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94 Cards in this Set
- Front
- Back
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virus that attacks anterior horn cells
-motor neuron only still have sensation |
polio
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when most of group is vacinated, the liklihood of the unvacinated to get the disease is unlikely
-only refers to communicable diseases |
herd immunity
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autoimmune disorder
antibodies against acetylcholine receptors prevalence: 5-10/100,000 population two broad categories: younger: classic older: thymoma, more common tumor originating from thymus |
Myasthenia Gravis
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associated with weakness and fatiguability
-DTRs intact -No sensory loss |
Myasthenia Gravis
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tests:
ACH receptor antibody titer specific electrophysiologic testing confirmatory Tensilon test |
Myasthenia Gravis
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What is myasthenia gravis treated with
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pyridostigmine (Mestinon)
neostigmine corticosteroids azathioprine(immunosuppresive) thymectomy - remove thymus |
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thymectomy is curative
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Myasthenia Gravis
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disorder of the NM junction
caused by exotoxin of Clostridium |
botulism
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can cause problems with breathing and diplopia
treated with antitoxin |
botulism
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It acts by blocking nerve function and leads to respiratory and musculoskeletal paralysis
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botulism
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Blurring of vision (with unreactive dilated pupils) is characteristic, and there may be dryness of the mouth, constipation (paralytic ileus), and postural hypotension. Sensation is preserved, and the tendon reflexes are not affected unless the involved muscles are very weak.
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botulism
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The clinical manifestations are caused when toxin blocks inhibitory nerve impulses, by preventing the release of inhibitory neurotransmitters GABA and glycine. The result is disinhibition, or increased relative excitation. This leads to unopposed muscle contraction and spasm. Seizures may occur, and the autonomic nervous system may also be affected
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tetanus
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refers to sustained muscle contraction that is NOT caused by tetanus
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tetany
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treatment includes immune globulines
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tetany
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a medication widely used in emergency medicine and anesthesia to induce muscle relaxation, usually to make endotracheal intubation possible. It imitates the action of acetylcholine at the neuromuscular junction, acting on muscle type nicotinic receptors, but it is not degraded by acetylcholinesterase but by pseudocholinesterase, a plasma cholinesterase. This hydrolysis by pseudocholinesterase is much slower than that of acetylcholine by acetylcholinesterase.
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Suxamethonium chloride (also known as succinylcholine, scoline, or colloquially as sux
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an inherited blood plasma enzyme abnormality. People who have this abnormality may be sensitive to certain anesthetic drugs, including the muscle relaxants succinylcholine and mivacurium as well as other ester local anesthetics.
The patient experiences prolonged paralysis of the respiratory muscles, requiring an extended period of time during which the patient must be mechanically ventilated. Eventually the muscle-paralyzing effects of these drugs will wear off |
pseudocholinesterase deficiency
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disorders of growth
difficult to differentiate them poor prognosis and few therapies refer them out |
muscular dystrophy
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inherited
usually present in childhood presents as progressive atrophy and weakness most survive but Duchenne’s type is fatal in 2nd-3rd decades genetic counseling |
muscular dystrophy
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refers to a group of genetic, hereditary muscle diseases that cause progressive muscle weakness.
characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue. |
muscular dystrophy
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current: any age but peak is in 50 and 60s
women twice as often as men usually young people, but any age can get it? confirm with muscle biopsy MRI guided to find "hot spots" can have false negative associated with AI disorders muscle inflammation muscle weakness, tenderness, achy Dx: muscle biopsy Rx: corticosteroids and immunosuppressives |
polymyositis
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a type of inflammatory myopathy, related to dermatomyositis and inclusion body myositis. means 'many muscle inflammation'.
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polymyositis
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tends to become evident in adulthood, presenting with bilateral proximal muscle weakness, often noted in the upper legs due to early fatigue while walking. Sometimes the weakness presents itself by the person being unable to rise from a seated position without help, or inability to raise their arms above their head. The weakness is generally progressive, accompanied by lymphocytic inflammation (mainly cytotoxic T8 lymphocytes). The cause is unknown, but seems to be related to autoimmune factors, genetics, and perhaps viruses.
