Neuropathophysiology

Question 1

Multiple Sclerosis

Answer 1

An immune-mediated inflammatory disorder that causes demyelination of CNS neurons.
Lesions can occur in a wide variety of locations.
Females > Males
Onset between 20 and 40 yo

Question 2

Common MS S/S

Answer 2

Double vision
Tingling on anterior thigh upon neck flexion
Symptoms worsen when patient becomes heated
Emotional instability

Question 3

MS Dx

Answer 3

LP CSF sample

Plaques visible on MRI

Question 4

MS course

Answer 4

Exacerbation and remission pattern
Stress can trigger exacerbation
Some can progress and die very quickly

Question 5

MS Mgmt

Answer 5

Corticosteroids
ACTH
Interferon Beta 1a

Question 6

Parkinsons Dz

Answer 6

Degenerative dz of the basal ganglia involving failure of dopamine secreting neurons.
Can primary, or secondary to another dz

Question 7

Primary parkinsons dz

Answer 7

Begins after the age of 40, peak age of 60
Slowly progressive, 10-20 yr course
Males > Females

Question 8

Primary parkinsons S/S

Answer 8

Slowing of movements (bradykinesia)
Difficulty initiating movements
Poor balance
Face becomes immobile
Decreased autonomic function (sweating, orthostatic hypotension, constipation)

Question 9

Alzheimer Disease

Answer 9

Dementia of alzheimer type

A loss of ordered neural fxn

Question 10

Dementia S/S

Answer 10

Difficulty discriminating stimuli
Memory issues
Abstraction and problem solving
Judgement and reasoning
Language processing
Appropriate use of objects

Question 11

Alzheimers Epidemiology

Answer 11

Can be as young as 50
Increases with age
Half of ppl over 85 have it
Diagnosis of exclusion

Question 12

Alzheimers Patho

Answer 12

Pyrimidal cell death
Gyri shrink, ventricles and sulci expand
Neuritic plaques
Amyloid angiopathy
Linked to down syndrome

Question 13

Alzheimers Tx

Answer 13

Exercise, nutrition
Therapy
Levodopa

Question 14

Myasthenia gravis

Answer 14

Paralysis
Autoimmune disease characterized by the presence of antibodies against nicotinic ACh receptors.
Weak end plate potentials

Question 15

Myasthenia gravis tx

Answer 15

anti-AchE (Neostigmine)

Question 16

Lambert-Eaton Syndrome (LES)

Answer 16

Autoimmune attack against voltage gated calcium channels on the presynaptic motor nerve terminal.
Weak end plate potentials
Can be treated with Neostigmine

Question 17

Reye’s Syndrome

Answer 17

May have genetic predisposition
Generally occurs after a child has varicella, flu, or URI.
Ages 6mo to 15 yrs

Question 18

Epilepsy

Answer 18

Second most common neuro disorder
Increasing incidence w/ age
Recurrent disorder of seizures

Question 19

Petit mal seizure

Answer 19

Almost imperceptible
alterations in consciousness
absence seizure

Question 20

Normal ICP

Answer 20

5 - 15 mmHg

Question 21

Signs of upper motor neuron lesions (UMNL)

Answer 21

Paralysis or weakness, but not atrophy initially
Babinski sign
Loss of fine skilled voluntary movements
Absent abdominal reflexes
Spasticity
Clasp knife reaction
Exaggerated DTR's

Question 22

Signs of lower motor neuron lesions

Answer 22

Flaccid paralysis, atrophy
Loss of DTR’s
Muscle fasciculations, fibrillation, contracture
Muscle wasting