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pom-neuro disorders Flashcards

1
Q

seizures- do they mean epilepsy? what else?

A

stress, sleep deprivation, drug/alcohol withdrawal, syncope

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2
Q

2 types of seizures?

A

partial (focal, local), generalized (convulsive or non-convulsive)

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3
Q

3 types of partial seisures

A

simple partial, complex partial, partial sizuresevolving to secondarili generalized seizures

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4
Q

5 types of generalized seizures

A

absence (petit mal), myoclonic, tonic clonic (grand mal), tonic, atonic

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5
Q

most common infection in kid?

A

acute otitis media

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6
Q

who is most likely to get seizure?

A

kid- due to fever (otitis media)

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7
Q

who else is likely to get seizures

A

elderly

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8
Q

why do old people get seizures

A

cerebrovascular dz

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9
Q

causes of seizurs- 6

A

head trauma, intracranial neoplasm, meningitis/encephalitis, metabolic disturbances, drug effects, ideopathic/epilepsy

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10
Q

does type of brain lesion determine what type of seizure you’ll have?

A

no

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11
Q

pathophysiology of seizure

A

excessive focal neuronal discharge that may spread to areas throughout the brain

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12
Q

first stage of gm seizure

A

aura

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13
Q

second stage of gm seizure

A

epileptic cry (air through diahram)

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14
Q

describe tonic phase of gm seizure

A

muslce rigidity, pupil dilation, eye movment, lose congiousness

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15
Q

describe clonic phase of gm seizure

A

uncoordinated movment

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16
Q

describe post-ictal phase (post neuronal firing ) of gm seizure

A

headache, confusion, sleepy

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17
Q

status epilepticus

A

emergency- seizure doesnt stop

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18
Q

describe absence seizure

A

seconds of lost conciousness, facial twitch, daydreaming, eyes flutter

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19
Q

ied-

A

interictal epileptiform discharges- neurologist looks for on eeg

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20
Q

tests to do on pt with seizure

A

diag, hx, blood test (cbc, electroylytes, glucose), eeg, ct, mri

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21
Q

draw what seizure looks like on eeg

A

ied- bigger squiggles than normal

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22
Q

who should take drugs for seizure

A

high risk pt? not sure who that would be

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23
Q

after how long of not having a seizure can you come off the drugs

A

2 yr

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24
Q

classic drugs for seizures

A

carbamazepin, phenytoin, valproic acid, phenobarbital

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25
Q

recent drugs for seizures

A

gabapentin, lamotrigine, oxcarbazepin, topirimate

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26
Q

valproic acid side effect?

A

bone marrow supression

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27
Q

what percent of pt are resistant to drugs?

A

20

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28
Q

what should we do for pt who are resistant to drug

A

surgery or vagus nerve stimultion (increases seizure threshold)

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29
Q

how do we do dental tx on pt with seizures?

A

gotta do v. thorough hx- lab eval if needed (if on phenobarb do lab bc narrow TI

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30
Q

if pt is on VNS (vagal nerve stimulator) what should you avoid?

A

diathermy or any other device that heats up-

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31
Q

should you use a mouth prop on a seizure pt?

A

only if you have a retrieval method

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32
Q

what could we use if pt is having seizure to stop it?

A

diazepam iv or im

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33
Q

drugs that cause gingival hypertropy?

A

rinses: chlorohexidine rinse, folic acid, dilantin

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34
Q

what other oral issue is related to seizures

A

dry mouth, candida

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35
Q

what is ms

A

demylination of neurons in cns, an most common autoimmune dz of nervous system

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36
Q

age for ms?

A

age 20-40

37
Q

men or women get more ms?

A

women 3/2

38
Q

what infectious agents can cause ms?

A

trigger by infectious agent (rabies, mumps, measles, clap, hsv1,2, ebv, hhv-6

39
Q

what else can cause ms other than infections ?

A

geneic factors (20-49x greater chance child getting it if parent has), geographical factors- countries further from equiator get it worse

40
Q

what cant the nerves do in ms

A

impulse cant travel down ason, no saltatory conductin

41
Q

affected areas in ms are called

A

plaques

42
Q

what are plaques made of

A

macs, b+t cells, plasma cells, cytokines, ig

43
Q

most common demylinated regins

A

optic nerve, periventricular cerebral white, cervical spinal cord

44
Q

uhthoff’s sign

A

symptoms are more hnoticable when there is a rise in body temp, so do some exercisoes to inc body temp to test this

45
Q

lab findings for ms

A

inc ig in csf, mylin basic protein in csf (from breakdown of mylin), and mri sos hypodense demyelinated regions

46
Q

meds for pt w ms?

