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Flashcards in CNS DIS Deck (85):
1

Progressive failure of cerebral functions that is not caused by an impaired level of consciousness is:

Dementia

2

T or F: Dementia frequently has an abrupt onset.

FALSE. Dementia never has an abrupt onset. If there is abrupt onset it is not dementia but another disease

3

What causes Alzheimer's disease?

An abruption in the cholenergic system, decrease in ACE, decrease in number of cells in the brain

4

Alzheimer's can cause an disturbances in:

Nerve cell communication, Decreased Metabolism, decreased Cell repair

5

What is the most common clinical manifestation of Alzheimer's disease?

Gradual onset with a chronic progressive decline in cognitive functioning

6

Other cognitive manifestations of Alzheimer's include:

Short term memory loss, Anxiety and agitation, Judgment, problem-solving and communication problems

7

On a day to day care basis, Alzheimer's can cause

Loss of ability to complete ADLs

8

An end stage clinical manifestation of Alzheimer's is:

Loss of bowel and bladder incontinence

9

The MMSE test is used to assess:

The stages of Alzheimer's

10

A high MMSE score correlates with (beginning or end) stage of the disease, a low MMSE score correlates with (beginning or end) stage of the disease

Beginning; end

11

Compared to a healthy brain, a brain of a person with Alzheimer's disease will have these key differences:

Cortical shrinkage, enlarged ventricles, shrinking of the hippocampus- the more severe the disease, the more shrinkage will occur

12

How is the decrease in ACE (associated with Alzheimer's disease) managed?

*Increase ACETYLCHOLINE level by decrease its reuptake
*Pharmacologic agents that prevent Acetylcholine from breaking down.
[Acetylcholinesterase Inhibitors (AChEls)]

13

T or F: The purpose of Alzheimer's treatments is to slow the progression of the disease.

FALSE. The progression cannot be stopped

14

What are the two main goals of Alzheimer's drug treatments?

Improve cognitive function: memory, and Symptom control

15

T or F: Alzheimer's drugs should be given in very small doses.

TRUE.

16

Seizures are:

Abnormal electrical activities within the NERVE CELLS in the brain

17

Seizures occur when:

A Synchronous, high frequency depolarization of a focus spreads to other parts of the brain

18

T or F: All seizures will manifest in generally the same way.

FALSE. Manifestations depend on location of focus and recruitment of other parts of the brain.

19

Congenital defects, Hypoxia at birth, Head Trauma, and cancer are all causes of:

Seizures

20

Hypokinesia causes:

paresis, paralysis

21

Define paresis:

Muscular weakness due to nerve damage

22

Hyperkinesia causes:

Chorea, tremors

23

Define chorea:

A neurological disorder characterized by jerky involuntary movements

24

flaccidity and floppiness is a result of:

Hypotonia

25

Dysphagia, speech impairment, excitability, spasticity, and posturing are results of:

Hypertonia

26

Define dysphasia:

Difficulty swallowing as a symptom of disease

27

What are two types of posturing?

decerebrate, decorticate

28

A position in which the patient holds their upper arms at their sides with elbows, wrists, and fingers flexed while legs are extended and internally rotated, and feet are plantar flexed is _______________ posture.

Decorticate

29

A position in which jaws are clenched, neck is extended, arms are addicted and stiffly extended at the elbows with forearms probated, wrists and fingers flexed is____________posturing

Decerebrate

30

What are the two types of seizures?

Partial and generalized

31

What is the major difference between simple and complex partial seizures?

Level of consciousness: in complex you will see loss of consciousness

32

A seizure that only involves part of the brain is considered:

A partial seizure

33

A seizure that involves the whole brain in addition with loss of consciousness is:

A generalized seizure

34

A tonic seizure involves:

Contraction of the muscles

35

A clonic seizure involves

Relaxation of muscles

36

T or F: febrilE seizures are associated with epilepsy.

FALSE. They are a result of a fever.

37

What are the three seizure stages?

Aura, seizure, post-ictal

38

Visual or audio warning signs happen during the ____________ stage

Aura

39

T or F: The time block between the aura and seizure stage varies between person to person.

TRUE

40

Confusion, Disorientation, Weakness, and Hypoglycemia are common during the _____________seizure stage.

Post-ictal

41

What is a Status Epilepticus seizure?