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polymyositis
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it is polymyositis with associated rash
dusky red, malar distrubution like SLE underlying malignancy 20% association with internal malignancies no cause and effect, but there may be association |
dermatomyositis
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is connective-tissue disease that is characterized by inflammation of the muscles and the skin. Its cause is unknown, but it may result from either a viral infection or an autoimmune reaction. Up to 50% of the cases may be a paraneoplastic phenomenon, indicating the presence of cancer.
X-ray findings include dystrophic calcifications in the muscles. Tx: corticosteroids |
dermatomyositis
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Act and behave normal
but can go into total body paralysis within short period of time may be due to disruptions in electrolytes hypo or hyperkalemic can have paralysis of respiratory association with hyperthyroidism |
periodic paralysis
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loss of speech, abnormality of language
difficulty with spoken word, written word generalized language problem |
aphasia
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same as aphasia but used elsewhere
-may actually be a better description |
dysphasia
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dysfunction of speech, articulation
-not a language problem -not a process of dementia |
dysarthria
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Loss of ability to do something practical that they used to know how to do
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apraxia
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loss of ability to read when a person used to be able to read
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alexia
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associated with loss of neurons, plaques, tangles
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Alzheimer's
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these patients are not sedate
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Alzheimer's
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#2 cause of dementia
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vascular dementia:
multi-infarct dementia |
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decline is "step-like" loss of function vs progressive even decline
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multi-infarct dementia
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#3 cause of dementia
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mixed vascular dementia and Alzheimer's
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is the name given by doctors to a type of depression which appears superficially as a problem with memory and which is relatively common in older people and may be confused with the presence of dementia.
The term applied to illnesses where memory and other higher mental functions are affected and includes illnesses such as Alzheimer's disease. |
pseudo-dementia
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patients' memory appears to be affected, but closer examination will reveal that they are inattentive to their surroundings and hence unable to retain new information in the form of new memories. Also they are able to precisely date the onset of this impairment and are acutely aware that memory is insufficient. They have slowness and apathy. However, other signs and symptoms of depression are usually present. The significance is that depression in this age group can generally be successfully treated if recognized.
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pseudo-dementia
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what is associated with "something they hate" and "something they cannot escape"
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common factors in depression
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drug induced, any combination of tremor, rigidity, bradykinesia, progressive postural instability
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Parkinsonism
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idiopathic parkinonism =
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Parkinson's disease
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is any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, mitral valve prolapse dysautonomia, pure autonomic failure, multiple system atrophy (Shy-Drager syndrome), autonomic instability and a number of lesser-known disorders.
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dysautonomia
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dysautonomia may be seen in this:
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Parkinson's
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a combination of Parksinson's and dysautonomia
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Shy-Drager Syndrome
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"multiple system atrophy"
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Shy-Drager syndrome
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is a rare, progressively degenerative disease of the autonomic nervous system.
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Shy-Drager syndrome
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will be passed to next generation, only one gene is required for it to be passed
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autosomal dominant
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carrier: will not be passed to next generation
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autosomal recessive
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Huntington's Chorea:
autosomal dominant or autosomal recessive |
autosomal dominant
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symptoms are abnormal body movements called chorea and a lack of coordination, but it also affects a number of mental abilities and some aspects of personality
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Huntington's Chorea
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These physical symptoms occur in a large range of ages, with a mean occurrence in a person's late forties/early fifties. As there is currently no proven cure, symptoms are managed with various medications and care methods.
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Huntington's Chorea
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irreversibly, progressively leads to dementia and institutionalization and death
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Huntington's Chorea
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Fridreich's Ataxia:
autosomal dominant or autosomal recessive |
autosomal recessive
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an inherited disease that causes progressive damage to the nervous system resulting in symptoms ranging from gait disturbance and speech problems to heart disease.
Bilateral: feet curling |
Friedreich's Ataxia
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uncontrolled/involuntary movements that are "snake-like", typically in the hands and feet
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athetosis
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extra movements that are jerky
characterized by brief, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next. |
Chorea
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jerky movements during intended movements
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ataxia
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combination of uncontrolled/involuntary movements that are "snake-like", typically in the hands and feet and characterized by brief, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next.
