Term
| What are the signs of UMN Defects? |
|
Definition
Spastic Weakness
Hyperreflexia
Babinski Reflex may be present |
|
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Term
| What are the signs of LMN Defects? |
|
Definition
flaccid weakness
significant atrophy
fasciculations present
hyporeflexia |
|
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Term
| Can peripheral nerves regenerate? |
|
Definition
| peripheral nerves can regenerate |
|
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Term
| What are some sensory consequences of trauma to peripheral nerves? |
|
Definition
loss of sensation in region supplied by nerve
phantom pain/abnormal sensations |
|
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Term
| What are some motor consequences of trauma to peripheral nerves? |
|
Definition
loss of motor function in region of damage
hypotonia
areflexia
atrophy
fasiculations
Autonomic consequences variable |
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|
Term
| What are the symptoms of peripheral neuropathy? |
|
Definition
loss of sensation in hands or feet
Weakness of skeletal muscle
Autonomic - orthostatic hypotension, GI problems, Thermoregulation, vision, sexual dysfunction |
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Term
| Which condition is the only neuromuscular disease that involves both rapid fatigue of voluntary muscle and prolonged recovery time? |
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Definition
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Term
| What is mortality with Myasthenia Gravis due to? |
|
Definition
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|
Term
| What is the peak age of onset for Myasthenia Gravis? |
|
Definition
|
|
Term
| What is the pathophysiological cause of Myasthenia Gravis? |
|
Definition
| The number of normal acetylcholine receptors is reduced due to autoimmune damage of the receptors |
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Term
| Which condition is characterized by sx including progressive muscle weakness, early fatiguability with activity, that usually presents with ocular sx including diplopia and ptosis? |
|
Definition
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|
Term
| What are some signs of respiratory muscle weakness in pts with Myasthenia Gravis? |
|
Definition
weak cough
attacks of dyspnea
inability to clear mucus |
|
|
Term
| What is the treatment for myasthenia gravis? |
|
Definition
Anticholinesterase
Prednisone to tx AI attack |
|
|
Term
| How is Myasthenia Gravis diagnoses confirmed? |
|
Definition
| Tensilon Test - Anticholinesterase drug given IV with marked improvement in muscle strength within 30 seconds |
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Term
| Which type of crisis associated with the disease Myasthenia Gravis is treated with more anticholinesterase meds? |
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Definition
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|
Term
| Which type of crisis associated with the disease Myasthenia Gravis is due to an excess of anticholinesterase meds? |
|
Definition
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|
Term
| Is Guillain-Barre Syndrome slow-onset or rapid onset? Where do the sx begin and what is the pattern of movement? |
|
Definition
| Rapid Onset; Ascending motor paralysis starting in the legs |
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|
Term
| When are symptoms with Guillain-Barre Syndrome most severe? |
|
Definition
| Most severe within 3 weeks |
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|
Term
| What is the prognosis for a pt with Guillain-Barre Syndrome? |
|
Definition
| Pt can recover fully within a few weeks to years |
|
|
Term
| What are the positive symptoms of Guillain-Barre Syndrome? |
|
Definition
|
|
Term
| What are the negative symptoms of Guillain-Barre Syndrome? |
|
Definition
| muscle weakness, paralysis, loss of DTRs and decreased sensation |
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|
Term
| What type of onset is Guillain-Burre Syndrome (sudden or slow)? What do patients generally present with? |
|
Definition
Rapidly progresses in an ascending fashion
Pts generally notice a weakness in their legs "rubbery legs", or legs that tend to buckle |
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|
Term
| What is the treatment for Guillain-Barre syndrome? |
|
Definition
supportive care
ventilation prn
plasmapheresis
meds (steroids) |
|
|
Term
| When does postpolio syndrome occur? |
|
Definition
| Occurs 20 to 30 y after poliomyelitis |
|
|
Term
| What is the classic triad in postpolio syndrome? Which part of the body is most often affected? |
|
Definition
Unusual Fatigue
New Muscle Weakness (+/- atrophy)
Muscle Pain - often with twitching
Limb are most often affected |
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|
Term
