Exam 1: neuro

Question 1

At least ___ of 9 diagnostic tests must be met to be categorized as depression

Answer 1

5

Question 2

Risk of suicide is high in which groups of people with depression?

Answer 2

white and asian-american men

Question 3

what are some common meds used to treat depression?

Answer 3

-remeron, effexor, paxil, wellbutrin

Question 4

dementia is a ___, not a disease

Answer 4

syndrome

Question 5

Most common form of dementia is ___, which constitutes about ____% of cases

Answer 5

Alzheimer’s; 50-60%

Question 6

what are the 4 main types of dementia?

Answer 6

alzheimer’s, fronto-temporal,vascular, dementia with lewy bodies,

Question 7

2 main types of AD disease?

Answer 7

familial, nonfamilial

Question 8

AD type: Only 5-10% of cases
Early onset
Gene mutation

Answer 8

familial

Question 9

AD type: Role of apolipoprotein E (ApoE)

Complex gene/environment interactions

Answer 9

nonfamilial

Question 10

patho of AD

Answer 10

amyloid plaques & abnormal deposits of proteins, neurofibrillary tangles, loss of synaptic connections, cell death /neuron (brain atrophy - shrinks)

Question 11

• 5th leading cause of death in age >65

Answer 11

AD

Question 12

what is the incidence of AD gender-wise/ethnicity?

Answer 12

women get it more, b/c they live longer. higher in African-american and hispanics

Question 13

Impairment of language

Answer 13

aphasia

Question 14

Inability to perform purposeful acts or manipulate objects

Answer 14

apraxia

Question 15

Inability to recognize familiar objects or persons

Answer 15

agnosia

Question 16

Loss of memory

Answer 16

amnesia

Question 17

what are the 4 A’s related to AD?

Answer 17

amensia, agnosia, apraxia, aphasia

Question 18

3 main causes of death for AD patients?

Answer 18

pneumonia (aspiration), malnutrition, and dehydration

Question 19

med for AD:Increases levels of ACh (involved in memory and judgment)
Maintains memory skills for a period of time

Useful only in early stages

Answer 19

Cholinesterase Inhibitors

Question 20

what are some meds given for patients with AD?

Answer 20

aricept, exelon, razadyne, cognex

Question 21

what is the precaution needed for cognex(AD med)?

Answer 21

must monitor liver enzymes

Question 22

med for AD:Regulates activity of glutamate
Used more often in middle to late stage AD
May combine with a cholinesterase inhibitor

Answer 22

memantine (namenda)

Question 23

what are the alternative therapies to AD?

Answer 23

ginko biloba(vasodilation), huperzine A(cholinesterase inhibitor), Vitamin A

Question 24

caused by reduced or blocked blood flow to the brain

Answer 24

vascular dementia

Question 25

Treatment of Vascular Dementia-besides meds

Answer 25

Lower blood pressure Reduce cholesterol Prevent blood clotting Control blood glucose

Question 26

meds used to treat vascular dementia-

Answer 26

Anticoagulants | Alzheimer’s medications

Question 27

which form of dementia has Parkinsonian sx?

Answer 27

DLB dementia with lewy bodies

Question 28

Most striking symptom of DLB (dementia with lewy bodies)

Answer 28

visual hallucinations or delusions

Question 29

this disease: Extreme sensitivity to neuroleptic meds (extreme agitation, even death)* no anticholinergic

Answer 29

DLB

Question 30

Progressive, degenerative, hereditary neurologic disease (rare) S/S usually begin in 30s-40s Child of affected person has 50% chance of inheritance 1 in 10,000 men and women

Answer 30

Huntington's

Question 31

Poor prognosis: death usually occurs due to heart failure, pneumonia/infection, fall, or choking

Answer 31

Huntington's

Question 32

Slow progression (over 10-20 yrs) of: Involuntary choreiform movements(writhing) Speech problems Dementia

Answer 32

Huntington's

Question 33

Rare brain disorder Progressive degeneration of the gray matter of the brain (spongiform degeneration) Cause: abnormal glycoprotein Onset usually around age 60

Answer 33

cruetzfeldt-jacob disease

Question 34

Unilateral facial paralysis Sudden onset Dysfunction of CN VII

Answer 34

Bell's Palsy

Question 35

Treatment – medications (steroids), artificial tears, sunglasses, facial massage (for pain), soft diet

Answer 35

Bell's

Question 36

Etiology unknown: | Possibly vascular ischemia, viral disease (herpes simplex, herpes zoster), autoimmune disease, or combination

Answer 36

Bell's

Question 37

another name for Trigeminal Neuralgia

Answer 37

tic douloreux

Question 38

Chronic pain condition that affects CN V Sudden, severe facial pain lasting a few seconds to minutes: stabbing and lightning-like Etiology: likely due to vascular pressure

Answer 38

TIC douloreux (trigeminal neuralgia)

Question 39

what are some meds used for trigeminal neuralgia?

Answer 39

carbamazepine (Tegretol) Dilantin Neurontin Lioresal

Question 40

Assist w/minimizing episodes of pain Get creative re: ways to maintain hygiene w/o the typical means Ex., use cotton to wash face, rinse mouth with mouthwash vs. brushing Keep bathing water & beverages/food room temp

Answer 40

trigeminal neuralgia

Question 41

Abnormal increase in CSF in the brain Occurs if flow of CSF in brain/spinal column blocked Ventricles enlarge, creating pressure on brain tissue Can occur at any age, more common in elderly May result from head trauma, infection, tumor, complications from surgery, subarachnoid hemorrhage; unknown.

Answer 41

Normal Pressure Hydrocephalus

Question 42

what is the classic triad for pts. with normal pressure hydrocephalus?

Answer 42

-Progressive mental impairment & s/s dementia -Impaired gait General slowing or feeling “stuck” common -Impaired bladder control leading to urinary frequency &/or incontinence

Question 43

Surgical placement of shunt to drain excess CSF into abdomen (reabsorbed) Brain then returns to normal size

Answer 43

normal pressure hydro.