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PCE - Neurology > Tumours and Degenerative neuromuscular/neurological disorders > Flashcards

Tumours and Degenerative neuromuscular/neurological disorders Flashcards

1
Q

Tumour etiology

A

viruses, chemical agents, physical agents (radiation, asbestos), drugs, hormones, alcohol

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2
Q

Tumour treatment

A

surgery, radiation, chemotherapy, biotherapy, antiangiogenic therapy, hormonal therapy

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3
Q

Tumour types

A 
Epithelial - Carcinoma 
Mesenchymal - Sarcoma 
Glial - glioma 
Lymphoid - lymphoma 
Hematopoietic - leukemia
Melanocytic - melanoma
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4
Q

Types of lung carcinoma

A

squamous metaplasia, squamous dysplasia, carcinoma in situ, invasive carcinoma

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5
Q

Colon tumours is the ___ cause of death

A

2nd

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6
Q

Prostate cancer Rx

A

surgery, external beam radiation, brachytherapy, androgen deprivation therapy

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7
Q

3 types of skin cancer

A
  • Basal Cell Carcinoma
  • Squamous Cell Carcinoma
  • Malignant melanoma
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8
Q

What is the most common form of skin cancer

A

Basal cell Carcinoma

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9
Q

What is the appearance of Basal cell carcinoma?

High risk or low risk of spreading?

A

Translucent and red in colour

Low risk of spreading

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10
Q

What is the appearance of Squamous cell carcinoma?

High risk or low risk of spreading?

A

Solid skin tumor, often volcano shaped

High risk for metastasis

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11
Q

What is the most dangerous form of skin cancer?

A

Malignant melanoma

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12
Q

ABCD rule for melanoma

High risk or low risk of spreading?

A

Asymmetry, Border, Color, Diameter

High

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13
Q

Mutation in Duchennes muscular dystrophy?

Male or female more?

Maternal or paternal carrier?

A

X-link mutation of Chromosome 21 - Dystrophin protein is not produced which is a structural component within muscle tissue - tissue now prone to damage and necrosis

M>F

Maternal Carrier

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14
Q

Duchennes muscular dystrophy effects

A
  • muscle cells are replaced by fat and CT
  • progressive symmetrical wasting
  • in w/c by 10-12 years, die by age 20
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15
Q

Duchennes muscular dystrophy Dx + classic signs

A

Genetic testing, physical exam, CK levels

Gowers Sign - pushing on thighs to stand up off floor
Calf Psuedohypertrophy - Well defined calves but by fat and CT not muscle

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16
Q

Duchennes muscular dystrophy S&S

A
  • proximal muscle weakness
  • waddling gait
  • toe walking
  • lordosis
  • difficulty standing up and climbing stairs, frequent falls
  • lower IQ
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17
Q

Duchennes muscular dystrophy Rx

A
  • exercise by maintain strength and balance (avoid eccentric)
  • respiratory therapy
  • prevention of contractures, seating, equipment
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18
Q

6 other types of muscular dystrophies

A 
Beckers 
Congenital 
Facioscapulohumeral MD 
Myotonic MD 
Emery-Dreifus 
Spinal muscle atrophy
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19
Q

What is beckers muscular dystrophy

A

A slower and progressive form of DMD but not as severe

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20
Q

What is the most common type of muscular dystrophy after DMD

A

Myotonic MD

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21
Q

What occurs in SPinal muscle atrophy

A

Skeletal muscles weaken when anterior horn degenerates

22
Q

Spinal muscle atrophy S&S

A

hypotonia, decreased function, weakness (symmetrical, proximal > distal), fatigue

23
Q

What is another name for Amyotrophic lateral sclerosis

A

Lou Gehrig’s disease

24
Q

What is Amyotrophic lateral sclerosis

A

motor neuron disease w/ gradual deterioration of BOTH UMN and LMN
- can have both flaccid and spastic paresis

25
Q

Amyotrophic lateral sclerosis M or F more common

A

M

26
Q

Amyotrophic lateral sclerosis Disease course

A

2-5 years after Dx - only 10% survive 10 years

27
Q

Amyotrophic lateral sclerosis S&S

A

o paresis in a single muscle group
o corresponding muscle groups are asymmetrically affected (patchy distribution)
o fasciculation’s (twitching)
o Metabolic involvement of the skin (papery, fragile, cold)
o gradual involvement of striated muscle (bulbar = major concern)
o progress to permanent paralysis
o Flaccidity + spasticity may co-exist
o selective sparing (no ocular or cardiac, urethral & anal sphincter)

28
Q

Amyotrophic lateral sclerosis Dx

A

Physical exam, medical history, muscle biopsy (not needed to confirm Dx)

29
Q

Amyotrophic lateral sclerosis Rx

A

Meds, rehab for immobility, symptom relief (spasticity, secretions, psychological)

30
Q

What is spared in amyotrophic lateral sclerosis

A

Ocular
Cardiac
Urethral + anal sphincter

31
Q

What is an essential tremor evoked by? Cause?

