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362 Cards in this Set
- Front
- Back
Acute pain has a _____ onset
|
sudden
|
|
acute pain lasts....
|
<6 months
|
|
acute pain is relieved when...
|
stimulus is removed
|
|
4 types of acute pain
|
parietal
somatic visceral referred |
|
chronic pain is _____ or _______
|
persistant or intermittent
|
|
chronic pain lasts
|
>6 months
|
|
with chronic pain why is HR, BP, and respiratory rate all normal?
|
the body compensates with long term pain
|
|
if chronic pain is intermittent then s/s can be...
|
acute
|
|
what are 5 physiologic responses to chronic pain?
|
depression
difficulty sleeping eating preoccupation with pain social-cultural influence |
|
prognosis for chronic pain?
|
not likely to see complete relief
|
|
course of acute vs chronic pain....
|
acute suffering decreases over time, chronic suffering increases over time
|
|
pain threshold
|
lowest intensity that a stimulus is percieved as painful
|
|
Tolerance
|
amount of time or intensity of pain that an individual will endure before initiating treatment
|
|
pain tolerance is influenced by what 4 things?
|
cultural perception
expectations role behaviors physical and mental health |
|
pain tolerance increases with what 6 things?
|
alcohol consumption
medication hypnosis warmth distraction activities strong faith beliefs |
|
what 6 things decrease in the elderly to affect temperature regulation?
|
Decreased....
blood circulation heat-producing activities shivering response metabolic rate thirst, nutrition peripheral sensation; heat and cold |
|
what skin changes affect temp regulation in the elderly?
|
structural and functional skin changes
|
|
strabismus
|
deviation of one eye while focusing on an object (lazy eye)
|
|
amblyopia
|
reduced vision in affected eye
|
|
diplopia
|
double vision
|
|
what is the primary symptom of strabismus
|
double vission
|
|
nystagmus
|
involuntary unilateral or bilateral rhythmic movement of the eyes
|
|
nystagmus is caused by...
|
imbalanced reflex activity of inner ear
|
|
how do you test for nystagmus?
|
test c 6 cardinal eye movements
|
|
Normal Intraocular pressure is...
|
12-20 mm Hg
|
|
3 types of glaucoma....
|
open angle
angle closure congenital |
|
Open angle glaucoma is typically uni, or bilateral?
|
bilateral
|
|
what is the leading cause of blindness?
|
open angle glaucoma
|
|
open angle is glaucoma is caused by...
|
outflow obstruction of aqueous humor...does not drain from the canal
|
|
open angle glaucoma is typically....
|
inherited
|
|
angle closure glaucoma is the displacement of....
|
the displacement of iris toward the cornea
|
|
angle closure glaucoma is caused by...
|
obstruction of aueous humor from anterior chamber
|
|
angle closure glaucoma has a ____ onset
|
sudden
|
|
what symptoms are seen with angle closure glaucoma?
|
pain and visiual disturbance
|
|
congenital glaucoma is....
|
associated with other anomalies
|
|
Macular Degeneration is...
|
severe and irreversible loss of vision
|
|
What are the risk factors for MD? (3)
|
HTN
Cigarette smoking DM |
|
when is the typical onset of macular degeneration?
|
>60 yrs
|
|
what are the 2 types of macular degeneration?
|
atrophic (dry)
neovascular (wet) |
|
Atrophic macular degeneration causes...
|
limited night vision and difficulty reading
|
|
neovascular (wet) macular degeneration cuases
|
loss of central vision
|
|
neovascular (wet) macular degeneration is caused by (4)
|
leakage of blood or serum
retinal detachment fibrovascular scarring loss of photoreceptors |
|
why is neovascular (wet) so critical?
|
risk of hemorrage
|
|
alterations in accommodation are caused by...
|
changes in thickness of the lens
|
|
accommodation is needed for what kind of vision?
|
clear vision
|
|
presbyopia
|
age related loss of accommodation; occular lens becomes larger, firmer and less elastic
|
|
what is related to accommodation?
