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Bio 252 > Nov. 27, 2019 > Flashcards

Nov. 27, 2019 Flashcards

1
Q

What does ALS stand for (be able to spell this shit)

A

Amyotrophic Lateral Sclerosis

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2
Q

What does MYOTROPHIC indicate?

A

Atrophy of muscle fibers

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3
Q

Does ALS affect SENSORY or MOTOR neurons more?

A

MOTOR exclusively

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4
Q

In what people group is ALS more common?

A

Middle age men

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5
Q

How long does ALS typically last?

A

2-5 years

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6
Q

What is usually the cause of death in ALS?

A

Respiratory complications

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7
Q

What is the Et of ALS?

A
  • Genetic
    • Sporadic (90-95%)
    • Familial (5-10%)
  • Autoimmune
  • Viral?
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8
Q

What gene is often affected in ALS that results in the accumulation of FREE RADICALS?

A

SOD1 gene on Ch 21

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9
Q

What happens to MOTOR NEURONS in ALS?

A

They degenerate

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10
Q

The MOTOR NEURONS in what 3 areas are most affected?

A
  • The brain stem
  • The anterior horn in the spinal cord
  • Upper MOTOR NEURONS in the cerebral cortex
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11
Q

What is the difference between UPPER MOTOR NEURONS ans LOWER ones

A

UPPER go from the brain to the spinal cord, LOWER go from spinal cord to periphery

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12
Q

How do FREE RADICALS contribute to the patho of ALS?

A

They cause damage to the MOTOR NEURONS when they accum

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13
Q

How does GLUTAMATE contribute to the patho of ALS?

A

They cause damage to the MOTOR NEURONS when they accum. NEURO-toxic

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14
Q

Is GLUTAMATE a stim or inhib NEUROTRANSMITTER?

A

Stim

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15
Q

What are the mnfts of ALS?

A
  • Muscle atrophy
  • Fasciulations
  • Weakness
  • Dysarthria
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16
Q

What are fasciulations?

A

Twitching

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17
Q

What is dysarthria?

A

Difficulty speaking d/t resp muscle atrophy

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18
Q

What kind of eating precautions do ALS patients need? Why?

A

Swallowing precautions d/t high aspiration risk r/t dysphagia

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19
Q

What affect does ALS have on cognition and sensation?

A

None

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20
Q

How is someone diagnosed w ALS?

A
  • Hx
  • Presence of mnfts
  • Electromyography (ELECRTO
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21
Q

What is ELECRTO?

A

Stim nerve and observe its action

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22
Q

What is the cure for ALS?

A

There isn’t one

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23
Q

What is the Tx for ALS?

A
  • Mostly supportive
  • Symptom management
  • Prevent resp infct
  • Riluzole
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24
Q

What kind of drug is Riluzole?

A

An antiGLUTAMATE

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25
Q

How does Riluzole help Tx ALS?

A

By suppressing GLUTA-toxicity it helps prevent damage to MOTOR NEURONS

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26
Q

What is BACTERIAL MENINNGITIS?

A

Inflm of the MENINGES

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27
Q

Is BAC M dangerous?

A

Yes, life-threatening

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28
Q

What 2 flora are most commonly associated with BAC M?

A
  • NEISSERIA MENINGITDIS (NEISS M)

- STREPTOCOCCUS PNEUMONIA (STREP PNEU)

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29
Q

What age is most affect by NEISS M?

A

Youth

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30
Q

What age is most affected by STREP PNEU?

A

Adults

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31
Q

Where can you find NEISS M and STREP PNEU most in the body?

A

In small numbers w/in the nasopharnynx

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32
Q

How do congruent infcts relate to the Et of BAC M?

A

A congruent infct (eg sinusitis) could cause the normal flora in the nasopharynx to make contact with the MEINGES and result in BAC M?

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33
Q

Why can BAC M occur after a neural Sx?

