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Physiology > Section 3 Lecture 6 > Flashcards

Section 3 Lecture 6 Flashcards

1
Q

What does DD stand for:

A

developmental disability

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2
Q

In order to be classified as a developmental disability in must occur before what age?

A

22, in NYS

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3
Q

List of DD’s:

A

autism, ID, CP, epilepsy/seizure disorder, neurological impairment, traumatic brain injury (22 or younger in NYS)

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4
Q

Two causes of DS:

A

trisomy-21 (all cells w 47 chromosomes) and trisomy mosaic (Some cells have 46 chromosomes, some have 47)

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5
Q

Most children w DS are born to (younger/older) women.

A

younger

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6
Q

Who is at greater risk for have a child w DS, younger or older women?

A

older

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7
Q

What % of DS babies result in miscarriage?

A

75%

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8
Q

How to detect DS:

A

amniocentesis

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9
Q

Are older dads at a higher risk of having a child w DS?

A

Yes

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10
Q

DS characteristics:

A

Higher arched palate, underdeveloped midface, and development of the CNS, face and mouth altered

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11
Q

An ID is clasified as an IQ lower than:

A

70

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12
Q

T or F? There is a huge range of IQ’s in DS.

A

T

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13
Q

Which portion of the brain is most affected with DS?

A

cortex, brain is smaller overall (about 25% smaller?)

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14
Q

Can strabismus be corrected?

A

yes, by surgically shortening an occular m.

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15
Q

Mx issues that come with DS:

A

heart surgery, strabismus, myopia, spontaneous nystagmus, short, obese, shorter life expectancy, protruding tongue, hypotonia w delayed M milestones, early onset Alzheimers, cervical spine instability (atlanto-axial subluxation: too much moves at the j bw skull and cord, danger of s.c. injury (positioning in dental chair)

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16
Q

nearsightedness is aka:

A

myopia

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17
Q

Why are DS and AD connected?

A

1 of the chromosomes implicated in AD is #21. Extra 21 means more likelihood of developing AD

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18
Q

What is atlanto-axial subluxation?

A

too much moves at the j bw skull and s.c., danger of s.c. injury in positioning in dental chair. Atlas can project too far anterior when leaning forward

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19
Q

The paralympics is for people w:

A

physical disability

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20
Q

The special olympics is for people w:

A

ID/DD

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21
Q

Issues related to DS affecting dental tx:

A

IS dysfunction, abnormal develop of teeth, incorrect # of teeth, late eruption of baby teeth, inc gum disease, retention of baby teeth, different order of tooth eruption, large/ small tongue, large/small jaw, grooves on tongue, behavioral issues, seizures, position in the dental chair bc of cervical instability, cognitive limitations.

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22
Q

Epilepsy is aka:

A

seizure disorder

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23
Q

What % of people w seizure disorders can not control the seizures w drugs?

A

35%

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24
Q

Define intractable:

A

can not control with drugs

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25
Q

Recurrent, unprovoked seizures:

A

seizure disorder

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26
Q

What can cause a child to have a seizure if its not due to epilepsy?

A

High fever

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27
Q

Neurological basis of seizures:

A

spontaneous, recurrent, simultaneous, massive discharges of neurons (AP’s at the same time)

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28
Q

Cause of seizure disorders:

A

DD, CP, DS, genetic mutations in genes affecting receptors/ transmitters in the brain, head injury, metabolic disturbances, paraneoplastic syndrome (metabolic effects of cancer on tissue), epilepsy secondary to cancer/tumors, brain tumors, autoimmune epilepsy (ABs to key proeins in neurotransmission), alcohol withdrawal

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29
Q

PET scan measures:

A

metabolic activity

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30
Q

Epilepsy syndromes:

A

Lennox-Gastaux syndrome, Benign Rolandic Epilepsy, Landau-Kleffner Syndrome, Rasmussen’s syndrome, Dravet Syndrome, Infalntile spasms

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31
Q

2 major classes of seizures:

A

partial (localized to a specific region) and generalized (all over brain)

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32
Q

How many types of seizures are there?

A

40+

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33
Q

What varies w seizure type?

A

part of CNS involved

34
Q

2 types of partial (focal) seizures:

A

simple and complex

35
Q

The progression of seizure contractions across the body in Jacksonian epilepsy reflects:

A

the orderly map of the body in MC, the “March of Epilepsy”, consciousness remains during

36
Q

Movement or sensory experience w no loss of consciousness or postural control:

A

partial simple seizure

37
Q

Partial complex seizures originate:

A

in the temporal lobe

38
Q

What types of movements are involved with partial complex seizures?