|
presbyopia
|
|
what is the most common type of visual problem?
|
refraction
|
|
3 types of refraction...
|
myopia
hyperopia astigmatism |
|
myopia
|
nearsighted (can see close not far)
|
|
hyperopia
|
farsighted
|
|
astigmatism
|
unequal curvature of cornea
|
|
3 types of refraction problems
|
myopia
hyperopia astigmatism |
|
in Conductive hearing loss, hearing is impaired from _______ to _______ ear
|
outer to inner
|
|
what are 3 possible causes of Conductive hearing loss
|
impacted cerumen
foreign body tumor (external) |
|
clinical s/s of Conductive hearing loss
|
diminished hearing and soft speaking voice
|
|
sensorineural hearing loss is...
|
impairment of the organ of Corti or its central connections
|
|
presbycusis
|
age related hearing loss
|
|
most common form of sensorineural hearin gloss
|
presbycusis
|
|
what happens in presbycusis?
|
atrophy of the basal end of organ of corti
|
|
what are 3 bacterium that could cause otitis externa?
|
pseudomonas, E. Coli, Staph
|
|
otitis externa occurs after...
|
prolonged exposure to moisture
|
|
most ocmmon infection of outer ear....
|
otitis externa
|
|
what ind of drainage occurs with otitis externa?
|
clear and purulent
|
|
what can be obstructed with otitis externa?
|
ear canal
|
|
what is the most common infection of children and infants?
|
otitis media
|
|
3 bacterium that can cause otitis media
|
strep
haemophilus moraxella catarrhalis |
|
tympanic membrane is ____ c otitis media
|
inflamed
|
|
3 system sins of otitis media
|
pain
fever irritability |
|
otitis media causes fluid in the _____ ____
|
middle ear
|
|
hyposmia
|
impaired sense of smell
|
|
anosmia
|
complete loss of smell
|
|
parosmia
|
abnormal/perverted sense of smell
( smelling the opposite of what you really should smell) |
|
olfactory hallucinations
|
smelling something that isn't really there
|
|
hypogeusia
|
decreased taste sensation
|
|
ageusia
|
absence of taste
|
|
parageusia
|
substances possess an unpleasant flavor
|
|
parageusia is typical with....
|
chemo
|
|
how many points are possible on the glasgow coma scale?
|
15
|
|
glasgow coma scale assess...
|
level of consciousness
|
|
what 3 areas does the glasgow coma scale assess?
|
eye opening
motor response verbal response |
|
Initiating signs usually of focal cerebral dysfunction compressing or displacing
is common in... |
Supratentorial mass lesions compressing or displacing the diencephalons or brain stem
|
|
Signs of dysfunction progress rostral to caudal in....
|
Supratentorial mass lesions compressing or displacing the diencephalons or brain stem
|
|
Neurologic signs at any given time point to one anatomic area (e.g., diencephalon, mesencephalon, medulla)
|
Supratentorial mass lesions compressing or displacing the diencephalons or brain stem
|
|
assymetric motor signs are common in...
|
Supratentorial mass lesions compressing or displacing the diencephalons or brain stem
|
|
History of preceding brain stem dysfunction or sudden onset of coma
|
Infratentorial mass of destruction causing coma
|
|
Localizing brain stem signs precede or accompany onset of coma and always includeoculovestibular abnormality
is a manifestation of... |
Infratentorial mass of destruction causing coma
|
|
Cranial nerve palsies usually manifest “bizarre” respiratory patterns that appear at onset in...
|
Infratentorial mass of destruction causing coma
|
|
Confusion and stupor commonly precede motor signs in what type of coma?
|
metabolic coma
|
|
Motor signs usually are symmetric
in what type of coma? |
metabolic coma
|
|
pupillary reactions usually are preserved
in what type of coma? |
metabolic coma
|
|
Asterixis, myoclonus, tremor, and seizures are common in what type of coma?
|
metabolic coma
|
|
Acid-base imbalance with hyperventilation or hypoventilation is common in what type of coma?
