physio final final lecture

Question 1

tumors

Answer 1

a mass of cells whose growth is uncontrollable and that serves no useful fx
can be malignant or benign
benign more common in women
malignant more common in men
depends on whether the tumor is encapsulated

Question 2

tumors damage brain tissue by…

Answer 2

compression
infiltration
malignant can compress and infiltrate
benign tend to only compress

Question 3

primary brain tumors

Answer 3

start in CNS
most commonly seen in those under 15 and above 65

Question 4

secondary brain tumors

Answer 4

metastasize to brain

Question 5

most common brain metastases are from….

Answer 5

lung and breast cancer

Question 6

grade 1 CNS tumor

Answer 6

low proliferative potential
possibility of cure after surgical resection

Question 7

grade 4 CNS tumor

Answer 7

histological evidence of malignancy
mitotically active
prone to necrosis
associated with rapid preoperative and postoperative disease progression and fatal outcome

Question 8

gliomas

Answer 8

most common primary brain tumor
~33%
tumor of the glial cells (astrocytes, oliogodendrocytes, etc)
astrocytoma
meningioma

Question 9

Astrocytoma

Answer 9

tumor of the astrocytes
can be low grade or high grade

Question 10

glioblastoma multiforme

Answer 10

grade 4 astrocytoma
most aggressive tumor form
average survival rate from dx ~ 2 years
higher incidence in white individuals

Question 11

meningioma

Answer 11

tumor of the meninges, usually benign and slow growing
encapsulated

Question 12

main tx for tumors

Answer 12

surgical resection - partial “debulking” or total gross
radiation - whole brain or hippocampus sparing
chemotherapy - must cross BBB, chemotherapy impregnated wafer

Question 13

seizure

Answer 13

a period of sudden, excessive activity of cerebral neurons
can be partial/focal or generalized

Question 14

epilepsy

Answer 14

chronic D/O of recurrent seizures

Question 15

partial/focal types

Answer 15

simple partial - no major change in consciousness
complex partial - cause a loss of consciousness

Question 16

generalized type

Answer 16

tonic-clonic (grand mal)
absence (petit-mal)
atonic

Question 17

tonic clonic/grand mal seizures

Answer 17

most severe form of seizures
includes convulsions (violent uncontrollable muscle movement)
tonic phase -stiffening of muscles
clonic phase - jerking or twitching
typical stages: aura > tonic > clonic > postictal

Question 18

absence “petit-mal”

Answer 18

sudden lapse in consciousness: staring into space, eyelid fluttering, lip smacking, involuntary hand movements)
less than 15 secs

Question 19

atonic seizures

Answer 19

“drop seizures”
sudden loss of muscle control = collapse or fall
different than cataplexy in narcolepsy due to loss of consciousness

Question 20

challenges that come with seizures

Answer 20

50% show damage to the hippocampus
falling
drowning
car accidents - unable to drive 1 year post seizure
pregnancy complications
emotional health issues:
- most common: ADHD, anxiety and aggression
- 6-10% experience post-ictal psychosis
- epilepsy increases risk of schizophrenia by 2.5x

Question 21

Seizure first aid

Answer 21

stay - stay with person until they are awake
safe - keep them safe
side - turn the person onto their side, keep airway clear, put something small and soft under head

Question 22

what not to do with seizures

Answer 22

restrain
put any object in their mouth

Question 23

prion disease

Answer 23

occurs when prion protein begins folding into an abnormal 3D shape
damage = destroyed brain cells leading to rapid decline in thinking and reasoning

Question 24

Creutzfeldt-jakob disease

Answer 24

most common
“mad cow disease”
can be sporadic or familial
causes severe mental deterioration and dementia
~8 months
from eating contaminated meat

Question 25

Kuru disease

Answer 25

from eating contaminated human brain tissue Fore people of Papa New Guinea cannabilism of deceased loved ones 10-50 incubation period "kuru" = trembling/laughing sickness = leads to total loss of muscle control and dysphagia

Question 26

Parkinson's Disease

Answer 26

caused by the degeneration of dopamine-secreting neurons in the substantia Nigra that send axon to the basal ganglia = a deficiency of automatic, habitual motor responses 95% of cases are sporadic

Question 27

Parkinson's Disease Symptoms

Answer 27

dystonia = rigidity = cog wheel test bradyskinesia and slowed reaction times = falls shuffling gait face masking tremors - pill rolling tremor = ~75%

Question 28

Parkinson's tx

Answer 28

L-dopa - time limited, side effects of hallucinations and delusions deprenyl - slows Parkinson's progression intentional lesioning of pathway deep brain stimulation (75% relief so symptoms)

Question 29

Huntington's Disease

Answer 29

inherited disease resulting in degeneration of the basal ganglia results in: chorea (involuntary jerking movement) dystonia slurred speech and swallowing difficulties

