Pathology Flashcards
Parkinson’s disease symptoms
Pill rolling tremor Akinesia Bradykinesia Lead pipe rigidity Hypertonia Fatigue Sleep disorders - violent dreams Sweating Constipation
Parkinson’s disease pathology
Death of dopaminergic cells in pars compacta of the substantia nigra
Prevents feedback loop of the basal ganglia
Loss of control over movement and some involuntary movement
Huntington’s pathology
Autosomal dominant condition
Htt protein gets CAG repeats
Gain of toxic function
Damage is originally in the striatum
Huntington’s symptoms
Loss of control over movement - Huntington’s chorea
Altered mood
Loss of higher cognitive functions
Myasthenia gravis pathology
IgG mediated blocking of the end plate ACh receptor
Myasthenia gravis symptoms
Fluctuating, fatiguable weakness of skeletal muscles
Extraoccular muscles often first
Progresses to limb weakness
Bulbar involvement causes dysphagia, dysphonia, dysarthria
Respiratory muscle involvement
Can have acute crises
Drugs exacerbating myasthenia gravis
Aminoglycosides Beta blockers CCBs Quinidine Procainamide Succinylcholine Chloroquinine, penicillamine Mg ACE inhibitors
Causes of cerebellar dysfunction
Tumour
Cerebrovascular disease
Genetic - eg Friedrich’s ataxia
Cerebellar signs
Dysdiadochokinesia Ataxia Nystagmus Intention tremor Speech - scanning or slurred Hypotonia
Upper motor neurone signs
Lesion above anterior horn cell
Hyper reflexia, hypertonia, positive Babinski sign - loss of descending inhibition
Clonus, spastic paralysis, cog wheel/lead pipe, choreoforms
Decerebrate
No reaction to pain
Worse than decorticate
Total loss of rubrospinal tract
Decorticate
No localisation of pain
But still a reaction
Lower motor neurone signs
(If upper and lower occur together, presents as lower) Muscle weakness Hypotonia Muscle atrophy Hypo/areflexia Fasciculations
Bladder lower motor neurone lesion
Loss of stretch reflex
Overflow incontinence
Bladder upper motor neurone lesion
Loss of coordination of input
Void as soon as stretch reflex is activated
Void incompletely
What is dementia?
Acquired loss of cognitive ability sufficiently severe to interfere with everyday function and quality of life.
Untreatable and progressive
Loss of intellect, personality and behaviour
Due to loss of neurones or loss of communication between neurones
Causes of dementia
Age related
Infective - CJD, HIV, viral encephalitis
Metabolic - hepatic disease, thyroid disease, parathyroid disease, cushings
Nutritional - Wernicke-Korsakoff (thiamine), B12, folate
Huntington’s
Hydrocephalus
Trauma
Tumour
Chronic inflammatory - collagen vascular disease, vasculitis, MS
Alzheimer’s disease
Main age related dementia
Symptoms of slowly progressive mental degradation
2:1 female
Duration usually about 5 years, some live up to 20.
Terminal phase - near complete or complete loss of memory, speech and continence
Pick disease
Age related dementia Frontal or temporal lobe Personality/behavioural changes Difficulty relating to others Difficulty organising everyday activities Understanding and fluency of language
Cortical dementia
Results in global type personality changes
Complex disabilities
Subcortical dementias
Slowness and forgetfulness
Changes in movement
Increased muscle tone
Savant syndrome
Severely autistic people
Have one or more areas of expertise which don’t correspond with their overall neurological limitations