|
metabolic coma
|
|
Lids close actively and
Pupils reactive or dilated (cycloplegics) in what coma state? |
psychiatric unresponsiveness
|
|
Oculocephalic reflexes are unpredictable; oculovestibular reflexes are physiologic (nystagmus is present) in what coma state?
|
psychiatric unresponsiveness
|
|
Motor tone is inconsistent or normal in what state of coma?
|
psychiatric unresponsiveness
|
|
hyperventilation or eupnea is common in what state of coma?
|
psychiatric unresponsiveness
|
|
No pathologic reflexes are present
in what type of coma? |
psychiatric unresponsiveness
|
|
lectroencephalogram (EEG) is normal
in what type of coma? |
psychiatric unresponsiveness
|
|
rate, rhythm, and pattern of breathing help evaluate...
|
level of brain dysfunction and coma
|
|
what 3 responses of the oculomotor system change with varying levels of brain dysfunction?
|
resting
spontaneous reflexive eye movements |
|
dolls eyes phenomenon
|
eyes should turn the opposite direction that the head is turned
|
|
negative dolls eyes phenomenon
|
eyes do not turn together
|
|
absent dolls eyes phenomenon
|
eyes do not turn at all when head is turned
|
|
normal oculovestibular reflex
|
conjugate eye movement
|
|
abnormal oculovestibular reflex
|
disconjugate or asymmetric eye movements
|
|
absent response with oculovestibular reflex
|
no eye movements
|
|
4 different pathologic reflexes
|
grasp reflex
snout reflex palmomental reflex suck reflex |
|
first critereum for brain death
|
completion of all appropriate and therapeutic procedures
|
|
what type of coma is a criteria for brain death?
|
unresponsive coma ( no motor or reflex movements
|
|
brain death in regards to breathing...
|
no spontaneous respiration
|
|
eye criteria for brain death 2 and pupils
|
no ocular responses to head turning or caloric stimulation
dilated, fixed pupils |
|
EEG criteria for brain death
|
isoelectric (flat) EEG (electrocerebral silence)
|
|
how long do respiratory, ocular, and EEG s/s have to persist for a person to be declared brain dead?
|
for 30 minutes to 1 hour and for 6 hours after onset of coma and apnea
|
|
what kind of alteration is there in brain function c a seizure?
|
sudden transient alteration in brain function
|
|
seizure is a suddent, explosive, disorderly discharge of.....
|
cerebral neurons
|
|
movement related with seizures
|
contract- relax (tonic-clnoic)
|
|
epilepsy
|
seizure with no underlying correctable cause
|
|
a seizure is any disorder that alters....
|
neuronal environment
|
|
what type of lesions are etiological for seizures?
|
cerebral lesions
|
|
biochemical disorders can lead to...
|
seizures
|
|
what type of trauma can lead to seizures?
|
cerebral trauma
|
|
myoclonic syndromes can cause...
|
seizure
|
|
metabolic defects, postnatal injury, infection and fever are all possible causes of....
|
seizures
|
|
3 kinds of partial epileptic seizures
|
simple
complex secondarily generalized |
|
simple partial epileptic seizure
|
no loss of consciousness
focal motor disruption |
|
complex partial epileptic seizures
|
impaired consciousness, psychomotor
|
|
secondarily generalized partial epileptic seizures
|
partial onset evolving to generalized seizure
|
|
3 types of generalized epileptic seizures
|
petit mal
grand mal drop attack |
|
petit mal generalized epileptic seizure
|
absense, myoclonic, clonic, tonic
|
|
grand mal epileptic seizure
|
tonic-clonic
|
|
drop attack
|
atonic
|
|
Aura
|
partial seizure preceding onset of generalized seizure
|
|
prodroma
|
early clnicial s/s: malaise, HA sense of depression hours or days before onset of seizure
|
|
tonic
|
state of muscle contraction with excessive tone (prolonged)
|
|
clonic
|
state of alternating contraction with relaxation of muscles ( usually rapid)
|
|
Postictal phase
|
time period immediately following the cessation of seizure activity
|
|
agnosia
|
recognition failur of objects or persons (tactile, visual, or auditory)
|
|
Dysphasia
|
impairment of comprehension or production of language
|
|
aphasia
|
loss of comprehension or production of language
|
|
what is lost with dysphasia?