Question 30

ALS

Answer 30

degenerative disorder that attacks spinal cord and cranial nerve motor neurons = brain and muscle connection loss symptoms: progressive weakness and muscular atrophy eventual loss of speech, swallow with paralysis eye movement spared death typically caused by respiratory failure within ~24 months

Question 31

multiple sclerosis

Answer 31

autoimmune demyelinating disease scattered locations within the CNS person's immune attacks myelin sheaths leaving behind hard patches of debris (sclerotic plaques) damage occurs in white matter

Question 32

MS risk factors

Answer 32

females > males Living far from the equator black or white race smoking

Question 33

MS symptoms

Answer 33

fatigue vision problems bladder/bowel dysfunction spasms slowed processing speed

Question 34

meningitis (causes, symptoms, etiology)

Answer 34

inflammation of the meninges caused by viruses or bacteria caused by: virus, bacteria, fungus, parasite symptoms: stiff neck, headache, AMS, fever, photophobia, *convulsions, LOC, death (*=sometimes) etiology: spread of middle-ear infection to the brain, head injury, embolus that has dislodged from bacterial infection in heart IV drug use with dirty needles = increased risk

Question 35

brudzinski's sign

Answer 35

flexion of the hips and knees in response to neck flexion

Question 36

kernig's sign

Answer 36

resistance to extension of leg while hip is flexed

Question 37

Dementia

Answer 37

umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life; many different types

Question 38

most common dementia

Answer 38

Alzheimer's 60-80%

Question 39

Alzheimer's

Answer 39

most common form abnormal shrinkage of the brain that affects every brain fx causes significant changes in behaviors and interpersonal relationships neuritic plaques (B amyloid) and neurofibrillary tangles (tau) exposure to toxins TBI, infections may trigger abnormal B amyloid formation APEO gene is involved in making a protein that helps carry cholesterol and other types of fat in the blood stream

Question 40

Dementia with Lewy bodies

Answer 40

causes tremors and stiffness (similar to Alzheimer's) it may be accompanied with sleeping disorders and visual hallucinations

Question 41

vascular dementia vs Alzheimer's on testing

Answer 41

vascular dementia - impairment in: semantic memory, visuo-spatial/perceptual skills, slowed processing speed, with cuing/recognition paradigm can recall information Alzheimer's Dementia - impairments in: episodic memory, language, cuing/recognition does not help

Question 42

Frontotemporal Dementia (and types)

Answer 42

umbrella term for a group of brain disease accumulation of tau protein in front part of brain = overwhelm the brain and cause tissue death 3 types: behavioral variant (most common) changes in personality and behaviors (lack of empathy/interest, increased inappropriate social bx, changes in eating bx/desire to eat inedible foods) primary progressive aphasia: communication progressively gets worse Movement disorders

Question 43

vascular dementia

Answer 43

associated with brain damage d/t ischemic injury or anoxia risk factors same as stroke "mini strokes" = lacunary infarcts accumulation over time = dementia symptoms

Question 44

Schizophrenia "split mind"

Answer 44

mutation in 21 of the 23 chromosomes 10x risk of African and Caribbean migrants men > women older paternal age minor physical anomalies (high steepled palate, webbing between toes, wide or narrow eyes)

Question 45

extrapyramidal

Answer 45

impairment in motor fx NOT related to the pyramids

Question 46

Tardive Dyskinesia

Answer 46

when your face/mouth make sudden uncontrollable movement symptoms irreversible but Vitamin E can prevent further deterioration

Question 47

Anti-cholinergic

Answer 47

dry mouth, urinary retention, blurred vision, constipation

Question 48

akathisia

Answer 48

subjective unpleasant feelings of restlessness

Question 49

treatment resistant?

Answer 49

failing of at least 2 antipsychotic medication trials = clozapine requires blood tests every 18 weeks d/t high risk of neutropenia

Question 50

Depression

Answer 50

heritability: families of persons with affective disorders are 10x more likely to develop MDD or BMD Neuropathology: hedonic tone/responsiveness = traits or genetic predisposition underlying one's baseline range and lifelong ability to feel pleasure disfx of mesolimbic and mesocortical pathway loss of 40-90% of glial cells LOW hedonic tone = increased risk of anhedonia, depression and dysthymia (seen in MDD and ADHD) hippocampal neurogenesis: explains 3-6 week lag in tx response time

Question 51

brain differences in GAD

Answer 51

reduced connections between amygdala and PFC activation of the VMPFC does not result in reduction of amygdala activation lowered GABA presence in amygdala

Question 52

brain differences in social anxiety

Answer 52

disproportionate activation of amygdala when viewing negative expressions and neutral ones

Question 53

brain differences during panic attack

Answer 53

increased activation of amygdala and preaqueductal gray cam be induced by the breathing of CO2 and injection of lactic acid

Question 54

Anxious apprehension vs Anxious arousal

Answer 54

anxious app: increased activation in left frontal lobe (Brocas) anxious arousal = increased activation in right temporal lobe (increased sensitivity to environmental sounds and noises)