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chora athetosis
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demylination of white matter nerve tracts nerve conduction is slowed down
CNS disease of white matter causes patches |
Multiple sclerosis
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prognosis:
better for younger ages better for females idiopathic can present in odd ways with peculiar neurologic losses or complaints manifests very differently in different patients common: dizzyness, vertigo, MLF, diplopia, weakness |
multiple sclerosis
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Hallmark: sx come on and then they go away
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multiple sclerosis
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What are the two criteria required in multiple sclerosis to make a diagnosis:
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1)patterns of neurologic deficit have to be traced to at least two locations
2) episodes must be seperated in time by at least a month |
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What test results may be seen in patients with multiple sclerosis
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CSF has changes
gamma globulins MRI will show areas of demylination as bright spots |
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electrical potential evoked by stimuli
can be auditory, pain, visual used in newborn screening with MS: subacute optic neuritis |
evoked potential
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what may be used in the treatment of mulitple sclerosis
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steroids
interferons |
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What are two diseases that may mimic multiple sclerosis:
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Acute disseminating encephalitis (ADE) and transverse myelitis
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this is often confused with MS and is associated with multiple spots and one episode
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acute disseminating encephalitis
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can mimick MS and is occurs when one spot in the cord gets demylinated
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transverse myelitis
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sudden change in behavior traced to corical electric discharge and may be sensory or motor
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seizure
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requires a history of at least two seizures
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epilepsy
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symptomatic epilepsy is an odd term that actually means:
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secondary epilepsy
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if a seizure is not secondary to anything else, if it is primary, it is called:
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ideopathic epilepsy
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EEG: shows activity all over and stop together
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generalized
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the two types of partial seizures:
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simple and complex
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what feature is unique to partial seizures that are not found in generalized seizures
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aura
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what is the distinguishing difference between simple and complex partial seizures
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whether or not the consciousness is impaired
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what are these considered:
1 Simple partial seizures evolving to generalized seizures 2 Complex partial seizures evolving to generalized seizures 3 Simple partial seizures evolving to complex partial seizures evolving to generalized seizures |
partial seizures evolving to secondarily generalized seizures
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a brief, involuntary twitching of a muscle or a group of muscles.
like suddenly jerky movement when one is falling asleep in class ex: hiccups |
myoclunus
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total sudden loss of muscle tone
usually occurs in children |
atonic
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usually begins with cry/groan/noise and then go into a stretching posture and begin rhythmic, symmetrical contractions and extension movements
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tonic clonic/grand mal
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the altered state of consciousness that a person enters after experiencing an epileptic seizure
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postictal state
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what are these characteristic of:
loss of consciousness cortical activity postictal state loss of bladder and bowel control |
tonic clonic
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the person may appear to be staring into space with or without jerking or twitching movements of the eye muscles. These periods last for seconds, or even tens of seconds. Those experiencing these seizures sometimes move from one location to another without any purpose
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absence seizures
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previously called petit mal seizures
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absence seizures
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this generalized seizure has no postictal state
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absence seizure
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may occur during seizure: look purposeful, but they are not conscious
ex: chewing gum |
automatism
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absence, myoclonic, clonic, tonic-clonic, and atonic are all what kinds of seizures:
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generalized
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these seizures are myoclonus that are regularly repeating at a rate typically of 2-3 per second.
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clonic
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involve an initial contraction of the muscles (tonic phase) which may involve tongue biting, urinary incontinence and the absence of breathing. This is followed by rhythmic muscle contractions (clonic phase). This type of seizure is usually what is referred to when the term 'epileptic fit' is used colloquially.
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tonic-clonic seizures
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a manifestation of thiamine deficiency, or beri-beri. This is usually secondary to alcohol abuse.
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Wernicke-Korsakoff syndrome
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two common drugs used for seizures:
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Valium (diazepam)
Ativan (Lorazepam) |
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a persistent neurologic deficit after a seizure suggests a:
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focal point
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also known as a fever fit, it is a generalized convulsion caused by elevated body temperature. They most commonly occur in children below the age of three and should not be diagnosed in children under the age of 6 months or over the age of 6 years. In many cases, the first sign of fever is the onset of the seizure. It has been theorized that the seizure is triggered by the rapidity of the rise in temperature, rather than the actual temperature reached.
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febrile seizure
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The diagnosis is one that must be arrived at by eliminating more serious causes of seizure: in particular, meningitis and encephalitis must be ruled out. Therefore a doctor's opinion should be sought and in many cases the child would be admitted to hospital overnight for observation and/or tests. As a general rule, if the child returns to a normal state of health soon after the seizure, a nervous system infection is unlikely.
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febrile seizure
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t or f
hypoxia in brain can cause a brief seizure like activity and/or syncope |
T
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