|
comprehension and use of symbols (written or veral)
|
|
data processing deficits (2)
|
agnosia
dysphasia |
|
what is the leading cause of severe cognitive dysfunction in older adults?
|
alzheimer disease
|
|
alzeihmers disease affects how many americans ?
|
5 million
|
|
risk of alzheimers increases c....
|
age
|
|
pathology of alzheimers
|
cartical atrophy and loss of neurons, particularly parietal and temporal lobes (senile plaques)
|
|
the presence of what is significant in alzheimers?
|
amyloid containing neuritic plagues and "neurofibrillary tangles"
|
|
what decreases in associateion with alzheimers?
|
choline acetyltransferase activity
|
|
stage 1 alzheimers lasts...
|
2-4 years
|
|
stage 1 alzheimers consists of...
|
memory loss, subtle personality changes, disorientation to time an place
|
|
stage 2 alzheimers lasts...
|
several years
|
|
stage 2 alzheimers is known as the...
|
confusion stage
|
|
stage 2 alzheimers consists of
|
impaired cognition, restlessness, agitation
|
|
wandering (sundownder's sundrome) occurs in what stage of alzheimers ?
|
stage 2
|
|
repetitive behavior occurs in what stage of alzheimers ?
|
stage 2
|
|
stage 3 alzheimers is known as the
|
terminal stage
|
|
emaciation occurs in what stage of alzheimers ?
|
3
|
|
inability to communicate, bowel and bladder incontinence, and seizures occur in what stage of alzheimers ?
|
3
|
|
normal cranial pressure?
|
5-15 mm Hg
|
|
what are 4 possible causes of increased intracranial pressure?
|
tumor growth, edema, excess CSF, hemorrhage.
|
|
ICP does what to pulse pressure?
|
widens
|
|
ICP does what to HR?
|
bradycardia
|
|
ICP does what to levels of arousal
|
decreases
|
|
what does increased ICP do to pupils?
|
makes them small and sluggish
|
|
ICP causes Cerebral _____ and _______
|
hypoxia and acidosis
|
|
2 describtions of incrased ICP?
|
subtle and transient
|
|
increased icp causes episodic _____
|
confusion
|
|
increased ICP makes people
|
restless and drowsy
|
|
what is the prolonged risk of increased intracranial pressure?
|
brain (ventricular) herniation
|
|
Guillain- Barre
|
lower motor neuron impairment extends proximal to affect nerve roots of neurons
|
|
hyperkinesia
|
excessive movements
|
|
3 categories of hyperkinesia
|
dyskinesias
paroxysmal dyskinesia tardive dyskinesia |
|
dyskinesias
|
type of hyperkinesia
abnormal involuntary movements |
|
paroxysmal dyskinesias
|
abnormal involuntary movements (spasms)
type of hyperkinesia |
|
tardive dyskinesia
|
inoluntary movement of face, trunk, and extremities
type of hyperkinesia |
|
tardive dyskinesia is usually caused by...
|
side effect of prolonged phenothiazine drug therapy
|
|
hypokinesia
|
loss of voluntary movement despite preserved conciousness and normal peripheral nere and muscle function
|
|
akinesia
|
decreased association and voluntary movements
type of hypokinesia |
|
bradykinesia
|
slowness of voluntary movements
type of hypokinsia |
|
clinical s/s of hypokinesia
|
expressionless face, stute-like posture, absensce of speech inflection, absence of spontaneous gestures
|
|
parkinsons disease is a...
|
degenerative disorder of basal ganglia function
|
|
parkinsons disease is characterized of...
