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PARKINSON'S DISEASE & MYASTHENIA GRAVIS Flashcards

1
Q

What is parkinson’s disease?

A

A chronic, progressive neurodegenerative disorder

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2
Q

Parkinson’s disease are characterized by:

A

-bradykinesia
-rigidity
- tremor at rest
- gait changes

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3
Q

what is bradykinesia?

A

slowness in the initiation & execution of movement

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4
Q

what is rigidity?

A

increased muscle tone

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5
Q

Etiology of Parkinson’s disease

A

-idiopathic
- traumatic brain injury
- Exposure to manganese, pesticides, herbicides, and chemicals
-gene mutations

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6
Q

What is parkinsonism?

A

A syndrome made up of disorders that mimic parkinson’s disease

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7
Q

Parkinsonism symptoms occur at

A

Symptoms occur after exposure to chemicals and metals

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8
Q

Degeneration of nerve cells in the brain

A

Parkinson Disease

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9
Q

Drug-induced, head trauma, neurological disease

A

Parkinsonism

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10
Q

Progresses slowly

A

Parkinson disease

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11
Q

Progresses more rapidly

A

Parkinsonism

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12
Q

Lesion in the basal ganglia

A

Parkinson disease

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13
Q

Bradykinesia, stiffness and tremor

A

Parkinsonism

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14
Q

Ongoing loss of motor control and non-motor control symptoms

A

Parkinson Disease

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15
Q

Similar to PD; symptoms disappear after removing the cause

A

Parkinsonism

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16
Q

Continuation etiology of parkinson disease

A

-degeneration of the DA- producing (dopamine producing) neurons in the substantia nigra of the midbrain

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17
Q

What is DA producing neurons?

A

needed for normal function of the extrapyramidal motor system

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18
Q

What are the extrapyramidal motor system?

A

-posture
- support
- voluntary motion

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19
Q

What is lewy bodies?

A

-unusual clumps of protein inside neurons
-indicates abnormal brain function

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20
Q

What is the common manifestation of Parkinson disease?

A

-Tremor
-Rigidity
- Bradykinesia
- Postural instability

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21
Q

What is tremor?

A

-often the first sign
- worsened by increased concentration
- can involve the diaphragm, tongue, lips and jaw

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22
Q

What is pill rolling?

A

Hand tremor; rolling a pill or coin

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23
Q

What is rigidity?

A

-increased resistance to passive motion when the limbs are moved through their range of motion (ROM)
-muscles do not relax; muscles soreness, feeling tired and achy

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24
Q

Bradykinesia

A

-slow movement
- due to decreased impulses from the basal ganglia
- task become frustratingly slow
- Lack natural activities like blinking, swinging of arms while walking, and swallowing saliva