A

anti inflamms, interferon b, chemotherapeutics

47
Q

drug for spasticity

A

baclofen, bdz

48
Q

drug for bladder control

A

anticholinergic

49
Q

drug for fatigue

A

stimulant

50
Q

symptoms dentist sould note when examining v1,2 3 if involved in ms

A

facial pain, can mimic trigemical neuralgia, facial paralysis, oral symptoms like skipping words, myokymia (muscle fasciculations)

51
Q

ms relapse- should we treat?

A

only for emergency

52
Q

when to tx?

A

during remission

53
Q

cerebral palsy definition

A

disorders in the develpment of movemnt and posture, causing activity limitation, that are attributed to non progressive disurbances that occured in developing fetal or infant brain

54
Q

motor probs of cp can be accompanied by these other things

A

disturbance in sensation, cognition, communicaiton, perception, behavior, and seizures

55
Q

cuases of cp

A

anoxia, ischemia during labor, trauma, congenital infections, rubella, cmv, hsv, syphilis, influenza

56
Q

spastic cp

A

70-80 percent of cases- inc muscle tone, results from upper motor neuron damage

57
Q

types of spastic cp

A

diplegia, hemipleigia (one side of body) quadriplegia

58
Q

oral problems seen in cp pt

A

malocc, injury, bruxism, sialorrhea, speach and swallowing difficulty, oral hygiene, venue for tx

59
Q

parkinsons definition

A

dopamine deficiency causes degenerative cns disorder

60
Q

primary parkinsons

A

degen of dopa neurons in substantia nigra

61
Q

secondary parkinsons

A

loss or interference w action of dopaimine

62
Q

factors cuasing parkinsons maybe

A

genetic mut, stroke, brain tumor, head injury, exporue to chemicals

63
Q

signs of parkinsons-

A

resting rhythmic tumors, pill rolling, pain, bladder probsl, mood problems, dementia

64
Q

meds for parkinsons

A

sinemet (carbidopa and levodopa)

65
Q

glossodynia

A

burning mouth syndrome

66
Q

oral issues in pt with parkinsons

A

oral and motor and sensory impariment, dysphagia, xero, candida, burning mouth suynrome

67
Q

things to help parkinsons pt with oral health

A

electric brush, chlorohexidine rinse, topical fluoride, sialogogues (for xero)

68
Q

alzheimers dz

A

neruodegenerative disorder characerized by dementia, gradual decline in cognitive processes, may lead to toal mental and physical disability

69
Q

primary pathophysio of alz

A

beta amyloid depositon, neuritisplaques, neurofibrillary tangles

70
Q

stage 1 alzheimers

A

memory loss, time disorientation, judgement erros, decline in appearance or hygiene

71
Q

3 stages of alz progress over

A

8-10 yr

72
Q

stage II alz

A

intellectual decline, cant recognize self, understand speech or recognize familar objects or people

73
Q

stage 3 alz

A

terminal- disoriented, wasting, seizure, hyperorality, aggressive

74
Q

death in alz is from?

A

malnutrition, infection, heart dz

75
Q

drugs for alz

A

acetylcholinesterase inhibitors- tacrine, donepezil, rivastigmine, galantamine

76
Q

what otc can help with alz

A

gingo biloba, nsaid, antioxidant

77
Q

memantine

A

know- nmda receptor antagonist

78
Q

nmda receptor antagonist action-

A

regulates glutamate activity, healp with learning and memory

79
Q

if you put a restoration in a pt that has alz and it is high twhat can happen

A

it can trigger a behavioral change

80
Q

myashthemia gravis

A

AI dz unknown cause

81
Q

what happens in mg

A

autoab combine with ach at neuromusclar jxn, prevent transmission of nerve impulse

82
Q

more men or women in mg?

A

women, but men more in the 60s and 70s yrs old

83
Q

what abnomrality do mg pt frequently have?

A

thymic

84
Q

what happens in itital phase of myasthenia gravis?

A

ptosis, diplopia, inability to blink continually

85
Q

myasthenia crisis

A

resp involvment, in 20% of pt, 8% fatal

86
Q

diag of mg?

A

serum level of ach receptor ab

87
Q

tx of mg

A

acetylcholinesterase inhibitors

88
Q

4 main tx modality in mg

A

anticholinesterase, thymectomy (dec quanity of ach receptor ab), ummunosupp therapy (high dose coritcostreoid), short term immunotherapy (plasmaphersis, iv ig)

89
Q

dental considerations for mg

A

cranial nerve exam, faial and masticatory weakness, probs with prostethics, do short morning appt when they are stronger, can can’t give muscle relaxants or anxiolytics to help bc ineract with mg

pom (7 decks)

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