|
progressive destruction of nigrostriatal pathway
subsequent reduction striatal concentrations of dopamine |
|
first visible sign of parkinsons
|
tremor
|
|
3 cardinal signs of parkinson
|
tremor, rigidity, bradykinesia (slowness of movement)
|
|
Rigidity
|
resistance to movement throughout full ROM
|
|
when is parkinsons rigidity most evident?
|
during passive joint movement
-jerky, cogwheel |
|
Cardinal manifestations of parkinson's re. water loss?
|
uncontrolled sweating (ANS involvement) and salivation
|
|
parkinsons s/s of walking...
|
shuffling gait; short steps; stooped posture
|
|
dementia occurs in what % of parkinson's pts?
|
20%
|
|
hypermimesis (R hemisphere injury)
|
pathologic laughter
|
|
hypermimesis (L hemisphere injury)
|
pathologic crying
|
|
hypomimesis
|
manifests as aprosody (loss of emotional language)
|
|
dypraxias/apraxias
|
inability to perform purposeful or skilled motor acts
|
|
what is absent with dyspraxias/apraxias?
|
paralysis, sensory loss, abnormal posture and tone, abnormal involuntary movement, incoordination, or inattentiveness
|
|
3 categories of injury
|
mild concussion
classical cerebral concussion diffuse axonal injury |
|
75-90% of head injuries are
|
either mild concussion or classical cerebral concussion
|
|
mild concussion
|
temporary axonal disturbance affecting attention and memory
|
|
conciousness is not lost c....
|
mild concussion
|
|
classical cerebral concussion
|
physiologic neurologic dysfunction with substantial anatomic disruption
|
|
is there loss of conciousness with classical cerebral concussion?
|
immediate loss of consciousness lasting < 6 hours
|
|
diffuse axonal injury make up what % of injuries?
|
1/3 of injuries
|
|
diffuse axonal injury
|
prolonged traumatic coma longer than 6 hours
|
|
8 warning signs after head trauma
|
changes in LOC
seizures bleeding or watery discharge from nose/ears pupils slow to react/unequal blurred vision loss of sensation to any extremity slurred speech vomiting |
|
spinal cord trauma patho forces
|
compress tissues
|
|
pull or exert traction ( tention) on tissues is a patho manifestation of...
|
spinal cord injury
|
|
shear tissues (sliding into one another) are patho manifestation of
|
spinal cord injury
|
|
where is the most common site of spinal injury?
|
most mobile portion of vertebral column
c1 to c2 c4 to c7 t10 to l2 |
|
where does activity cease with spinal injury?
|
at and below level of injury
|
|
spinal shock loses reflex function
|
in all levels below lesion
|
|
spinal shock lasts...
|
7-20 days; up to 3 months
|
|
spinal shock involves all....
|
skeletal muscle *bladder, bowel, sexual function; autonomic control
|
|
what causes disturbed thermal control with spinal shock?
|
SNS damage
|
|
when does spinal shock resolve?
|
c return of reflex activity, hyperreflexia, spasticity, reflex emptying of bladder
|
|
autonomic hyperreflexia (dysreflexia)
|
post spinal shock
|
|
autonomic hyperreflexia (dysreflexia) causes what cardio issues?
|
massive, uncompensated cardiovascular response from SNS
|
|
autonomic hyperreflexia (dysreflexia) is usually at...
|
level T6 or above
|
|
what is the most common cause of autonomic hyperreflexia (dysreflexia)?
|
distended bladder or rectum
|
|
autonomic hyperreflexia (dysreflexia) is...(severity)
|
life threatening and requires immediate treatment
|
|
what does autonomic hyperreflexia (dysreflexia) do to BP?
|
paroxysmal hypertension (~300 mm Hg)
|
|
Neuro affects of autonomic hyperreflexia (dysreflexia)?
|
pounding headache, blurred vision nausea
|
|
what is a herniated intervertebral disk?
|
nucleus pulposus herniating through tear in the annulus fibrosus
|
|
what are 3 cuases of herniated intervertebral disk?
|
trauma
aging degenerative disorders of the spine |
|
most common areas of herniated intervertebral disk
|
L4/L5
L5/S1 |
|
occasional places for herniated intervertebral disk
|
C6/C7
C5/C6 |
|
what is torn with a herniated intervertebral disk?