A
  • usually evoked by voluntary movement

causes: genetic, Increased thalamus activity

32
Q

What is dystonia? What is it commonly linked to?

Causes?

A
  • involuntary, sustained muscle contractions, writhing
  • commonly linked to a single repetitive action (ie. musicians)
  • causes: genetic, originates from different parts of brain
33
Q

What is Parkinsons Disease (PD)

A

Chronic neurodegenerative disease in basal ganglia

34
Q

What is the pathology of PD

A
  • Decreased dopamine produced by substantia nigra
  • dopamine normally inhibits ACh
  • without dopamine = excessive excitatory output
35
Q

PD Possible causes

A

o viral (infection swelling of brain)
o genetic
o toxic (drugs)
o injury or focal ischemia  can cause PD-like symptoms

36
Q

PD S&S

A

Classic
o bradykinesia: slowness of movement, can result in freezing
o resting tremor
o rigidity: velocity independent resistance to passive stretch
o postural instability

Other

  • loss of automatic movement (ie rolling over in bed)
  • micrographia
  • autonomic abnormalities
  • hypokinesia/akinesia
  • mask face
  • depression, dementia
  • postural hypotension
  • pain
  • sleep disturbance (restless leg)
  • fatigue
  • Dec. fine motor control
37
Q

PD Rx

A
  • drugs (L-dopa + anticholinergic) - patient will have movement tremor b/c of meds
  • education (protective effects of exercise)
  • functional mobility exercise - FOCUS ON BIG MOVEMENTS
    - cueing (tactile, verbal, music)
    - address postural changes and cardiorespiratory fitness
    - transfers, balance and falls prevention
  • prevention of secondary sequelae
  • environment safety and checks
  • care giver involvement and training
  • equipment
38
Q

PD outcome measures

A

UPDRS

Hoens & Yar

39
Q

What is Huntingtons Chorea?

Key features?

A

Hereditary disorder - atrophy of basal ganglia structures, personality disorder, dementia

Abnormal movements (they cant stop moving)

40
Q

Huntingtons Rx

A

symptom management, antipsychotic drugs, safety, nutrition

41
Q

What is Multiple Sclerosis (MS)

A

inflammatory disease : fatty myelin sheaths around brain + spinal cord axons are damaged

A demyelinating disorder

42
Q

MS leads to ___ and ____

A

Demyelination and scarring

43
Q

MS etiology?

A

Unknown

44
Q

MS typical onset? F or M?

A

20-40y F>M

45
Q

4 types of MS

A

Relapsing remitting
Primary progressive
Secondary progressive
Progressive relapsing

46
Q

Key features of relapsing remitting MS

A
  • new/old symptoms resurface or worsen
  • full or partial recovery between relapses
  • each flare up may cause more loss of function
47
Q

Key features of primary progressive

A
  • gradual worsening of symptoms overtime

- may stabilize but no remission

48
Q

key features of secondary progressive

A
  • Begins as relapsing remitting - gets to point where there is no remitting just steady worsening
  • does not re-myelinate
49
Q

Key features of progressive relapsing

A

Some degree of recovery between flares

More gradual slope than relapsing remitting

50
Q

Early symptoms of MS

A 
o	muscle weakness
o	optic neuritis, diplopia
o	sensory changes (paresthesia)
o	b/b incontinence
o	vertigo 
o	fatigue
o	impaired cognition/memory
o	pain
o	depression
51
Q

MS Rx

A

Pharmaceuticals:

  • anti-inflammatories + immunosuppressant’s
  • side effects: heat intolerance, photosensitivity

PT Treatment for:

  • vestibular dysfunction
  • exercise (posture, core, stretches, proprioception, pool therapy, interval training?)
  • osteoporosis (?)
52
Q

Contraindications/precautions to exercise with MS

A
  • Heat
  • Fatigue
  • pregnancy

PCE - Neurology (8 decks)

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