Neuro 4

Question 1

MS - what is happening?

Answer 1

Autoreactive T cells and B cells cross the BBB – triggering inflammation and loss of oligodendrocytes.

Question 2

MS - prevalence

Answer 2

More common in northern latitudes, among women, and those of north European ancestry.

Question 3

MS - risk factors

Answer 3

Potential risk factors include smoking, vitamin D deficiency, and Epstein-Barr virus.

Question 4

MS - how is it diagnosed?

Answer 4

Diagnosis is made through the formation of lesions noted on a CT scan.

Question 5

MS - signs & symptoms

Answer 5

Visual disturbance, paresthesia of face, trunk, or limbs, weakness, and impaired gait.

Question 6

MS - symptom progression

Answer 6

Majority have a remitting-relapsing course; can also have primary-progressive, secondary-progressive, or progressive-relapsing.

Question 7

MS - remitting relapsing course

Answer 7

Each exacerbation is followed by a relapse that brings the individual back to normal or near normal function.

Question 8

MS - primary progressive

Answer 8

Starts with initial onset with no relapsing and continues to progress.

Question 9

MS - secondary progressive

Answer 9

Initially remitting-relapsing, but changes to progression without relapses.

Question 10

MS - progressive relapsing

Answer 10

Each exacerbation is followed by a relapse, but they do not return to a baseline of function.

Question 11

GB - what is happening?

Answer 11

Rare demyelinating disorder caused by an autoimmune reaction directed at the peripheral nerves.

Question 12

GB - what happens prior to condition

Answer 12

History of respiratory or GI infection.

Question 13

GB - signs & symptoms

Answer 13

Starts with tingling and numbness, progresses to paresis of the legs to complete quadriplegia, respiratory insufficiency, and ANS instability.

Question 14

GB - symptom progression

Answer 14

Starts at the periphery and moves up; recovery is the reverse.

Question 15

ALS - what is it?

Answer 15

Amyotrophic lateral sclerosis - Lou Gehrig’s Disease.

Question 16

ALS - what is happening?

Answer 16

Motor neurons eventually die, impacting voluntary muscle movement.

Question 17

ALS - signs & symptoms

Answer 17

Muscle weakness, trouble lifting a cup or pen, trouble with speaking or swallowing, choking, excessive drooling, depression, inappropriate laughter.

Question 18

ALS - who is at risk?

Answer 18

Genetics and environmental interactions.

Question 19

ALS - survival rate

Answer 19

Less than 3 years.

Question 20

Parkinson’s - Cause

Answer 20

Dopamine deficiency in the basal ganglia.

Question 21

Parkinson’s - Who is at risk?

Answer 21

Begins after age 40, more common in males.

Question 22

Parkinson’s - TRAP

Answer 22

T: tremor, R: rigidity, A: akinesia, P: postural disturbance.

Question 23

Dysarthria

Answer 23

Difficulty forming words due to loss of muscle control.

Question 24

Dysphagia

Answer 24

Difficulty swallowing due to loss of muscle control.

Question 25

Delirium - what is it?

Answer 25

Acute state of confusion, typically reversible, with loss of memory, language, and problem solving.

Question 26

Delirium - causes

Answer 26

Metabolic concerns, medications, or toxins.

Question 27

Excited Delirium

Answer 27

Agitated delirium that can lead to sudden death.

Question 28

Delirium - risk factors

Answer 28

General hospital population, post-surgical, patients in long-term care, elderly patients, patients with sensory deficits, and brain injury.

Question 29

How is dementia different than delirium?

Answer 29

Dementia develops slowly over time, progresses over months to years, with clear consciousness and normal attention span; rarely reversible.

Question 30

How is delirium different than dementia?

Answer 30

Delirium develops rapidly over days to weeks, with chaotic progression, altered level of consciousness, impaired attention, and is reversible.

Question 31

Alzheimer's types

Answer 31

Late onset (70-90%), early onset (familial), early onset.

Question 32

Alzheimer's early onset

Answer 32

Forgetfulness, memory loss, missing appointments, getting lost, personality changes (emotional upset, flat affect, no sense of humor).

Question 33

Alzheimer's late onset

Answer 33

Difficulty with abstract thinking, communication; deterioration of memory, language, and motor function; repetitive actions, restlessness, wandering; irritability, mood swings, depression; disorientation.

Question 34

Alzheimer's early onset - familial

Answer 34

Has a strong genetic inheritance.

Question 35

Alzheimer's - what is happening?

Answer 35

Build-up of proteins in and around brain cells, causing accumulation of extracellular neuritic plaques and intraneuronal neurofibrillary tangles.

Question 36

Alzheimer's - early signs and symptoms

Answer 36

Memory loss that affects job, difficulty performing familiar tasks, learning difficulties, deterioration of appearance and personal hygiene.

Question 37

Alzheimer's - late signs and symptoms

Answer 37

Difficulty with abstract thinking, communication, deterioration of memory, language, and motor function, repetitive actions, restlessness, wandering, irritability, mood swings, depression, disorientation.

Question 38

Sundowner syndrome

Answer 38

Increase in dementia-type symptoms later in the evening or at night.

Question 39

Alzheimer's - risk factors

Answer 39

Lifestyle, environment, and genetic background.

Question 40

Cataracts - what is happening?

Answer 40

Cataracts are proteins that normally found on the lens but start clumping together with age, leading to blindness.

Question 41

Cataracts - signs & symptoms

Answer 41

Cloudy or opaque area in the lens resulting in vision loss.

Question 42

Glaucoma - what is happening?

Answer 42

Increase in intraocular pressure within the anterior chamber of the eye.

Question 43

Glaucoma - closed angle

Answer 43

Displaced iris pushes the ciliary body and blocks fluid from reaching the trabecular meshwork.

Question 44

Glaucoma - open angle

Answer 44

Ciliary body is in the correct position but something is blocking the trabecular meshwork.

Question 45

Glaucoma - signs & symptoms

Answer 45

Cloudy or opaque area in the lens resulting in peripheral vision loss.

Question 46

Macular degeneration - what is it?

Answer 46

Deterioration of tissue in the macula of the eye, causing severe and irreversible loss of central vision.

Question 47

Macular degeneration - signs & symptoms

Answer 47

Blurred vision and loss of central vision.

Question 48

Macular degeneration - risk factors

Answer 48

Hypertension, smoking (2X), diabetes, family history, women, and elderly.

Question 49

Sensorineural hearing loss

Answer 49

Impairment in the Organ of Corti within the cochlea or its connections; presbycusis is the most common cause.

Question 50

Conductive hearing loss

Answer 50

Conduction of sound is impaired from the outer ear through to the inner ear.

Question 51

Otitis media - risk factors

Answer 51

Eustachian tube is shorter, wider, and more horizontal, allowing bacteria to travel.

Question 52

Acute otitis media

Answer 52

Ear pain, fever, irritability, inflamed TM, & fluid in middle ear.

Question 53

Otitis media with effusion

Answer 53

Accumulation of fluid in the middle ear without symptoms of an acute infection.