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Flashcards in [MND] All Pathologies Deck (49):
1

Traumatic Brain Injury is defined as

Damage to the brain resulting from external mechanical forces

2

Parkinson's Disease is defined as a

Chronic-progressive disorder of the CNS due to a loss of dopamine producing neurones from the substantial nigra in the basal ganglia

3

Multiple Sclerosis is defined as

An autoimmune inflammatory disease of upper motor neurons that results in the destruction of myelin, oligodendrocytes, and axons, which can result in physical, mental and sometimes psychiatric problems

4

The term spinal cord injury is defined as/refers to

Neurological damage of the spinal cord following trauma

5

A haemorrhagic stroke results from a

weakened vessel that ruptures and bleeds into the surrounding brain. Resulting in blood accumulating and compressing the surrounding brain tissue.

6

What types of haemorrhagic stroke is there?

Intracerebral (within the brain)
Subarachnoid

7

What does ischemic stroke refer to?

An interruption in the flow of blood to the brain. The most common kind of stroke

8

Cerebral Palsy is defined as a

Group of disorders primarily affecting the development of movement and posture causing limitation of activity

9

Dementia can be defined as a

clinical syndrome characterised by a disturbance in memory, cognitive and emotional abilities severe enough to interfere with daily function and quality of life.

10

What are the causes of traumatic brain injury

transportation accidents, construction, sports. Violence, especially in countries such as the US. Firearms, blast injuries, falls.

11

What are the causes of Parkinson's Disease

Most cases it is idiopathic (no known cause; approx 70% of cases. Some cases may result from infections, drugs, toxins, trauma, genetic factors and vascular disease

12

What are the causes of Multiple Sclerosis?

Idiopathic (no known cause)
Factors such as genetics and environments may play a roll. The underlying mechanism is thought to be destruction by the immune system or the failure of myelin producing cells (oligodendrocytes)

13

What are the causes of Spinal Cord Injury?

Falls is considered a common cause. Other causes include gunshots, knife (penetrating causes), whiplash, car crash (hyper flexion), tumours etc

14

What is the cause of stroke?

The primary cause is underlying heart or blood vessel disease.

15

What is the cause of cerebral palsy?

Caused by damage to the developing nervous system, before or during birth or in the early months of infancy. Causes can be all types of strokes, head injuries, hereditary disease, brain injuries and infections

16

What is the cause of dementia?

Same as the main subtypes:
Alzheimer's disease
Dementia with lewy Bodies
Dementias linked with other medical conditions, i.e. hunting tons and parkinsons

17

What is the definition of Downs Syndrome?

A genetic syndrome relating to an abnormality associated with chromosome 21. The syndrome comprises of several specific physical and psychological features and an increased risk of medical complications

18

What is the cause of Downs Syndrome?

In 95% of cases the cause is an extra copy of chromosome 21 occurring in the developing foetus resulting in the child being born with 47 chromosomes in each cell instead of 46. This changes the normal development of the body and brain

19

What are the risk factors for traumatic brain injury?

Risk factors can range from alcohol use to not wearing helmets when riding a motorbike

20

What are the risk factors for Parkinson's Disease?

Age appears to be the leading risk factor (>60). Affects mostly men that females. Other risk factors include toxins (i.e. exposure to pesticides, copper, and magnesium)

21

What are the risk factors for Multiple Sclerosis?

Some studies suggest factors such as genetics, the environment, smoking, and inadequate vitamin D may all play a role

22

What are the risk factors for stroke?

Non Reducible risk factors include history of stroke, TIA's, family hx of stroke, age, ethnicity, and diabetes.
Reducible risk factors include hypertension, cholesterol, and smoking

23

What are the risk factors for Cerebral Palsy?

Low birth weight (50%), multiple pregnancies (twins, triplets etc), infections

24

What are the risk factors for Downs Syndrome?

- Increased risk with increasing age of mother
- Previous birth of a baby with DS is another risk factor

25

What are the risk factors for Dementia?

Advancing age in most forms of dementia

26

What are the risk factors for Vascular dementia?

Stroke and associated risk factors such as hypertension, diabetes, coronary artery disease and smoking

27

What are some risk factors for Alzheimers disease?

