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IMS Final Flashcards

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1
Q

What is accumulation of CSF called?

A

hydrocephalus

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2
Q

What is edema of the optic disk called & what is it a sign of?

A

papilledema

sign of increased intracranial pressure

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3
Q

What is a subfalcine hernia?

A

lateral shift across the hemisphere btwn the corpus collosum & tip of falx cerebri

has better prognosis

brain herniation

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4
Q

Name the types of brain herniations

A

protrusion of the brain tissue through the supporting dura

  1. Subfalcine hernia
  2. Tentorial herniation
  3. Tonsillar herniation
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5
Q

What is a tentorial herniation?

A

central or lateral brain herniation

causes compression of the brainstem

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6
Q

Which brain hernia causes compression of the brainstem?

A

tentorial herniation

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7
Q

What is a tonsillar herniation?

A

brain herniation through the foramen magnum

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8
Q

Which brain hernia goes through the foramen magnum?

A

tonsillar herniation

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9
Q

What is decorticate posturing?

A

abnormal FLEXOR response of arms & wrists
feet extend & internally rotate

due to brain injury

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10
Q

What is decerebrate posturing?

A

arms EXTEND w/ external rotation of wrists & legs/feet extend & rotate internally

due to brain injury

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11
Q

What is penumbra?

A

the area of viable cells surrounding the ischmic area in stroke that may be reperfused & restored

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12
Q

What is a TIA?

A

transient ischemic attack

obstructive clot is efficiently lysed before permanent brain injury occers
any neurologic defecit resolves w/in 24 hrs

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13
Q

What is the most common artery occluded in ischemic stroke?

A

middle cerebral atery

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14
Q

What is a lacunar infarct?

A

occlusion of small penetrating arterioles

not typically observed on a CT scan

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15
Q

What is epileptogenic focus?

A

area of the brain that initiates excessive abnormal electrical discharges

may spread to other areas of the brain & cause seizures if enough neurons involved

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16
Q

Describe a petit mal seizure

A

no LOC
lasts 2-10 seconds
become motionless & stare, unaware of surroundings
tend to report ‘losing’ of convos

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17
Q

Describe a grand mal seizure

A

aka tonic-clonic
staring, limbs become rigid for 10 sec
then jerking of limbs, eyes roll back, drooling, lasts 1-2 mins
apneic during this period so deep breath usually marks end
often accompanied by bowel/bladder incontinence

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18
Q

What is the postictal phase of a seizure?

A

Pt does not remember & are often embarrassed

very tired, want to sleep

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19
Q

What is aura?

A

the period before a seizure where they may have sensory disturbances, mood changes, HAs, etc.

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20
Q

What is status epilepticus?

A

a life threatening condition…continuous seizures w/o recovery
more common w/ tonic-clonic seizures
esp. at risk if ceasing anti-seizure meds

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21
Q

Describe the pathology of dementia

A

intracellular neurofibrillary tangles

amyloid plaques

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22
Q

What are intracellular neurofibrillary tangles & what disease do you find them in?

A

the proteins become hyperphosphorylated & form helical segments w/in cells in Alzheimer’s Pts

the protein tau/neural threads usually stabilize microtubular systems in normal cells

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23
Q

What are amyloid plaques & what disease do you find them in?

A

APP is in the cell membrane then cleaved and beta-amyloids are produced when cleaved in wrong spot
this causes inc. action of glutamate

assoc. w/ dementia

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24
Q

What are lewy bodies & what disease do you find them in?