|
ligament and posterior capsule of disk
|
|
how is the herniated intervertebral disk determined?
|
by location, size, and amount of space in canal
|
|
what is the first and most common sign of a herniated intervertebral disk?
|
pain
|
|
what are signs associated with a lumbar herniated intervertebral disk?
|
radiating pain to hamstring and sole of foot
|
|
ROM is ______ with herniated intervertebral disk
|
limited
|
|
4 ways to diagnose a herniated intervertebral disk
|
H&P
muscle stregth and reflex testing straight leg test MRI/CT |
|
what is the most frequently occurring neuro disorder?
|
cerbrovascular accident (stroke)
|
|
what is the leading cause of disability in US?
|
cerbrovascular accident (stroke)
|
|
cerbrovascular accident (stroke) is a....
|
sudden, nonconvulsive focal neuro deficit. specific to an area
|
|
cerbrovascular accident (stroke) is caused by....
|
ischemic injury c or without infarction
|
|
cerbrovascular accident (stroke) is sometimes...
|
hemorrhagic
|
|
cerbrovascular accident (stroke) is classified according to...
|
pathophysiology
|
|
global hypoperfusion (shock) is common in...
|
cerbrovascular accident (stroke)
|
|
3 possible causes for cerbrovascular accident (stroke)
|
ischemia
thrombotic or embolic hemorrhage |
|
cerbrovascular accident (stroke) risk factors
|
HTN
smoking diabetes polycythemia and thrombocythemia |
|
the presence of what is indicative of cerbrovascular accident (stroke)
|
lipoprotein-a
|
|
impaired cardiac function can cause...
|
cerbrovascular accident (stroke)
|
|
nonrheumatic atrial fibrillation is caused by...
|
cerbrovascular accident (stroke)
|
|
TIA (transient Ischemic Attack) is a precurrsor to...
|
major stroke
|
|
what changes are a result of TIA (transient Ischemic Attack)
|
vision
speech motor function |
|
what are symptoms of TIA (transient Ischemic Attack)?
|
dizziness and loss of consciousness
|
|
TIA (transient Ischemic Attack) is caused by...
|
platelet clumps or vessel narrowing with spasm
|
|
TIA (transient Ischemic Attack) resides within...
|
24 hours
|
|
TIA (transient Ischemic Attack) is without...
|
resideula dysfunction
|
|
there is _____ brain injury with TIA (transient Ischemic Attack)
|
no
|
|
what causes an ischemic stroke (thrombotic)
|
intracranial vessels are occluded with thrombi
|
|
ischemic stroke (thrombotic) is common with...
|
athersclerosis and inflammatory disease (arthritis) that damage arterial walls
|
|
what are the 3 categories of ischemic stroke (thrombotic)
|
transient ischemic attacks (TIA)
stroke in evolution completed stroke |
|
what are clinical s/s dependant on for ischemic stroke (thrombotic)?
|
dependent on artery obstructed
|
|
an ischemic stroke (embolic) is caused by...
|
fragments that break from thrombus formed outside the brain (heart, aorta, carotid)
|
|
what are possible thrombus that can cause ischemic stroke?
|
air, fat, tumors
|
|
what is the 3rd most common cause of CVA (stroke)
|
hemorrhagic stroke
|
|
what are 5 possible causes of hemorrhagic stroke?
|
HTN
ruptured aneurysm vascular malformation bleeding into tumor aticoag. disorders |
|
clinical s/s of hemorragic stroke are...
|
dependent on location and size of bleed
|
|
hemorragic stroke is associated with (2...
|
DM and HTN
|
|
what size of bleed in the brain will cause a hemorragic stroke
|
<1 cm
|
|
hemorragic stroke involve..
|
small perforating arteries
|
|
hemorragic strokes are due to...
