Reviewer #10 Flashcards
(102 cards)
1
Q
Most frequent cause of CVA
A
Thrombosis
2
Q
The most common cause of cerebral thrombosis is
A
Atherosclerosis
3
Q
Atherosclerosis usually affecting elderly persons Tends to occur during
A
Sleep or soon after arising
4
Q
Thrombosis is characterized by
A
Gradual deterioration of the client’s condition
5
Q
The second most cause of CVA
A
Embolism
6
Q
Embolism most commonly affecting
A
Younger people
7
Q
Embolism is most frequently caused by
A
Myocardial Infarction and Rheumatic Heart Disease
8
Q
May be due to HPN, subarachnoid hemorrhage, rupture of aneurysm, A-V malformation, hypocoagulation
A
Hemorrhage
9
Q
Refers to transient cerebral ischemia with temporary episodes of neurologic dysfunction
A
Transient Ischemic Attacks (TIA)
10
Q
Refers to the development of a neurologic deficit over several hours to days
A
Stroke in evolution
11
Q
Refers to a permanent neurologic deficit
A
Complete stroke
12
Q
Loss of ability to understand or express speech
A
Aphasia
13
Q
Loss of half of the visual field
A
Hemianopsia
14
Q
The process of learning to live to one’s maximum potential with chronic impairment and its resultant disability
A
Rehabilitation
15
Q
States that, because of the limited space for expansion within the skull
A
Monro-kelle hypothesis
16
Q
Cushing’s triad
A
Bradycardia, Hypertension, and Bradypnea
17
Q
Abnormal flexion of the upper extremities and extension of the lower extremities
A
Decortication
18
Q
Extreme extension of the upper and lower extremities
A
Decerebration
19
Q
This response is seen clinically as an increase in systolic blood pressure, widening of the pulse pressure, and reflex showing of the heart rate
A
Cushing’s reflex
20
Q
Due to CN III compression. There is ipsilateral pupil dilatation
A
Anisocoria
21
Q
Results from the compression of the optic nerve. It is also known as “choked disc”.
A
Papilledema
22
Q
This is contralateral loss of motor function due to decussation of motor fibers at the level of medulla oblongata, e.g., left brain affectation leads to right hemiplegia; right brain affection leads to left hemiplegia
A
Lateralizing sign
23
Q
The most common scanning and diagnostic tests of ICP are
A
CT Scan and MRI
24
Q
Avoided in patients with increased ICP, because the sudden release of pressure in the lumbar area can cause the brain to herniate
A
Lumbar puncture
25
Sudden excessive, disorderly electrical discharges of the neurons
Seizure disorders
26
Types of Seizure
Grand Mal (most common type)
Petit Mal
Jacksonian/Focal
Psychomotor
Febrile Status Epilepticus
27
Inflammation of the lining around the brain and spinal cord caused by bacteria or viruses.
Meningitis
28
Caused by bacteria. The bacteria Streptococcus pneumoniae and Neisseria meningitides are responsible for 80% of cases of meningitis in adults
Septic meningitis
29
Caused by viral or secondary to lymphoma, leukemia, or human immunodeficiency virus (HIV).
Aseptic meningitis
30
Increase the risk of bacterial meningitis, because the bacteria can cross the epithelial membrane and enter the subarachnoid space.
Otitis media and mastoiditis
31
This syndrome is the result of endothelial damage and vascular necrosis caused by the bacteria. Complications include visual impairment, deafness, seizures, paralysis, hydrocephalus, and septic shock.
Waterhouse Friderichsen syndrome
32
Key diagnostic tests of meningitis
Culture, CSF and Blood Gram Staining
33
It is used to detect a shift in brain contents (which may lead to herniation) prior to a lumbar puncture.
CT scan and MRI
34
Demonstrate low glucose, high protein levels, and high white blood cell count.
CSF Studies
35
Allows for rapid identification of the causative bacteria and initiation of appropriate antibiotic therapy.
Gram Staining
36
In combination with one of the cephalosporins (e.g., ceftriaxone sodium, cefotaxime sodium) is administered intravenously (IV).
