types
1) with aura (classic migraine)
2) without aura (common migraine)
triggers
* emotional stress or relaxation after stress
* abrupt weather changes
* alcohol
* certain foods
* missing a meal
Neurological & Endocrine Disorders
intensity associated with migraine headaches may be worsened by what 2 routine physical activities
bending forward & walking
Neurological & Endocrine Disorders
migraine headaches have been linked to low levels of this neurotransmitter
serotonin
Neurological & Endocrine Disorders
the following are common treatments for what neurological disorder: NSAIDs, ergot alkaloids, SSRIs, SSRI agonists, beta blockers, and/or a combination of thermal biofeedback and autogenic training
migraine headaches
Neurological & Endocrine Disorders
list & describe the 2 types of hypertension
1) primary hypertension: (aka the “silent killer”) no clear cause, often asymptomatic
2) secondary hypertension: caused by another underlying medical condition
primary hypertension, accounts for up to ____% of all cases.
90%
Neurological & Endocrine Disorders
this type of hypertension is diagnosed when high blood pressure is due to a known disease. This disease is a known cause of this type of hypertension
secondary; Cushing’s syndrome
Neurological & Endocrine Disorders
list common risk factors for primary hypertension
- Gender: male
- Race: African American
- Age: over 65+ years old
- Lifestyle: obesity, high stress, tobacco use, excessive alcohol consumption, excessive salt intake
- Family Hx: of hypertension
- Co-existing diseases: diabetes
Neurological & Endocrine Disorders
common forms of treatment for hypertension
- lifestyle changes
- biofeedback & relaxation training
- a duiretic
- a beta blocker
- an ACE inhibitor
- other blood pressure meds
Neurological & Endocrine Disorders
most common endocrine disorders affect this gland
thyroid gland
Neurological & Endocrine Disorders
this disorder is caused by hypersecretion of thyroid hormones. List the most common symptoms
hyperthyroidism
- heart issues: irregular or rapid heart rate, high blood pressure
- weight loss: unintentional weight loss despite an increased appetite
- increased body temp: heat intolerance, sweating more than normal
- executive dysfunction: difficulty concentrating, emotional lability, reduced attention span
Neurological & Endocrine Disorders
hypothyroidism is caused by too little production of thyroid hormones. List the most common symptoms
- heart issues: decreased heart rate, low blood pressure
- weight gain: unintentional weight gain despite decreased appetite
- body temp: lowered body tem & cold intolerance (main difference from hyperthyroidism)
- mental health issues: depression, impaired concentration, impaired memory, confusion
- other physical changes: dry skin, brittle nails, coarse hair, puffy face
- other: fatigue & reduced libido
Neurological & Endocrine Disorders
a low level of ADH due to a tumor, infection, stroke, pituitary surgery, or other factors can cause this disease
diabetes insipidus
Neurological & Endocrine Disorders
symptoms of diabetes insipidus
- frequent & excessive urination
- extreme thirst & dehydration
- constipation
- weight loss
- low blood pressure
Neurological & Endocrine Disorders
the term used when diabetes insipidus is caused by a failure of the kidneys to respond to ADH (i.e., vassopressin)
nephrogenic diabetes insipidus
Neurological & Endocrine Disorders
this bodily organ maintains the body’s blood glucose balance by controlling the release of insulin and other hormones
pancreas
Neurological & Endocrine Disorders
this physical illness is the result of an overactive pancreas & potentially due to a tumor
hypoglycemia due to blood glucose levels decreasing
Neurological & Endocrine Disorders
symptoms of severe hypoglycemia
- confusion
- seizures
- loss of consciousness
- coma
Neurological & Endocrine Disorders
common causes of hypoglycemia
- too much diabetes medication
- not eating enough
- vigorous exercise
- critical illness / organ failure
- an insulin-producing tumor in the pancreas
Neurological & Endocrine Disorders
the disease is caused by increased blood glucose levels (often due to the pancreas releasing too little insulin or the body being unable to use the insulin the pancreas produces)
diabetes mellitus
Neurological & Endocrine Disorders
this type of diabetes is an autoimmune disease that destroys insulin-producing cells in the pancreas. common causes include a genetic predisposition and/or a viral infection
type 1 diabetes
Neurological & Endocrine Disorders
this type of diabestes is more common & occurs when the pancreas produces an insufficient amount of insulin or the body is unable to use the insulin produced by the pancreas.