| What condition is an infection of the meninges? |
|
Definition
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Term
| What condition is characterized by symptoms including acute onset of HA, fever and nuchal rigidity other sx may include N/V, rashes, sore throat and malaise? |
|
Definition
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|
Term
| What condition presents with menigitis and decreased level of consciousness, and seizures and focal symptoms? |
|
Definition
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|
Term
| Which condition begins with sx including vomiting, convulsions, delirium and coma then progresses to acute encephalopathy, fatty infiltration of the liver and decerebrate posturing and coma? |
|
Definition
|
|
Term
| What posturing is characteristic of Reye syndrome? |
|
Definition
| Decerebrate Posturing (Extensor Response) |
|
|
Term
| What is the most important tx for Reye syndrome? |
|
Definition
| Reduce intracranial pressure |
|
|
Term
| What is the best study to see fatty infiltration of the liver? |
|
Definition
| Ultrasound study of the Liver |
|
|
Term
| Which bacteria are the common pathogens infecting the meninges and parenchyma of the brain? |
|
Definition
| Staph Aureus, Strep Pneumo, and HiB |
|
|
Term
| What are the most common entry points of bacteria infections? |
|
Definition
|
|
Term
| What is the best prevention of bacterial infection in the CNS? |
|
Definition
| Early treatment of infection in portal of entry |
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|
Term
| What condition is characterized by HA, N/V and decreased LOC (Level of Consciousness)? |
|
Definition
| Brain Abscess caused by bacterial infection |
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|
Term
| What condition is described as the result of excess paroxysmal d/c from a hyperexcitable group of neurons? |
|
Definition
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|
Term
| With simple partial, complex partial and generalized seizures, describe the level of consciousness of each? |
|
Definition
Simple Partial - No LOC, pt is aware of seizure
Complex Partial - No LOC, pt has amnesia of seizure event
Generalized - Pt is unconscious and unaware of their seizure and surroundings |
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|
Term
| Which seizure type is described as lasting for less than a minute and includes sx such as abnormal uncontrolled movement, twitching, abnormal smells, sounds or sensations, tachycardia, flushing, tachypnea, memory distortions and dysphagia? |
|
Definition
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|
Term
| Which type of seizure is described as disturbances in higher level cognitive function which creates sx including coordinated involuntary repetitive movements ("robot-like")? |
|
Definition
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|
Term
| What area of the brain do most complex partial seizures arise from? |
|
Definition
| medial temporal or inferior frontal lobes |
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|
Term
| Which type of generalized seizure is described as sudden brief lapses of consciousness without loss of postural control that last for a short time period? |
|
Definition
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|
Term
| Which type of generalized seizure has sx including rapid eye blinking, and vacant stare with rapid return to consciousness and resumption of activity? |
|
Definition
|
|
Term
| When do absence seizures usually begin? |
|
Definition
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|
Term
| Which general seizure is the classic seizure of epilepsy? |
|
Definition
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|
Term
| What state follows a tonic-clonic seizure? How long can this state last? What are some sx of this state? |
|
Definition
Post-Ictal state
Lasts up to 30min
Pt may be confused, depressed, agitated |
|
|
Term
| Where does a tonic-clonic seizure originate in the brain? |
|
Definition
| from both hemispheres simultaneously |
|
|
Term
| Which type of generalized seizure is described as beginning with a loud cry, with patient falling unconscious then body goes through stiffening/contraction and relaxation cycles repeatedly, additionally incontinence may occur? |
|
Definition
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|
Term
| Which type of generalized seizure is described as "jumps" or sudden shock-like movements localized to a few muscles or limbs and tends to be brief? |
|
Definition
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|
Term
| Which type of generalized seizure is described as a sudden loss of muscle tone with loss of body posture, aka "drop attacks"? |
|
Definition
|
|
Term
| What is a serious complication of Tonic seizures? |
|
Definition
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|
Term
