w3 content Flashcards
Parkinsonism vs PD
group of neurological motor symptoms characterized by tremor, rigidity, bradykinesia, and postural instability.
These symptoms can arise from various underlying causes:
__________ = Parkinson’s disease
- idiopathic (genetic or sporadic)
_________ = Parkinsonism
- acquired by:
- infection
- intoxication
- trauma
- drug-induced
The key distinction is whether the parkinsonian motor symptoms result from:
- the neurodegenerative process of ________ Parkinson’s disease
or
- an ________, secondary cause of parkinsonism
Parkinsonism vs PD
group of neurological motor symptoms characterized by tremor, rigidity, bradykinesia, and postural instability. These symptoms can arise from various underlying causes:
- Primary = Parkinson’s disease
- idiopathic (genetic or sporadic)
- secondary = Parkinsonism
- acquired by:
- infection
- intoxication
- trauma
- drug-induced
The key distinction is whether the parkinsonian motor symptoms result from:
- the neurodegenerative process of idiopathic Parkinson’s disease
or
- an external, secondary cause. parkinsonism
______ treatment: Goals of drugs
1. modify the disease process
- avonex 1a - injectable interferon beta
- copaxone – injectable glatiramer acetate
- fingolimod – oral
- dimethyl fumarate – oral
- natalizumab – infusion
- alemtuzumab – infusion
- mitoxantrone – infusion
MS
the neuron
- consists of cell body, axon, myelin sheath and dendrites
_________– metabolic center of the neuron
__________ – short extensions from the body that receive and conduct nerve impulses
_________– extend varying distances from the cell body and carry nerve impulses, myelinated or unmyelinated
__________ – lipid insulates and helps conduct the impulses
the neuron
- consists of cell body, axon, dendrites
- Cell body – metabolic center of the neuron
- dendrites – short extensions from the body that receive and conduct nerve impulses
- axons – extend varying distances from the cell body and carry nerve impulses, myelinated or unmyelinated
- myelin sheath – lipid insulates and helps conduct the impulses
3 classic characteristics of _______
tremor/pill roll
rigidity/cogwheel
bradykinesia
3 classic characteristics of ______
inflammation
demyelination
scar tissue development (gliosis)
PD
MS
3 classic characteristics of ____:
- Tremor: A resting tremor, often described as a “pill-rolling” motion in the hands. Tremor lessens with purposeful movement.
- Rigidity: Increased muscle tone and stiffness, with a “cogwheel” catching sensation when the limbs are passively moved.
- Bradykinesia: Slowness of movement initiation and execution. Simple tasks become difficult as automatic movements are impaired. This leads to shuffling gait and postural instability.
PD
s/s
- insidious onset
- fluctuating weakness of skeletal muscle
- eyes/eyelids
- facial
- speaking
- breathing
- drooling
- difficulty chewing/swallowing
- strength comes back after resting
s/s
!!- bradykinesia – slow movements
!!- cogwheel rigitidy – stiff muslces
!!- resting tremor – pill rolling hand tremor
- shuffling gait
- mask like expression
- postural instability
- gradual onset and progression
- may start with 1 side of body at first, progresses to both sides
s/s
- cognitive fog
- vision issues
- depression
- fatigue
- pain – chronic, acute, burning, stabbing
- bowel/bladder issues
- weakness – including paralysis
- sexual issues
- muscle stiffness/spasms
- numbness/tingling
- walking/balance issues
- vertigo
MG
PD
MS
MG Patho
1. anti-AChR antibodies attack ___________ receptors
2. ___crease in Ach/acetylcholine receptor sites at the neuromuscular junction
3. this prevents Ach/acetylcholine molecules from attaching and stimulating ______________
Patho
1. anti-AChR antibodies attack Ach/acetylcholine receptors
2. decrease in Ach/acetylcholine receptor sites at the neuromuscular junction
3. this prevents Ach/acetylcholine molecules from attaching and stimulating muscle contraction
remeber with MG we see weakness of skeletal muscle
migraine
Classifications
______ present – visual sensory or motor s/s
______ not present – most common
______ – 15 days/month for 3 months
aura
aura
chronic
- works with cerebellum to make smooth and coordinated movements
- has cells that produce dopamine
Basal ganglia
How to differentiate myasthenic gravis crisis vs cholinergic crisis if patient presents the same (with respiratory insufficiency and extreme muscle weakness):
1. give ___________– short acting cholinesterase inhibitor increases ___________ temporarily
- if they are in ____ crisis = they will improve bc of increase in acetylcholine
- if they are in _____ crisis = they will worsen bc they have too much acetylcholine
- give edrophonium – short acting cholinesterase inhibitor increases acetylcholine temporarily
- if they are in MG crisis = they will improve bc of increase in acetylcholine
- if they are in cholinergic crisis = they will worsen bc they have too much acetylcholine
_____________
- Auto immune disease
- Characterized by fluctuating weakness of certain muscle groups
- ocular, limbs, respiratory, bulbar (brainstem nerves)
_________________
Progressive
Degenerative disorder of basal ganglia function
_______________
Chronic
Inflammatory
Autoimmune
Potentially disabling
affects both the white and gray matter of the brain and spinal cord
Myasthenia Gravis
Parkinson’s disease
Multiple Sclerosis
MS treatment: Goals of drugs
2. treat acute relapse
1st line
-high dose IV glucocorticoid – increases ________ levels
- ex: methylprednisolone
- frequent or long-term _________ use should be avoided
2nd line
-IV gamma globulin – used for pts ________ to glucocorticoids
-ACTH (H.P. acthar gel) – used for pts intolerant to ______ or ______ are ineffective
- Adrenocorticotropin hormone in a gel form
- Prolonged release of ACTH after injection
1st line
-high dose IV glucocorticoid – increases glucose levels
- ex: methylprednisolone
- frequent or long-term steroid use should be avoided
2nd line
-IV gamma globulin – used for pts intolerant to glucocorticoids
-ACTH (H.P. acthar gel) – used for pts intolerant to steroids or steroids are ineffective
