Neuro 1 pt9 Flashcards
(27 cards)
With CJD, there are 2 types. which affects who, is more common, which is mad cow disease?
Sporatic is more common – older ppl
Varient is less common – younger ppl
Mad cow disease = varient. Ppl ingest prions.
__ type of CJD, soil can be reservoir for prions from shedding/decomposition of carcasses
Sporatic
In CJD, the mutated gene assembles the cytoplasm’s amino acids wrongly, producing _____
infectious proteins, or prions
CJD- typical clinical course (5)
Psychiatic (depression) followed by sensory manifestations
advanced once ataxia occurs
50% develop paresis of upward gaze (lose ability to look up)
cog. impairment, invol. movements, immobility
unresponsiveness, mutism are common
3 tests for CJD. Which is the gold standard that is rarely done?/why is it rarely done?
LP
EEG
Brain Biopsy - rarely done b/c the evidence is already overwhelming. You notice how quickly this develops, much quicker than Alzheimers
Pulvinar sign on an MRI helps identify:
CJD
don’t tell PETA this way to definitely diagnose CJD
transmission of characteristic neurdegenerative dz to experimental animals
*Triad to diagnose Normal Pressure Hydrocephalus (NPH)
Wet (incontinence), Wacky (dementia), wobbly (genetic, wide based gait –can’t pick up feet, stomp like a robot)
Only Tx available for NPH:
Ventriculoperitoneal Shunt
attentive pt. c impaired retentive memory way out of proportion to all other cognitive functions(global confusional state)
but patient has no insight into his illness, is apathetic & indifferent about it
Wernicke-Korsakoff Syndrome
low B1(thiamine); also dz that affects medial thalami or hippocampal portion temp. lobe. AN EMERGENCY
Beriberi aka Wernicke-Korsakoff Syndrome
Wernicke is __
Korsakoff is __
Acute
Chronic
the chronic phase of it Beriberi Can still do calculations, but can’t remember the 3 components of the MiniMental test.
Korsakoff
Tx of wernicke-korsakoff syndrome
give thiamine & folate
\_\_\_ is the brain’s conductor regulates muscle contraction force of contraction sequence of movement works by enabling or suppressing movements via two simultaneous pathways
Basal Ganglia
in the basal ganglia motor circuit, what are the 2 NT? What is each’s function
Glutamate - excite
GABA - inhibit
Substantia Nigra uses what NT? Is it excitatory or inhibitory?
Dopamine. It’s both!
What goes wrong with the Basal Ganglia motor circuit with Parkinsons?
normally the direct and indirect pathways work normally, with parkinson’s the direct pathway is not working.
there is no substantia nigra
Normal dopamine producing neurons number 550,000 in Substancia Nigra; PD=___
100,000
4 cardinal signs of Parkinson’s Ds
Resting tremor (only one side)
Rigidity
Bradykinesia
gait disturbance w/postural instability
__ pathway dysfunction (D1) create __ signs when can’t disinhibit desired movements well:
akinesia(“absence of movement”/less spontaneous movement/blinking)/bradykinesia(slowness)/postural instability
__ pathway dysfunction(D2) create __ signs when can’t functionally inhibit undesired movements well:
rigidity, tremors
Direct - positive
Indirect - negative
What common drugs can cause a Parkinsonism-like movement Problems?
*What is the most common drug to cause movement disorders?
D2 antagonism causes extrapyramidal side effects
*Reglan
Parkinson Ds tx: (4)
Exercise, therapy
Levodopa
Dopamine agonists
COMT - Catecholomine -O-MethylTransferase - increase plasma levodopa, tolcapone
in advanced Parkinson Ds, when meds are no longer effective, you can evaulate for:
DBS - deep brain stimulation