| Which type of generalized seizure is described as a sudden increase in muscle tone such as a stiffening of the face and upper body with flexion of the arms and extension of the legs, with the possibility of head and eye deviation to one side? |
|
Definition
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|
Term
| Which type of generalized seizure is described as slow single or multiple sharp, repetitive jerking movements of arms, legs or torso? |
|
Definition
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|
Term
| What term is described as continuous or intermittent seizure activity lasting 20 min or longer during which the pt does NOT regain consciousness? |
|
Definition
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|
Term
| What physiologic effects occur after less than 15 min of tonic-clonic seizures? |
|
Definition
tachycardia
elevated BP
hyperglycemia
elevated temp
leukocytosis |
|
|
Term
| What physiologic effects occur after 15 to 30 min of tonic-clonic seizures? |
|
Definition
hypotension
hypoglycemia
dysrhythmias
pulmonary edema |
|
|
Term
| What physiologic effects occur after 1 hour of tonic-clonic seizures? |
|
Definition
hypotension w/decreased cerebral blood flow
disruption of BBB causing cerebral edema |
|
|
Term
| What is the tx for seizure disorders? |
|
Definition
| Benzodiazepines (Ativan, Valium) |
|
|
Term
| What is the Gold Standard study for diagnosing a seizure disorder? |
|
Definition
|
|
Term
| What is the normal range for intercranial pressure? |
|
Definition
|
|
Term
| What are increased Intercranial pressures due to? |
|
Definition
brain tumors
brain injury
obstruction of CSF flow |
|
|
Term
| What type of posturing occurs when lesion is above the brainstem? |
|
Definition
| Decorticate Posturing (Arms In - Up) |
|
|
Term
| What type of posturing occurs when a brain lesion or increased ICP interrupts signals from higher structures to the pons and medulla (lower structures) causing damage to the brainstem? |
|
Definition
| Decerebrate Posturing (Arms Out - Low) |
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|
Term
| What condition has signs and symptoms including dilated pupils with no light reaction? |
|
Definition
|
|
Term
|
Definition
| When both hemispheres or brainstem are dysfunctional |
|
|
Term
| What are the three layers of the meninges from outside in? |
|
Definition
Dura Mater
Arachnoid Mater
Pia Mater |
|
|
Term
| What type of bleed is an epidural hematoma caused by? Which vessel is usually involved? |
|
Definition
| Arterial bleed from the middle meningeal artery |
|
|
Term
| What type of bleed is an subdural hematoma caused by? |
|
Definition
|
|
Term
| When does the primary damage of spinal chord injury occur? What are the causes of secondary damage of spinal chord injury? |
|
Definition
Primary - Caused by initial trauma at time of injury
Secondary - Caused by inflammation, edema, and cord hypoxia |
|
|
Term
| What is the basic tx for spinal cord injury? |
|
Definition
| immobilization and steroids |
|
|
Term
| What temporary condition is described as a loss of autonomic nervous control, areflexia, loss of sensation and flaccid paralysis that is usually caused by trauma? How is it tx and what is the time frame of administration? |
|
Definition
| Spinal Shock; Steroids w/in 3 h of injury |
|
|
Term
| What is the most common type of brain tumor? Are they most often benign or malignant? |
|
Definition
|
|
Term
| What condition has characteristic signs and sx including seizures, HA, Increased ICP, N/V and papilledema? |
|
Definition
|
|
Term
| Which type of spinal cord tumors arise from the bone or within the extradural space? Are these generally benign or malignant? |
|
Definition
| Extradural tumors; malignant |
|
|
Term
| Which type of spinal cord tumor lies between the dura mater and the spinal cord? |
|
Definition
| Intradural extramedullary tumors |
|
|
Term
| Which type of spinal cord tumors arise from within the spinal cord itself? |
|
Definition
| Intradural intramedullary tumors |
|
|
Term
| What is the difference in duration between acute and chronic pain? |
|
Definition
acute = < 3 m
chronic = > 3 m |
|
|
Term
| What can chronic pain lead to? |
|
Definition
Social withdrawl/depression
preoccupation with health leading to inappropriate use of healthcare |
|
|
Term
| Which type of chronic pain has no identifiable physical cause? |
|
Definition
|
|
Term
| Which type of chronic pain has multiple dramatic physical complaints? |
|
Definition
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|
Term
| Which type of chronic pain has pathologic preoccupation with minor symptoms? |
|
Definition
|
|
Term
| Which type of chronic pain has a physical (identifiable) cause? |
|
Definition
|
|
Term
| Which type of HA condition has sx including severe unilateral pounding/throbbing, N/V, photophobia, phonophoboa? |
|
Definition
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