|
subcortical location (pure motor and sensory deficits)
|
|
headache, mental changes, aphasia, and agnosia are s/s of
|
stroke
|
|
incontinence, seizures, hemiparesis/hemiplagia and emotional liability are all s/s of
|
stroke
|
|
visual changes and apraxia are possible s/s of hemorragic
|
stroke
|
|
Meningitis is caused by what 5 things?
|
bacteria
virus (aseptic) fungus parasites toxins |
|
what type of bacterial infection can cause meningitis?
|
primary infection
|
|
what 4 areas can be affected in bacterial meningitis?
|
pia mater and arachnoid
subarachnoid ventricular system CSF |
|
what 2 bacertium can cause bacterial meningitis?
|
neisseria meningitidis and streptococcus pneumoniae
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what are systemic clinical manifestations of bacterial meningitis?
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fever, tachycardia, chills, petechial rash
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what are neuro clinical manifestations of bacterial meningits?
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throbbing HA
photophbia nuchal rigidity decreased LOC cranial nerve palsies focal deficits |
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viral meningitis is limited to...
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meninges
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what 3 things can cause viral meningitis?
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enteroviral viruses, mumps, herpes simplex I
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what are the 3 clinical s/s of viral meningitis?
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MILD generalized HA
photophobia neck stiffness |
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fungal meningitis is...
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chronic; develop slowly and insidiously
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2 fungus' that can cause viral meningitis?
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cryptococcosis
aspergillosis |
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clinical s/s of fungal meningitis?
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dementia
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Multiple sclerosis is the destruction of...
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CNS myelin sheath
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Multiple sclerosis spares...
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peripheral nervous system
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onset of Multiple sclerosis
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20-50 years
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male/female ratio for Multiple sclerosis
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1:2
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what is the leading cause of neuro disability in early adulthood?
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Multiple sclerosis
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exacerbations and remissions are common in
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Multiple sclerosis
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manifestations of Multiple sclerosis are dependent on....
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location and extent of lesion
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optic nerve, speech swallowing, muscle strength, gait/coordination, and balance are all symptoms of...
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Multiple sclerosis
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Multiple sclerosis presents with (3)
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acute parasthesias
optic neuritis (cloudiness) diplopia |
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muscle weakness/ spasticity, fatigue, intention tremors/ataxia is caused by
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Multiple sclerosis
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dysarthria/dysphagia, diplopia/nystagmus, decreased vision/hearing acuity, tinnitus, bowel and bladder dysfunction are all signs of...
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Multiple sclerosis
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bowel and bladder dysfunction and cognitive changes (memory loss, judgment impairment)
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Multiple sclerosis
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myasthenia gravis is a...
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chronic autoimmune disease
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myasthenia gravis affects...
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neuromuscular junction
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what is afected at the neuromuscular junction in myasthenia gravis?
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acetylcholine
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what kind of onset does myasthenia gravis have?
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insidious onset
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what are s/s of myasthenia gravis?
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muscle weakness and fatigability
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what is the first muscular weakness in myasthenia gravis?
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neck
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diplopia, ptosis, and acular palsies occur in....
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myasthenia gravis
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what are 4 common clues to musculoskeletal woes?
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deformity
edema pain throbbing |
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complete fracture
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bone is broken all the way through
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incomplete fracture
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bone is damaged, but still in one piece
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open(compound) fracture
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skin is broken
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closed fracture
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skin is closed
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bone healing (A)
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bleeding at broken ends of the bone
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what happens after the broken ends of the bone bleed?
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hematoma formation
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bone healing (B)
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organization of hematoma into fibrous network
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bone healing (C)
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invasion of osteoblasts, lengthening of collagen
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what happens after (C) the invasion of osteoblasts and lengthing of collagen in a bone break?