A

Because the cranium is compromised, this creates a perfect portal of entry for bacteria to reach the meninges. Head trauma can result in this problem too

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34
Q

Why do chronic diseases and steroid use also put someone at risk for BAC M?

A

Because these cause dec immunity

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35
Q

A quick overview of the patho for BAC M?

A

Bacteria make contact with the MENINGES -> they prolif -> inflm -> purulent exudate

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36
Q

Why does inc INTRACRANIAL PRESSURE become a problem during BAC M?

A

because the inflm and exudate take up a lot of room, increasing the pressure to dangerous levels if not relieved

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37
Q

Vascular _________ is a risk of BAC M

A

Congestion

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38
Q

Can infarction become of complication of BAC M?

A

Yes

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39
Q

What could happen as the MENINGES swell?

A

They could become fused

40
Q

What is HYDRCEPHALUS and how does it occur in BAC M?

A

HYDROCEPH is caused when CSF flow is disrupted and begins to accum

41
Q

Mnfts of BAC M?

A
  • Nuchal rigidity
  • Back pain
  • BRUDINSKI’S SIGN (BRUDS)
  • KERNIG’S SIGN (KERNS)
  • Fever
  • Nausea/vomiting (from the pain)
42
Q

How does BRUDS present?

A

Flexation of the neck causes lifting of knees

43
Q

How does KERNS present?

A

Knee is resistant to flexation

44
Q

What is done to diagnose BAC M?

A
  • Hx and Px
  • C+S of CSF
  • CBC
  • Serology
  • CSF content evaluated
45
Q

What contents w/in CSF could indicate BAC M?

A
  • Pus
  • WBCs
  • Protein
  • Dec glucose
46
Q

Why is there dec glucose in CSF w BAC M?

A

Because the bacteria are using the glucose as an energy source

47
Q

What are the Tx for BAC M?

A
  • Abx

- Steroids

48
Q

What is another name for VIRAL MENINGITIS (VIR M)?

A

ASEPTIC MENINGITIS

49
Q

What viral infct is most commonly associated w VIR M?

50
Q

What does paramyxovirus cause?

51
Q

Which is more dangerous: BAC M or VIR M?

52
Q

T or F:

VIR M will not get better unless aggressively treated, healthcare providers must monitor very closely

A

F, VIR M is usually self-limiting, although it still requires monitoring to be sure it doesn’t continue to get worse

53
Q

What is elevated in the CSF of a pt w VIR M?

A

Lymphocytes

54
Q

How is glucose affected in VIR M?

A

It isn’t

55
Q

How are proteins affected by VIR M?

A

There are elevated levels of proteins in the CSF

56
Q

Why should you administer anti-viral meds in VIR M?

A

You shouldn’t, not unless it gets out of hand

57
Q

What is the Tx of VIR M?

A

Largely supportive and monitoring

58
Q

What is ENCEPHALITIS? (ENCEPH)

A

Inflm of the brain tissue

59
Q

Specifically what brain tissue is affected in ENCEPH/

A

Parenchymal tissue

60
Q

T or F:

ENCEPH is usually VIRAL

61
Q

What 2 VIRUSES are associated w ENCEPH?

A
  • Herpes simplex type 1

- Arbovirus

62
Q

Where does the ARBOVIRUS generally come from?

A
  • Ants
  • Crabs
  • Lobsters
  • Ticks
  • Many things like the above
63
Q

ENCEPH is highly _________

64
Q

What causes the degeneration of cell bodies in ENCEPH?

A

Virus disrupts the genetic info within the neuron, causing neurons to lyse,
resulting in degeneration of cell bodies and necrosis of healthy neurons

65
Q

What causes hemorrhage in ENCEPH?

A

BVs are affected through the inflm process and tissue damage, causing hemorrhage

66
Q

What causes edema in the brain d/t ENCEPH?

A

Inflm causes exudate production resulting in edema in the brain tissue

67
Q

How does the disease differ if pt is infected w the HERPES VIRUS as opposed to the ARBOVIRUS?