- Adrenocorticotropin hormone in a gel form
- Prolonged release of ACTH after injection
anticholinergics vs Cholinergic
__________ enhance or mimic the effects of the neurotransmitter acetylcholine
____________ block or inhibit acetylcholine’s actions.
Cholinergic
anticholinergics
Risk factors
- age 20-40
- women
- cool climate (northern US)
- white
- family hx
- smoking
- vitamin D deficiency
- obesity
- infection (including Epstein-barr)
risk factors
- age 10-65 years
- women
Risk factors
- family hx
- estrogen and progesterone
- environmental factors
risk factors
- age – 70s
- men
- genetics
- environmental exposure
- depression
- head trauma
- hysterectomy
MS
myasthenic gravis
migraines
PD
Tremor
T/F
- 1st sign of PD
- effects handwriting
- tremor occurs with motor function/movement
- tremor occurs with rest and improves with movement
- more prominent at rest
- aggravated by stress or concentration on movement
- “pill roll”
-T 1st sign of PD
T - effects handwriting
F - tremor occurs with motor function/movement = this is essential tremor
T - tremor occurs with rest and improves with movement
T - more prominent at rest
T - aggravated by stress or concentration on movement
T - “pill roll”
Myasthenic Gravis: Treatment
- immunosuppressants (steroids)
- cholinesterase inhibitors - cholinesterase breaks down acetylcholine/Ach = stopping cholinesterase = prevents acetylcholine/Ach from being inactivated = acetylcholine/Ach stays active longer
cholinesterase inhibitors T/F
1. allows ACh to remain active for a longer period at cholinergic receptor sites
2. cholinesterase increases levels and effects of Ach in the body
3. more ACh in the body with myasthenic Gravis would ___creases muscle strength
4. can give prior to eating to strength swallowing muscles
5. cholinesterase is it a cure
6. cholinesterase provides symptomatic relief
- T
- T
- increase
- T
- F
- T
Essential tremor vs PD tremor
- caused by dopamine deficiency
- caused by faulty neurological impulses
- tremor occurs with motor function/movement
- tremor occurs with rest and improves with movement
- other s/s of PD present
- no other s/s of PD present
PD - caused by dopamine deficiency
ET - caused by faulty neurological impulses
ET - tremor occurs with motor function/movement
PD - tremor occurs with rest and improves with movement
PD - other s/s of PD present
ET - no other s/s of PD present
nervous system cells - neuroglia vs neurons
__________
- primary functional unit of the nervous system
- generally don’t divide or replace themselves
- some may generate from stem cells after a brain injury
____________
- more numerous
- located in brain and spinal cord
- different functions
- support, nourish and protect neurons
- can replicate
- generally when neurons die, neuroglia cells replace them
neurons
- primary functional unit of the nervous system
- generally don’t divide or replace themselves
- some may generate from stem cells after a brain injury
neuroglia (glia cells)
- more numerous
- located in brain and spinal cord
- different functions
- support, nourish and protect neurons
- can replicate
- generally when neurons die, neuroglia cells replace them
Cholinergic vs anticholinergics
1. enhance or mimic the effects of the neurotransmitter acetylcholine
2. block or inhibit acetylcholine’s actions.
3. atropine
4. Neostigmine
5. (acetyel)cholinesterase inhibitor
6. anti(acetyl)cholinesterase
7. causes rest and digest
- C
- A
- A
- C
- C
- C
- C
Nerve impulses
- action potentials travel along the _______ to the end of the nerve fiber
- it goes across the ___________ between nerve cells by neurotransmitters (ex: acetylcholine, epinephrine, norepinephrine, serotonin, and dopamine)
- a nerve impulse is initiated
Nerve impulses
- action potentials travel along the axon to the end of the nerve fiber
- it goes across the junction/gap/synapse between nerve cells by neurotransmitters (ex: acetylcholine, epinephrine, norepinephrine, serotonin, and dopamine)
- a nerve impulse is initiated
MG crisis vs cholinergic crisis
1. not enough stimulation or acetylcholine
2. too much acetylcholine or neostigmine
3. muscles are not stimulated and weak
4. muscles are overstimulated and worn out
5. leads to respiratory failure
- MGC
- CC
- MGC
- CC
- Both