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deposition of calcium
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bone healing (D)
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callus formation, new bone is built up as osteoclasts destroy dead bone
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bone healing (E)
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remodeling is accomplished as excess callus is reabsorbed and trabecular bone is laid down
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CLinical s/s of fracture
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unilateral alignment
swelling muscle spasm tenderness, pain impaired sensation decreased motility |
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complication of fracture
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non-union
delayed union malunion |
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non union
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failure of bone ends to grow together (common c illness and diabetes)
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delayed union
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union that does not occur for 8-9 months after injury
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average amount of time for fracture to heal
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4-6 wks
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malunion
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healing of bone with incorrect anatomic position
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strain
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tear in tendon
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sprain
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ligament tear
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avulsion
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complete separation from tendon or ligament from bone
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55% osteoporosis pts are...
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55+
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osteoporosis
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bone tissue is mineralized but the mass (density) is decreased
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what is impaired with osteoporosis?
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structural integrity of trabecular bone
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cortical bone in osteoporosis
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porous and thin and prone to fractures
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normal bone density according to WHO
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>833 mg/cm
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osteopenia values according to WHO
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833-648 mg/cm
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osteoporosis values according to WHO
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<648 mg/cm
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in osteoporosis...
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old bone is absorbed faster than new bone is formed (problem is that new bone is not adequatly formed)
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what are the most common clinical signs of osteoporosis?
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pain and bone deformity
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paget disease is a state of...
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increased meatbolic activity
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paget disease is caused by abnormal and excessive...
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bone remodeling -> thickened bone
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what are the 6 most commonly affected bones in paget disease??
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vertebrae, skull, sacrum, sternum, pelvis, femur
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the cause of paget disease?
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unknown but strong genetic component
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paget disease is often...
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asymptomatic
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paget disease skull...
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assymetrical
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imparied motor function, deafness, atrophy of optic nerve, AMS, dementia, and decreased sesory are all s/s of
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paget disease
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what is the most prevlent form of bone disease?
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osteoarthritis
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osteoarthritis is the...
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degeneration and loss of articular cartilage in synovial joints
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what are 2 types of osteomyelitis?
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exogenous and endogenous
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exogenous osteomyelitis?
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open fractures, penetrating wounds, surgery
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endogenous osteomyelitis
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staphyloccoccus aureus
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osteomyelitis
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infectious bone disease from bacteria
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what are 3 contributors to osteomyelitis?
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-multiple microscopic channels in bone tissue
- microcirculation vulnerable to damage -limited capacity to replae bone destroyed by infection |
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what are 3 pathologic characteristics of osteoarthritis?
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erosion of articular cartilage
sclerosis of bone underneath cartilage formation of bone spurs (osteophytes) |
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pain with osteoarthritis occurs in what joints?
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weight bearing or load bearing
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nocturnal pain often occurs in
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osteoarthritis
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what is the most important factor associated with osteoarthritis?
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aging
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what are commonly affected joints of osteoarthritis?
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hand, wrist, neck, hip, knees, ankles, feet
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osteophytes are...
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bone spurs
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osteophytes are common with...
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osteoarthritis
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crepitus and grinding joints are common in...
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osteoarthritis
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long term mechanical stress is a risk factor for...
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osteoarthritis
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diabetic neuropathy
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pain and proprioceptive reflexes diminished or lost
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diabetic neuropathy is a risk factor for...
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osteoarthritis
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rheumatoid arthritis is a....
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systemic autoimmune disease
polyarticular |
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rheumatoid arthritis...
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chronic inflammation of connective tissue (primarily joints)
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in rheumatoid arthritis neutrophils...
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become activated, degrading surface layer of articular cartilage
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in rheumatoid arthritis cytokines...
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cause chondrocytes to attack cartilage
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with rheumatoid arthritis synovium....
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digests neary cartilage
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rhumatoid arthritis is...
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insidious
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what are the general systemic manifestations of rheumatoid arthritis?
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inflammation (fever, fatigue, weakness, anorexia, weight loss, generalized aching and stiffness
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what are the local manifestations of rheumatoid arthritis?
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joint pain, stiffness, swelling, sclerosis of subchondral bone and new bone formation, RA nodules
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Gout
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inflammatory response in relation to uric acid production or excretion
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what are the results of gout?
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hyperuricemia
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what happens to all of the uric acid produced by gout?
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it either crystalizes or is deposited in connective tissue
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