A

eosinophilic cytoplasmic inclusions found in surviving neurons

also found in amyloid plaques & assoc. w/ dementia
parkinsons

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25
What are the 8239 S/S of Parkinson's?
1. Rest tremor 2. Pill rolling - finger-to testing 3. Bradykinesia - veryyyyy slow mvmts 4. Cogwheel rigidity 5. Masked facies 6. Difficulty arising from a chair 7. Difficulty initiating first few steps 8. Shuffling gait 9. Dec. arm swing
26
What is the treatment for Parkinsons?
DOPAMINE! | MAOI & COMTI
27
What are the S/S of hydocephalus?
1. Gait instability 2. Urinary incontinence 3. Dementia Can't think, Can't walk, Can't pee!!!
28
What is ataxia?
muscle incoordination sign of cerebellar disorder
29
What is found in a LP w/ MS?
oligoclonal bands
30
Where would you find oligoclonal bands?
MS
31
What is a main cause for spina bifida?
folate deficiency
32
Which nerve is messed up in bell's palsy?
Facial Nerve VII
33
What is a synarthroses joint?
fibrous & cartilaginous
34
What is a diarthroses joint?
synovial joint surrounded by fibrous capsule, contains synovial fluid for lubrication, articulating surface covered in hyaline cartilage
35
Explain the grades of a sprain
stretching or tearing of the ligaments 1 - stretching, no instability 2 - moderate injury w/ some instability 3 - complete disruptino/tearing w/ loss of stability
36
What deQuervian's tendonitis?
tendonitis of extensor pollicus brevis & abductor pollicus longus of the thum pain & numbness Finkelstein test painful
37
What are the layers in the joint capsule?
Fibrous membrane - outer, collagenous, poorly vascularized, innervated Synovial membrane - inner, highly vascularized w/ little innervation, inner layer contain synoviocytes
38
What is adhesive capsulitis?
frozen shoulder from scarring
39
What bursae are commonly inflamed?
1. Trochanteric bursitis - hip 2. Subacromial bursitis - shoulder 3. Olecranon bursitis - water on the elbow 4. Prepatellar bursitis - knee
40
What is compartment syndrome?
serious injury pressure inc. & causes problems Check the 5 Ps
41
What should you check for with compartment syndrome?
``` Pain out of proportion to injury Pallor Pulselessness Paresthias Paralysis ```
42
What is a spiral Fx?
rotational forces causing the bone to fracture & split in 'S' shape
43
What is a longitudinal Fx?
splits bone along its length
44
What is an oblique Fx?
rotational forces but occurs at 45 degree angle rather than rotating around entire bone
45
What is a comminuted Fx?
more than one Fx line & more than 2 bone fragments
46
What is an impacted Fx?
force telescopes bone upon itself
47
What is a greenstick Fx?
incomplete Fx w/ one side of the cortex still intact seen in children more often
48
What is a stress Fx?
failure on one cortical surface but can become complete if stimulation continues usually cause of repetitive activity rather than acute injury
49
What is an avulsion Fx?
complete separation of a small fragment of bone
50
What is sublaxation?
displaced bone that partially loses contact
51
DXA scan scores
osteoporosis - T score>= osteopenia - T score - 1 to -2.5
52
What is osteomalacia & what is it caused by?
Vit D deficiency impairs maintenance of Ca & PO4 levels so bone is poorly mineralized/calcified similar to rickets prone to collapse & compression fractures
53
What is a myocyte?
single muscle cell or fiber
54
What is a sarcolemma?
membrane surrounding muscle fiber
55
What is a fasciculi?
bundle of muscle fibers
56
What is the sarcoplasm?
cytoplasm of the muscle fiber
57
What are the thick filaments?
myosin
58
What are the thin filaments?
actin | w/ smaller amounts of troponin & tropomysin
59
Describe duchenne muscular dystrophy
most common & severe X-linked, only affects males starts in pelvic girdle then shoulder deficient in protein dystophin that weakens cell membrane & allows influx of fluid that leads to inflammation & muscle cell destruction
60
What causes osteoarthritis?
hyaline cartilage destruction forms bone spurs by trying to heal itself Heberden nodes at DIP joints Bouchard nodes at PIP joints
61
What is the main cause of septic arthritis?
N. gonorrhoeae
62
What is the classic manifestation of SLE?
butterfly/malar rash autoantibodies directed at components in cell nucleus
63
Name the types of scleroderma
``` C - calcinosis (Ca deposits in tissue) R - Raynauds E - Esophageal motility S - Sclerodactyly T - Telanciectasis (face, lips, fingers) ``` Anti-Scl-70
64
What is ankylosing spondylitis?
immune mediated inflammation bony outgrowth from spinal ligaments - syndesmophytes that cause fusion of the spine Bamboo spine assoc. w/ HLA-B27
65
Which disease has a strong association w/ HLA-B27?
ankylosing spondylitis
66
What is the skin manifestation of polymyositis/dermatomyositis?
gottron sign
67
What bacteria cause reiter syndrome?
appear 2-4 wks after GI - campylobacter, Yersinia, Shigella, Salmonella GU - Chlamydia trachomatis
68
What is the rare classic triad of reiter syndrome?
1. Arthritis 2. Conjunctivitis 3. Urethritis/cervicitis - comes 1st
69
What causes rheumatic fever?
B-hemalytic group A strep | strep throat
70
What bacteria causes lyme disease & what is it's vector?
Berrelia burgdorferi deer ticks
71
Where is the most common site for gout formation?
MTP big toe have elevated serum uric acid

IMS III (2 decks)

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