Neuro Diagnoses

Question 1

Alzheimer’s Disease

Answer 1

• Irreversible degeneration of acetylcholine transmitters within cerebral cortex
• progressive
• amyloid plaques

Question 2

Alzheimer’s Disease - etiology

Answer 2

Unknown
-Maybe: lower levels of neurotransmitters, higher levels of aluminum in brain, genetics, autoimmune, abn amyloid processing, virus

Question 3

Alzheimer’s Disease - risk

Answer 3

Older women

Question 4

Alzheimer’s Disease - sxs (early, middle, late)

Answer 4

-early on: difficulty w/ new learning, subtle changes to memory and concentration

• word finding difficulties, no orientation, depression, poor judgement
• rigidity, bradykinesia, shuffling gait, unable to self-care

-end stage: severe intellectual/physical destruction, incontinence, funct dep, inability to speak

Question 5

Alzheimer’s Disease - tx

Answer 5

No cure

-treat sxs w/ rx

Question 6

Alzheimer’s Disease - rx

Answer 6

• Rx: block acetylcholinesterase, Alleviate cog sxs, control behavior
• Tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon)

Question 7

Amyotrophic Lateral Sclerosis

Answer 7

• chronic degenerative
• muscle denervation and atrophy, weakness
• upper AND lower motor neuron impairment

Question 8

Amyotrophic Lateral Sclerosis - UMN/LMN

Answer 8

• UMN: Coritcospinal/bulbar demye

- LMN: loss of ant horn cells in spinal cord, loss of motor cranial nerve nuclei in brainstem

Question 9

Amyotrophic Lateral Sclerosis - risk

Answer 9

40-70 y.o. men

Question 10

Amyotrophic Lateral Sclerosis - etiology

Answer 10

Unknown

-Maybe: genetics, virus, metabolic disturbances, toxicity of lead/aluminum

Question 11

Amyotrophic Lateral Sclerosis - sxs

Answer 11

• Distal to proximal ASYMM muscle weakness
• fatigue, oral motor deficits, motor and resp paralysis

-fasciculations, cramping, hand atrophy, incoordination, spasticity, clonus, +Babinski

Question 12

Amyotrophic Lateral Sclerosis - tx

Answer 12

-tx: PT, OT, SLP, RT, Nutritional Therapy

Question 13

Amyotrophic Lateral Sclerosis - rx

Answer 13

riluzole (Rilutek)

Question 14

Carpal Tunnel Syndrome

Answer 14

• median nerve entrapment
• normal pressure 2 to 10 mmHg, CTS > 30mmHg
• nerve ischemia

Question 15

Carpal Tunnel Syndrome - etiology

Answer 15

Unclear

-associated: repetitive use, RA, pregnancy, DM, cumulative trauma disorders, tumor, hypothyroidism, wrist sprain or fx

Question 16

Carpal Tunnel Syndrome - sxs

Answer 16

• Median sensory changes and paresthesia
• May radiate up
• Night pain, weakness, muscle atrophy, clumsy, dec mobility

Question 17

Guillain-Barre Syndrome - risks

Answer 17

Young adults; adults 5th-8th decade

Question 18

Guillain-Barre Syndrome

Answer 18

• autoimmune “acute polyneuropathy”
• temp inflammation and demye of peripheral nerve myelin sheath
• axonal degeneration

Question 19

Guillain-Barre Syndrome - etiology

Answer 19

Unknown
-possible response from previous resp infection, flu, immunization, sx

-associations: viral infection, Epstein-Barr syndrome, cytomegalovirus, bacterial infection, sx, and vaccinations

Question 20

Guillain-Barre Syndrome - sxs

Answer 20

• distal to proximal and symm
• sensory impairment

-sometimes: absent DTR, can’t speak, or swallow, respiratory paralysis

Question 21

Guillain-Barre Syndrome - progression

Answer 21

2-4 weeks: peak impairment

Question 22

Guillain-Barre Syndrome - tx

Answer 22

• hospitalization

- PT, OT, SLP

Question 23

Guillain-Barre Syndrome - rx

Answer 23

• immunosuppressive, analgesics, narcotic

- cardiac monitoring, plasmapheresis, mechanical vent

Question 24

Guillain-Barre Syndrome - PT

Answer 24

Pulmonary rehab, strength/mobility, WC/orthotics, AD

Question 25

Huntington’s Disease

Answer 25

basal ganglia and cerebral cortex degeneration/atrophy

Question 26

Huntington’s Disease - etiology

Answer 26

Autosomal dominant | 35-55 y.o.

Question 27

Huntington’s Disease - sxs

Answer 27

- affective dysfunction, personality changes - cog impairment - chorea, choreoathetoid, ataxia - grimacing, tongue protrusion

Question 28

Huntington’s Disease - Late stage

Answer 28

-mental deterioration, dec IQ, depression, dysphagia, incontinence, immobility, rigidity

Question 29

Huntington’s Disease - tx

Answer 29

Family counseling, rx

Question 30

Huntington’s Disease - PT

Answer 30

Endurance, strength, balance, postural control, funct mobility

Question 31

Multiple Sclerosis

Answer 31

- autoimmune demyelination patches in brain and spinal cord | - plaque development

Question 32

Multiple Sclerosis - types (best to worst)

Answer 32

Relapse and remitting Secondary progressive Primary progressive Progressive relapse remitting - worst prognosis

Question 33

Multiple Sclerosis - etiology

Answer 33

Unknown - maybe: slow acting virus initiates autoimmune response - associations: genetics, viral inf, enviro

Question 34

Multiple Sclerosis - risks

Answer 34

20-35 y.o.

Question 35

Multiple Sclerosis - initial sxs

Answer 35

- visual problems, clumsiness, fatigue | - paresthesias, sensory changes, weakness, ataxia, balance dysfunct,

Question 36

Multiple Sclerosis - tx and goals

Answer 36

Tx: rx, medical intervention, PT, OT, SLP, Goal: dec length of exaccerbation

Question 37

Multiple Sclerosis - PT

Answer 37

Energy conservation, normalization of tone, balance and gait, core, AD and adaptive devices

Question 40

CVA Types (5)

Answer 40

``` Transient Ischemic Attack Completed Stroke - total sxs at onset Stroke in Evolution - thrombus usu, gradual onset of sxs Ischemic (embolus/thrombus) Hemorrhagic ```

Question 41

CVA Transient Ischemic Attack

Answer 41

Usu atherosclerotic thrombus Sxs resolve quickly (24-48h) Carotid and vertebrobasilar arteries

Question 42

CVA Ischemic

Answer 42

Embolus (20% of ischemic CVAs) or thrombus -loss of perfusion w/i seconds Irreversible infarct w/ surrounding ischemia