Vancomycin hydrochloride
37
Proved to be beneficial as an adjunct therapy in the treatment of acute bacterial meningitis and pneumococcal meningitis.
Dexamethasone
38
An immune-mediated, demyelinating disease of the CNS.
Multiple Sclerosis
39
Interrupts the flow of nerve impulses and results in a variety of manifestations, depending on the nerves affected.
Demyelination
40
Characterized by clearly acute attacks with full recovery or with sequelae and residual deficit upon recovery. Periods between disease relapses are characterized by lack of disease progression.
Relapsing-remitting (RR) MS
41
Characterized by disease showing progression of disability from onset, without temporary plateaus and minor improvements.
Primary Progressive (PP) MS
42
Begins with an initial RR course, followed by progression of variable rate, which may also include occasional relapses and minor remissions.
Secondary Progressive (SP) MS
43
Shows progression from onset but with clear acute relapses with or without recovery.
Progressive-Relapsing (PR) MS
44
Muscle hypertonicity of the extremities and loss of the abdominal reflexes result from involvement of the main motor pathways (pyramidal tracts) of the spinal cord.
Spasticity
45
The diagnosis of MS is based on the
Presence of multiple plaques in the CNS observed with MRI.
46
What cure is there for MS?
No cure for MS therefore Symptomatic
47
The goals of treatment are
To delay the progression of the disease, manage chronic symptoms, and treat acute exacerbations.
48
The disease modifying medications reduces the frequency of relapse, the duration of relapse, and the number and size of plaques observed on MRI.
Disease-Modifying Therapies
49
Reduces the rate of relapse in the RR course of MS. It decreases the number of plaques noted on MRI and increases the time between relapses.
Glatiramer acetate (Copaxone)
50
Is administered subcutaneously daily. acts by increasing the antigen-specific suppressor T cells.
Copaxone
51
Is administered via IV infusion every 3 months. It can reduce the frequency of clinical relapses in patients with secondaryprogressive or worsening relapsing-remitting.
Mitoxantrone (Novantrone)
52
A gamma-aminobutyric acid (GABA) agonist is the medication of choice for treating spasticity.
Baclofen (Lioresal)
53
A chronic problem most resistant to treatment. Medications used to treat ataxia include beta-adrenergic blockers (Inderal), antiseizure agents benzodiazepines (Klonopin).
Ataxia
54
Defects of articulation
Dysarthria
55
An autoimmune disorder affecting the myoneural junction is characterized by varying degrees of weakness of the voluntary muscles.
Myasthenia gravis
56
Clinical manifestation of myasthenia gravis
Cephalocaudal (Descending Paralysis)
57
Double vision
Diplopia
58
Drooping of the eyelids
Ptosis
59
Voice impairment
Dysphonia
60
Myasthenia gravis is purely a
Motor disorder without no effect on sensation or coordination
61
Used to diagnose myasthenia gravis. acetylcholinesterase inhibitor stops The breakdown of acetylcholine, thereby increasing availability at the neuromuscular junction.
Acetylcholinesterase inhibitor test
62
Confirmatory test for myasthenia gravis
Edrophonium chloride (Tensilon) test
63
Detects a delay or failure of neuromuscular transmission and is about 99% sensitive in confirming the diagnosis of myasthenia gravis.
A single fiber electromyography (EMG)
64
Cure for myasthenia gravis
There is no cure for MG since treatments do not stop the production of the acetylcholine receptor antibodies.
65
An anticholinesterase medication is the first line of therapy. It provides symptomatic relief by inhibiting the breakdown of acetylcholine and increasing the relative concentration of available acetylcholine at the neuromuscular junction.
Pyridostigmine Bromide (Mestinon)
66
Suppress the patient's immune response, decreasing the amount of antibody production, and this correlates with clinical improvement.
Corticosteroids
67
Used to treat myasthenia gravis if there is inadequate response to steroids.
Cytotoxic medications
68
Inhibits T lymphocytes and reduces acetylcholine receptor antibody levels.
Azathioprine (Imuran)
69
A technique used to treat exacerbations. The patient's plasma and plasma components are removed through a centrally placed large-bore double-lumen catheter.