A seizure that lasts >30 minutes

42

CNS depression during the post-ictal stage could lead to a patient:

Forgetting to breathe

43

A sign that a patient is hypoglycemic in the post-ictal stage is:

Tremors

44

What is the goal of anticonvulsant drugs?

To control or prevent recurrence of seizures

45

What is the action of anticonvulsant drugs?

stabilize cell membrane by affecting cation transport

46

Can a child with epilepsy ever be off of medication?

Possibly, but must be weaned off slowly

47

Cerebrospinal fluid (CSF) leakage from nose or ear may indicate:

A skull fracture

48

Increased ICP, amnesia, hypotension are common signs of

Concussion

49

A contusion will present as

Increased ICP

50

Increased ICP; nuchal rigidity; fixed dilated pupil on the affected side; papilledema; hemiparesis; hemiplegia; and leakage of CSF from ears or nose are all s/s of:

Hematoma

51

A patient presenting with no loss of consciousness, confused would be described as a Grade ______ concussion.

I

52

A patient presenting with No loss of consciousness, brief retrograde amnesia would be described as a Grade ______ concussion.

II

53

A patient presenting with confusion & amnesia @ impact would be described as a Grade ______ concussion.

III

54

A patient presenting with immediate loss of consciousness would be described as a Grade ______ concussion.

IV

55

What is Second Impact Syndrome?

After one concussion, 2nd blow causes catastrophic IICP, herniation, ischemia, and cell death

56

What is the difference between concussion and contusion?

Concussion is a bruised brain, contusion refers to a lesion in the brain

57

Epidural:

head strikes a surface

58

Epidural hematoma:

tearing of an artery & blood accumulates between inner skull & dura

59

Coup:

impact of head against something

60

Contrecoup:

impact within the skull (rebound effect)

61

What is an example of an epidural?

unrestrained MVA (head hits windshield)

62

Subdural:

violent motion of brain tissue in the skull

63

What is an example of a subdural injury?

Shaken baby syndrome

64

What are the most common s/s of acute brain injury?

acute alteration in LOC, change in respiratory patterns

65

Abrupt onset of persistent neurological signs and symptoms because of a decreased blood supply to the brain is defined as:

A stroke

66

Which neurological condition is the #3 cause of death in US, Hypertension is the major risk factor, responsible for 500,000/yr., 1/3 with neuro deficit

Stroke

67

T or F: Age, race, gender, predisposing conditions, and substance abuse are all risk factors for stroke.

TRUE

68

What are the two classifications for CVA?

Ischemic and Hemorrhagic

69

An ischemic CVA is due to

An interruption of blood flow

70

atherosclerosis, idiopathic are examples of:

thrombotic ischemic CVA

71

heart disease, carotid athero/art.pressure, and edema are examples of:

embolic ischemic CVA

72

Tissue damage as a result of IICP would be classified as:

An ischemic CVA

73

A Hemorrhagic stroke results in:

A hemorrhage in the brain

74

List 6 serious effects of a Hemorrhagic stroke

edema, hydrocephalus, re-bleeding, infarction, coma, death

75

Clinical manifestations of stroke are dependent on:

area affected and adequacy of collateral circulation

76

List 5 clinical manifestations of a hemorrhagic stroke:

1. LOC 2. aphasia: receptive, expressive, mixed 3. hemineglect syndrome 4. Cognitive and motor disorders 5. Long term; motor defects, language, speech, aphasia, Dysphagia

77

paralysis, gait, paresis, decision making, voluntary activity, thought process, affective responses, incontinence indicates a stroke in which region?

ant. cerebral

78

hemiplegia, sensory, aphasia, confusion/coma, neglect indicates a stroke in which region?

middle cerebral

79

visual defects, hallucinations, memory loss, and repetitive activity are clinical manifestations of a stroke in which region?

post cerebral

80

An injury in the thalamus manifests with:

sensory, pain, tremors, aphasia

81

A celebellar injury may be observed by:

brain stem; visual deficits

82

What is the most important factor in treatment of a CVA?

Salvage brain tissue within 3 hrs!

83

An acute or chronic inflammation of the pia mater & arachnoid membranes is:

Meningitis

84

headache, nuchal rigidity, low grade fever are s/s of:

Meningitis

85

leukocytosis in CSF via spinal tap confirms which type of meningitis?

Bacterial