A

complex moves (lip-smacking)

39
Q

Are pts conscious or unconscious during partial (focal) seizures?

A

conscious

40
Q

Are pts conscious or unconscious during partial complex seizures?

A

not fully conscious, may not remember the seizure

41
Q

What type of seizure is often preceded by an “aura?”

A

Partial complex seizures

42
Q

Do people fall to the ground immediately with a partial complex seizure?

A

no, they feel funny prior

43
Q

How do partial complex seizures begin?

A

as focal and spread or “generalize”

44
Q

2 major classes of generalized seizures:

A

Tonic-clonic (grand mal) and absense (petit mal)

45
Q

Tonic-clonic seizure:

A

protective reflexes don’t work, reflexes involving vestibular input don’t work, pt instnatly looses consciousness and falls, initial period of rigidity

46
Q

What type of seizure results in immediate loss of consciousness and falling?

A

tonic-clonic

47
Q

What is the tonic phase?

A

Full body rigidity

48
Q

What is the clonic phase?

A

back and forth moves of all body parts (alternating contraction of agonists and antagonists) (often loss of bladder control)

49
Q

What type of seizures can have an environmental stimulus?

A

tonic-clonic

50
Q

Seizure first aid:

A

keep person safe, don’t hold down, don’t put anything in the mouth

51
Q

When are tonic-clonic seizures dangerous?

A

Status epilepticus: continues for more than 5 minutes, tx with IV drugs and life support (resp compromised)

52
Q

How long do most seizures last?

A

a few minutes

53
Q

What is the period after a seizure called?

A

Post-ictal period

54
Q

How long does the post-ictal period last?

A

few minutes to several hours of deep sleep

55
Q

Which parts of the brain are involved in absence seizures?

A

the whole brain (petit mal)

56
Q

What does a absence seizure look like?

A

No loss of postural tone, looks like kid is daydreaming, may not be recognized as a seizure

57
Q

Who are affected by absence seizures?

A

children, frequently outgrown

58
Q

EEG are used to:

A

Record seizure type and look for seizure focus, electrodes on scalp record many neurons

59
Q

Duration of EEG recording:

A

less than one hour

60
Q

What does LTM stand for?

A

Long-term monitoring, usually w video recording as well

61
Q

When is a more invasive EEG with electrodes on the dura used?

A

When there is a seizure focus, to try to localize, PET can help too

62
Q

How can a seizure focus be localized?

A

EEG w electrodes on dura or PET

63
Q

AED drugs stands for:

A

Anti-Epileptic Drugs

64
Q

Break-through seizure:

A

when a pt will has a seizure despite being on medications

65
Q

Drugs for seizures:

A

Tegretol, Depakote, Lamictal, Felbamate, Dilantin, Keppra, Neurontin, Onfi, Topamaz, Manzel, Vimpat

66
Q

T or F? Most people can control their seizures by taking 1 Mx.

A

F. some take 4-5

67
Q

How do AED’s work?

A

dec excitation, inc inhibition by inc GABA, or alter levels or receps

68
Q

How is the correct dosage of Mx often achieved with AED’s?

A

blood levels

69
Q

Side effects of AEDs:

A

sedation, Vit D metabolism, bone density, triggering of allergic rxn, weight gain/loss, pain mgmt, used in psychiatry

70
Q

AED’s used in psychiatry:

A

Tegretol, Depakote, Lamictal

71
Q

AED’s that can trigger allergic rxns:

A

Tegretol, Dilanton, phenobarbital

72
Q

What AED interferes with Vit D metabolism?

A

Tegretol

73
Q

What diet helps prevent seizures?

A

fatty/ketogenic, modified Atkins diet (Johns Hopkins), low glycemic index diet (Mass. General)

74
Q

What seizure pts will respond well to a high fat diet?

A

Those w glucose transporter mutation, do genetic test for this

75
Q

When is surgery useful in seizure mgmt?

A

“focal cortical dysplasia”, remove seizure focus abnormal structure in restricted region of cortex, cut corpus callosum, prevents spreading, young kids w severe cases, remove an entire hemisphere

76
Q

VNS stands for:

A

Vagal neve stimulator

77
Q

What does a VNS do?

A

electrical stimulation to brain via CN X by an external magnet, mechanism not understood

78
Q

T or F? Protective reflexes are still functional during a seizure.

A

F.

79
Q

Seizure disorders often accompany:

A

DD’s, CP, DS

80
Q

What should you ask a pt known to have seizures?

A

typical duration? triggers?

81
Q

Dental side effect of Dilatin:

A

gingival overgrowth that requires surgery

82
Q

How are some people with autism treated for dental care?

A

sedation or general anesthesia in hospital

Physiology (55 decks)

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