Plasmapheresis
70
(Surgical removal of the thymus gland) can produce antigenspecific immunosuppression and result in clinical improvement.
Thymectomy
71
A course of _____ decreases the time needed for postoperative mechanical ventilation.
Preoperative plasmapheresis
72
An exacerbation of the disease process characterized by severe generalized muscle weakness and respiratory.
Myasthenic crisis
73
An autoimmune attack on the peripheral nerve myelin.
Guillain-Barré syndrome
74
Can result in a variety of clinical manifestations.
Cranial nerve demyelination
75
May result in blindness.
Optic nerve demyelination
76
Results in autonomic dysfunction, manifested by instability of the cardiovascular system
Vagus nerve demyelination
77
Classic sign GBS
Areflexia and Ascending Weakness
78
Are used to directly affect the peripheral nerve myelin antibody level. Both therapies decrease circulating antibody levels and reduce the amount of time the patient is immobilized and dependent on mechanical ventilation.
Plasmapheresis and IVIG
79
Tachycardia and hypertension are treated with short-acting medications such as
Alpha adrenergic blocking agents.
80
A disease of unknown cause in which there is a loss of motor neurons (nerve cells controlling muscles) in the anterior horns of the spinal cord and the motor nuclei of the lower brain stem.
Amyotrophic lateral sclerosis (ALS)
81
LAS is often referred to as
Lou Gehrig's Disease after the famous baseball player who suffered from the disease
82
ALS cause is
Unknown (Idiopathic)
83
The chief symptoms of ALS are
Fatigue, progressive muscle weakness, cramps, (twitching), and incoordination.
84
Is diagnosed based on the signs and symptoms, because no clinical or laboratory tests are specific for this disease
ALS
85
A glutamate antagonist, is the only medication with U.S. Food and Drug Administration approval for treatment of ALS.
Riluzole (Rilutek)
86
Also known as Tic Douloureux and is a condition of the fifth cranial nerve that is characterized by paroxysms of pain in the area innervated by any of the three branches, but most commonly the second and third branches of the trigeminal nerve
Trigeminal Neuralgia
87
May be useful for patients troubled by spasticity, which causes pain and interferes with self-care.
Baclofen (Lioresal), dantrolene sodium (Dantrium), or diazepam (Valium)
88
The pain ends as abruptly as it starts and is described as a
Unilateral shooting and stabbing sensation
89
Painful tic
Tic Douloureux
90
Certain areas are called trigger points because
Slightest touch immediately starts a paroxysm or episode.
91
Relieve pain in most patients with trigeminal neuralgia by reducing the transmission of impulses at certain nerve terminals.
Antiseizure agents, such as carbamazepine(Tegretol),
92
Taken with meals. Serum levels must be monitored to avoid toxicity in patients who require high doses to control the pain. Side effects include nausea, dizziness, drowsiness, and aplastic anemia.
Carbamazepine
93
Are also used for pain control in TN
Gabapentin (Neurontin) and baclofen
94
If pain control is still not achieved, ______ may be used as adjunctive therapy.
Phenytoin (Dilantin)
95
A slowly progressing neurological movement disorder that eventually leads to disability.
Parkinson's disease
96
The CARDINAL SIGNS of parkinsons
Tremor, rigidity, bradykinesia, and postural instability
97
The most effective agent and the mainstay of treatment. It is converted to dopamine in the basal ganglia, producing symptom relief.
Levodopa
98
Effective in relieving many of the symptoms of Parkinson's disease. The intent of thalamotomy and pallidotomy is to interrupt the nerve pathways and thereby alleviate tremor or rigidity
Thalamotomy and pallidotomy
99
A chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary choreiform movement and dementia.
HUNTINGTON DISEASE
100
Huntington is transmitted as an
Autosomal dominant genetic disorder
101
Purposeless involuntary movement
CHOREIFORM MOVEMENTS
102
Which predominantly block dopamine receptors, improve the chorea in many patients.
Thiothixene Hydrochloride (Navane) and Haloperidol Decanoate (Haldol)