Genetic predisposition
Cardiovascular risk factors
Downs syndrome
History or head trauma with loss of consciousness

28

Epidemiology: Parkinson's Disease

Mean age 58/59; 1 in 500 have PD, prevalence is 1% for those over 60 in NZ

29

Epidemiology: Traumatic Brain Injury

Every day 90 New Zealander's have a brain injury

30

Epidemiology: Multiple Sclerosis

Approximately 1 case per 1000 in New Zealand

31

Epidemiology: Spinal Cord Injury

49.1 cases per million per year in NZ

32

Epidemiology: Stroke

Third largest killer in NZ (2500 deaths a year), 9000 New Zealander's every year have a stroke, 65% of stroke occurs to people over 65

33

Epidemiology: Cerebral Palsy

2.0 - 2.5 / 1000 live births in New Zealand. Approximately 7000 people have a degree of CP (1/3 are under 21)

34

Epidemiology: Dementia

5-8% of NZ'ers aged 65 and over, 20% of people older than 80 have dementia.
Current dementia rates are expected to double by 2050
Alzheimers - 50-70% of all dementia
Vascular - 15-25%
Dementia with Lewy Bodies - 10-20% of late onset dementia

35

Epidemiology: Downs Syndrome

The most common genetic disorder causing intellectual disability
DS occurs in approximately 1 in 1000 live births

36

How is Parkinson's Disease diagnosed?

Medical history and neurological exam. Response to levodopa (i.e. relief to motor impairment will confirm diagnosis)

37

How is Multiple Sclerosis diagnosed?

based on presenting signs and symptoms in combination with medical imaging and lab test. Medical history and neurological exam. The most commonly used diagnostic tools are neuroimaging, analysis of cerebrospinal fluid (via lumbar puncture) and evoked potentials.

38

How is spinal cord injury diagnosed?

A radiographic evaluation using an X-ray, MRI or CT scan can determine if there is any damage to the spinal cord and where it is located. A neurological evaluation with sensory and reflex testing can help determine the motor function a person with SCI

39

How is stroke diagnosed?

Based on patients history and physical examination. CT & MRI can produce a 3-d image of the head and can be used to identify the types of strokes and other problems involving the brain, brain stem and spinal cord. The MRI is more detailed but more expensive.

40

How is Cerebral Palsy diagnosed?

Based on patient history and physical exam. CT and MRI can be useful if theca cause of CP has not been established. MRI is preferred due to more detail and safety.

41

How is Dementia diagnosed?

Three Diagnostic Criteria
1) Memory impairment AND related changes in another cognitive domain such as language, abstract thinking, and judgement
2) Severe enough to affect social and occupational functioning
3) decline from previously higher level of function

42

How is Downs Syndrome Diagnosed?

Before Birth: Screening through blood tests and ultrasound tests
After birth: Clinical observation combined with blood test to confirm DS

43

How is Traumatic Brain Injury diagnosed?

Use of clinical evidence, particularly a neurological examination, i.e. checking whether pupils constrict normally in response to light and assigning and Glasgow Coma Score. Neuroimaging can help in determining the diagnosis and prognosis and deciding what treatments to give.

44

What is the prognosis for Downs Syndrome?

Currently the average life expectancy is mid fifties. Prognosis is affected by effective management of medical conditions associated with DS

45

What is the prognosis for Cerebral Palsy?

Reduced life expectancy - 90% survival into teens and 20s (immobility and severe learning difficulties are main influencing factors)

46

What is the prognosis for Dementia?

Alzheimer's Disease: survival from diagnosis is very variable. Death is usually from complications
Vascular Dementia: Survival can be up to 20 years after diagnosis

47

What is the prognosis for Spinal Cord Injury?

Spinal cord injuries result in at least some incurable impairment even with the best possible treatment. In general, patients with complete injuries recover very little lost function and patients with incomplete injuries have more hope of recovery. Most neurological recovery occurs within the first 2 months after injury although recovery may continue for up to 1 year and occasionally after this.

48

What is the prognosis for Parkinson's Disease?

Chronic progressive. Motor symptoms for example advance aggressively in early stages and more slowly later. Untreated, individuals can lose independent ambulation and may even become bedridden. The life expectancy of people with PD is reduced.

49

A stroke can be defined as

An accident with rapidly developing clinical signs of focal or global disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than of vascular origin