A 
ARBO = self limiting (~2 weeks)
HERPES = more severe, requiring more aggressive Tx
68
Q

Systemic mnfts of ENCEPH?

69
Q

Local mnfts of ENCEPH?

A

Seizures & coma d/t neurological disturbances, fever, nuchal rigidity, and headache (fever and headache normally considered systemic but because this is an issue within the brain they are local)

70
Q

What is the mortality rate of ENCEPH?

71
Q

What are the Txs for ENCEPH?

A
  • Antiviral drugs for HERPES
    • Acyclovir IV
  • Symptom management
72
Q

Is a SEIZURE a disease or a mnft?

73
Q

What causes SEIZURES?

A

Excessive, acute, uncontrolled neural stimulation (altered behavior and movements)

74
Q

Is EPILEPSY a disease or a mnfts?

75
Q

What is EPILEPSY characterized by?

A

Recurrent, unprovoked, chronic SEIZURES

76
Q

What is the Et of SEIZURES?

A

Changes to the NEURILEMMA

77
Q

Describe PRIMARY SEIZURES?

A
  • Unprovoked
  • Idiopathic
  • Genetic??
    • Not a mutated gene, but a predisposition
78
Q

Describe SECONDARY SEIZURES?

A
  • CNS injury
  • Fever (esp in kids)
  • May come right after severe infct
  • Hypoxia
    • Brain is AEROBIC only, cannot use ANAEROBIC as
      a last resort
  • Hypoglycemia
  • ‘Lyte imbalance
79
Q

What is the origin of PARTIAL SEIZURES?

A

Focal (one hemisphere)

80
Q

How do SIMPLE PARTIAL and COMPLEX PARTIAL SEIZURES differ from each other?

A 
SIMPLE = No l/o consciousness 
COMPLEX = L/o consciousness
81
Q

What hemisphere does a GENERALIZED SEIZURE affect?

A

Both! It is non-focal

82
Q

How does NEURONAL DISCHARGE contribute to SEIZURES?

A

There is an acute, extreme inc in NEURONAL DISCHARGE that causes SEIZURES to happen

83
Q

Where does the NEURONAL DISCHARGE take place?

A

In the CEREBRAL CORTEX and HIPPOCAMPUS

84
Q

Where is the EPILEPTOGENIC FOCUS?

A

In the CORTEX and HIPPO

85
Q

Are the adjacent NEURONS affected by the over-stimulated ones?

86
Q

How are inhib NEURONS affected during a SEIZURE?

A

They are overwhelmed. I can totally relate to you inhibitory NEURONS :(

87
Q

When does a SEIZURE end?

A

When NEURONAL activity is controlled

88
Q

What happens during the intermittent contraction-relaxation phase?

A

Spastic, rigid movements

89
Q

What is the last phase in a SEIZURE?

A

The postictal phase

90
Q

What happens during the postictal phase?

A

The pt appears to be sleeping, drowsy, etc

91
Q

How might LACTIC ACIDOSIS occur during a SEIZURE if the brain is unable to metb anaerobically?

A

Other muscles throughout the body are also involved during a SEIZURE, and if the SEIZURE requires more o2 and ATP than the body is able to provide, hypoxia will set in, triggering anaerobic metb and as a result - LACTIC ACIDOSIS

92
Q

What is a STATUS EPILEPTICUS?

A

A prolonged SEIZURE

93
Q

What is the use of an EEG with a person who has had a SEIZURE?

A

It is used to detect or visualize the damage present

94
Q

Tx for SEIZURES?

A
  • Prevent injury during a SEIZURE
  • Anticonvulsants eg Ativan
  • Preserve brain Fx eg prevent ACIDOSIS
95
Q

What is a long term Tx for SEIZURES?

A
  • Anticonvulsants

- Sx??

Bio 252 (24 decks)

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