type 2 diabetes
Neurological & Endocrine Disorders
risk factors for Type 2 diabetes include the following…
- genetic predisposition
- obesity
- sedentary lifestyle
- over 45 years old
- Native American, Afrian American, or Hispanic/Latino American
Neurological & Endocrine Disorders
symptoms of Type 1 and Type 2 diabetes
- extreme thirst and hunger
- frequent urination
- unexplained weight loss
- fatigue
- blurred vision
- tingling & numbness in hands or feet
- frequent infections
Neurological & Endocrine Disorders
list the 2 types of neurological diagnostic tests
1) Electroencephalography (EEG)
2) neuroimaging techniques
Neurological & Endocrine Disorders
this type of neurological diagnostic test uses small electrodes placed on the scalp to measure the electrical impulses used by groups of neurons to communicate with each other
EEG
Neurological & Endocrine Disorders
list the typical uses of an EEG
- quickly identifying changes in brain activity
- diagnose seizure disorders, brain injuries, and sleep disorders
- confirming brain death
Neurological & Endocrine Disorders
list the 2 types of neuroimaging techniques
1) structural techniques
2) functional techniques
Neurological & Endocrine Disorders
list the 3 structural neuroimaging techniques
- CT
- MRI
- DTI
Neurological & Endocrine Disorders
list the 5 types of illnesses diagnosed by structural neuroimaging techniques
- TBIs
- strokes
- tumors
- degenerative disease
- infections
Neurological & Endocrine Disorders
CT and MRI primarily are primarily used to identify…
abnormalities in the density of brain tissue
Neurological & Endocrine Disorders
list the advantages and disadvantages of CT
advantages:
- scanners are usually available in hospital ERs
- lower cost
- quicker images
Disadvantages:
- exposure to ionizing radiation (x-rays)
Neurological & Endocrine Disorders
list the advantages and disadvantages of MRI
Advantages:
- more detailed, 3-D images
- can detect microhemorrhages, contusions (bruises on brain), and gliosis (scarring)
Disadvantages:
- requires ppl to remain motionless for a long period of time
- overly loud; requires use of earplugs or headphones
Neurological & Endocrine Disorders
this is technique is type of MRI-based neuroimaging used to assess the structural integrity of white matter tracts (myelinated axons) that connect different regions of the brain & identify abnormalities in the rate and direction of the movement (diffusion) of water molecules along the axons
this would be used to diagnosis & monitor the progression of MS
diffusion tensor imaging (DTI)
Neurological & Endocrine Disorders
functional techniques assess… by measuring…
- glucose & oxygen consumption
- regional cerebral blood flow (rCBF) & blood volume
Neurological & Endocrine Disorders
list the 3 types of functional neuroimaging techniques
- positron emission tomography (PET)
- single photon emission computed tomography (SPECT)
- functional MRI (fMRI)
Neurological & Endocrine Disorders
which 2 types of functional neuroimaging techniques use radioactive tracers (radiotracers) that are injected into the bloodstream to measure brain activity
PET & SPECT
this type of functional neuroimagining technique uses magnetic fields and radio waves
fMRI
Neurological & Endocrine Disorders
neuroimaging techniques are not sufficiently accurate to diagnose this disease
neurocognitive disorder due to Alzheimer’s
Neurological & Endocrine Disorders
Of the structural techniques, this type is usually preferred to CT because it provides an accurate three-dimensional measure of the volume of brain structures
MRI
Neurological & Endocrine Disorders
Of the functional techniques, fluorodeoxyglucose PET (FDG-PET) assesses glucose metabolism and is useful for distinguishing between these diseases
Alzheimer’s, fronotemporal & other types of neurocognitive disorders