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25
Characteristics Appearance of PD
-Blank facial expression - Slow, monotonous, slurred speech - Tremor - Short, shuffling gait ( festination) - Forward tilt to posture
26
What is posture instability?
-Being unable to stop themselves from going forward (propulsion) or backward (retropulsion) -they are at risk for falls/injury
27
Complications of PD
-dysphagia - malnutrition - aspiration - neuropsychiatric problems (depression, hallucinations) - dementia
28
Diagnosis of PD
-Pull test - DaT Scan (gold standard)
29
Examiner stands behind the patients and by pulling on their shoulder tries to make them fall backwards
Pull Test
30
What is pull test?
Examiner stands behind the patients and by pulling on their shoulder tries to make them fall backwards
31
A special CT scan; detects DA function in the brain and distinguish PD from similar diseases
Dat Scan
32
The purpose of the drug for PD
to correct the imbalance of neurotransmistters
33
Examples of antiparkinsonian drugs
-Levodopa with carbidopa (Sinemet)
34
Purpose of antiparkinsonian drugs
-Enhance the release of supply of DA (dopaminergic) - blocks the effects of the overactive cholinergic neurons in the striatum
35
Excess amount of dopamine drugs which worsens condition
Paradoxical intoxication
36
Primary treatment for symptomatic patients
Levodopa with carbidopa
37
More ____ reaches brain
levodopa
38
What is levodopa with carbidopa?
primary treatment for symptomatic patients
39
What is levodopa?
Precursor of DA; converted go DA in the basal ganglia
40
Precursor of DA; converted go DA in the basal ganglia
Levodopa
41
What is carbidopa?
inhibits the enzyme dopa-decarboxylase ( breaks down levodopa)
42
Example of anticholinergic drugs
Trihexyphenidyl & Benztropine (Cogentin)
43
Trihexyphenidyl & Benztropine (Cogentin)
-decreases the activity of acetylcholine -helps with tremors & rigidity
44
Examples of monoamine oxidase type B (Mao-B inhibitors)
Rasagiline (Azilect)
45
Rasagiline (Azilect)
-combined with carbidopa/levodopa - Inhibits mao-b; increases DA levels - Less effective in treating motor symptoms
46
What is the surgical management of PD?
-Deep Brain Stimulation - Ablation Surgery
47
Deep brain stimulation
-PD for more than 5 years -Involves placing an electrode and deliver a specific current to the targeted brain location -Reduces the increased neuronal activity produced by DA depletion
48
Involves placing an electrode and deliver a specific current to the targeted brain location
Deep Brain Stimulation
49
Reduces the increased neuronal activity produced by DA depletion
Deep Brain Stimulation
50
Ablation Surgery
- Involves finding, targeting, and destroying an area of the brain affected by PD - Destroys tissue that produces abnormal chemical or electrical impulses leading to tremors or other symptoms
51
Involves finding, targeting, and destroying an area of the brain affected by PD
Ablation Surgery
52
Destroys tissue that produces abnormal chemical or electrical impulses leading to tremors or other symptoms
Ablation Surgery
53
Nursing Management of PD
-Promotion of Exercise - referral to physical therapy programs and speech therapists - Promotion of safety - Aspiration precaution - Give diet that can be chewed easily (6 meals a day is less tiring than 3 big meals daily) - Emotional support
54
An autoimmune disease of the neuromuscular junction
Myasthenia Gravis
55
Presence of fluctuating weakness of certain skeletal muscle groups
Myasthenia Gravis
56
Weakness increases with muscle use
Myasthenia Gravis
57
What is Myasthenia Gravis?
- An autoimmune disease of the neuromuscular junction - Presence of fluctuating weakness of certain skeletal muscle groups -Weakness increases with muscle use
58
What is the etiology & pathophysiology of Myasthenia Gravis
-Autoimmune process - Medications (can worsen MG)
59
Autoimmune process
-Antibodies attack ACh receptors, resulting in a decreased number of ACh receptor (ACHR) sites at the neuromuscular junction. -Prevents ACh molecules from attaching and stimulating muscle contraction
60
Medication is one of the cause of myasthenia gravis, what medications that can worsen the MG?
-B-adrenergic blockers - quinidine - phenytoin (dilantin) - Certain anesthetics - aminoglycoside antibiotics
61
What is myasthenic crisis?
an acute exacerbation of muscle weakness triggered by: -infection -surgery -emotional distress -pregnancy -corticosteroids
62
Myasthenic crisis are triggered by:
-infection - surgery - emotional distress - pregnancy - corticosteroids
63
Myasthenic crisis occurs at
Occurs in the first 2 years after diagnosis
64
Complications of Myasthenia Gravis
Muscle weakness in areas that affect swallowing and breathing -aspiration - respiratory insufficiency - respiratory infection
65
Clinical Manifestations of Myasthenic crisis
-Fluctuating weakness of skeletal muscle - Strength restored after resting - muscles are the strongest in the morning; become exhausted with continued activity
66
Clinical Manifestations of Myasthenia Gravis
-Change in facial expression - Chronic muscle fatigue - Difficulty breathing - Difficulty chewing or swallowing - Drooping eyelids (Ptosis)
67
Diagnostics of Myasthenia Gravis
- Physical examination - AChr antibody test - Single-fiber electromyography (EMG) - Nerve stimulation testing - CT scan
68
Drugs for Myasthenia Gravis
Anticholinesterase medications
69
What is anticholinesterase medications?
- enhances function of the neuromuscular junction - prolongs the action of ACH and facilitate transmission of impulses by inhibiting acetylcholinesterase
70
Examples of Anticholinesterase Medications
-Pyridostigmine (Mestinon)
71
Surgical Management of Myasthenia Gravis
Thymectomy
72
For patients with thymoma
Thymectomy
73
Removal of thymus gland
Thymectomy
74
What enhances the thymus?
Thymus enhances the production of ACHR antibodies
75
What is thymectomy?
-for patients with Thymoma - Removal of thymus gland - Thymus enhances the production of ACHR antibodies
76
Other therapies of myasthenia gravis
Plasmapheresis
77
Directly removes circulating ACHR antibodies in the blood
Plasmapheresis
78
Initial choice in myasthenic crisis
Plasmapheresis
79
decreases symptoms
Plasmapheresis
80
What is plasmapheresis?
-directly removes circulating ACHR antibodies in the blood -initial choice in myasthenic crisis - decreases symptoms

NEC 3 (16 decks)

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