week 9

Question 1

Identify the common pathophysiological mechanisms involved in the neurodegenerative disorder:
Alzheimer’s disease

Answer 1

The pathophysiology o alzheimers disease is associated with neuronal loss in particular areas of the brain (hippocampus, limbic system, and frontal cortex) resulting in severe cerebral atrophy. The disease predominetly targets cholinergic neurons in these areas. Exitotoxicity via the overstimulation of glutamatergic NMDA receptors and oxidative stress are believed to make a major contribution to this process.

Question 2

Identify the common pathophysiological mechanisms involved in the neurodegenerative disorder:
Dementia

Answer 2

Dementia is an umbrella term for a collection of diseases. All of these diseases affect the brain by affecting thinking, behaviour, and the ability to peform everyday tasks.
The 4 most common types of dementia are alzheimers, vascular, lewy body, and frontotemporal

Alzheimers: key regions affected are hippocampus, limbic system, and frontal cortex - prominetly targeting cholinergic neurons. progessive
Vascular dementia: primarily caused by CVA’s but also caused by narrowing/constricting blood vessels (atherosclerosis) and brain hameorrhage.
Lewy body: Precise cause unknown, progressive abd build up of lewy bodies (clumped together), it is closely related to parkinsons disease and involves the depletion of dopamine and acetycholine
Frontotemporal dementia: progessive, normally behavioural changes noticed first, atrophy of frontal and temporal lobes. - the cause is poorly understood

the patho of dementia is broadly thought to be related to the aggregation an accumulation of misfolded proteins and/or associated with cerebrovascular disease.

Question 3

Identify the common pathophysiological mechanisms involved in the neurodegenerative disorder:
Parkinsons disease

Answer 3

results from damage to the nerve cells in a region of the brain the produced dopamine. Dopamine is crucial to the smooth control of muscles and movement.
causes tremors, slow movements, and rigidity
the causes are not known, and it is believed to be from a mixture from genetic and environmental factors.

Question 4

Describe the clinical manifestations and clinical support for:
Acute delirium

Answer 4

Delirium is acute and means a separation from reality
The 2 extremes are hyperactive (going between rooms, moving a lot) and hypoactive (all they want to do is sleep)
Risk factors include:
Cognitive impairment
Immobility
Sleep deprivation
Visual/hearing impairment
Dehydration

Trigger:
Fluid electrolytes
Infections
Organ dysfunction
Drug toxins
Pain
Withdrawal

Prolonged delirium can occur from:
Restraint
Immobilisation
New environment
Strange people/sights/sounds
Interrupted nutrition
Interrupted sleep
Benzos

Safe transport is dependent on the severity of the delirium
Mild/moderate:
Nonpharmalogical
Interpersonal
Manage environment
Don’t rush pt
Enlist trust of familiarity
Use words carefully

Severe:
Pharmological
Loraz, midaz, droperidol, ketamine

Severe +++
Police
Restraint
Net