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FD Chapter 13

Fund. of disease Chapter 13, Diseases of the Nervous System

Meningitis is an acute(sudden) inflammation of the arachnoid membrane and the pia mater
The meninges are the protective membranes surrounding the brain and spinal cord
Meningitis is an infectious disease that affects children and yound adults
Meningitis can be caused by a bacterial or viral infection
Bacterial meningitis can be serious and deadly
Most recover completely from viral meningitis
The infecting organism can reach the meninges from the middle ear, upper respiratory tract, frontal sinuses, or carried in the blood from other infected sites
Symptoms of meningitis include 1.Hyperthermia(temperature > 104 degrees 2.Chills 3.N&V(Nausea & vomiting) 4.Severe cephalalgia(head pain) caused by an increased ICP (IntraCranial Pressure) 5.Stiff neck 6.Rash 7.Seizures 8.Coma(unconsciousness without response to stimuli)
The hyperthermia (temperature > 104 degrees) can cause delirium(confusion), convulsions, and coma(unconsciousness without response to stimuli)
Dx of meningitis is confirmed with a LP(Lumbar Puncture) AKA "spinal tap"
The CSF (Cerebral Spinal Fluid) will contain protein, leukocytes(white blood cells) and the infecting organism
Tx for meningitis include 1.Antibiotic therapy for bacterial infections 2.Antipyretics(Tylenol, Motrin) for pyrexia(fever) control 3.IV(IntraVenous) therapy for dehydration
Without Tx permanent brain damage may occur causing blindness, deafness, paralysis, mental retardation(low IQ{Intelligence Quotient}), hydrocephalus(abnormal accumulation of fluid in the brain caused by an obstruction of the normal flow of CSF(Cerebral Spinal Fluid) and death
Meningitis is most commonly caused by meningococcus or pneumococcus
Immunizations for meningococcal infections include Menactra and Menomune
Immunizations for pneumococcal infections include Pneumovax 23 and Pnu-Immune 23
Encephalitis is an inflammation of the brain usually caused by herpes simplex I, influenza, rubeola(measles), parotitis(mumps), rubella(german measles), varicella(chicken pox) and arbovirus(west nile virus)
Signs & symptoms of encephalitis range from mild to severe and may include 1.Cephalalgia(headache) 2.Pyrexia(fever) 3.Lethargy(Mental sluggishness) 4.Personality changes 5.Seizures 6.Paralysis
Risk factors for encephalitis include 1.Children 2.Elderly 3.Those who are immunocompromised
Dx of encephalitis is confirmed with a LP (Lumbar Puncture)
Treatment of encephalitis include 1.Controlling pyrexia(fever) and ICP(Inter Cranial Pressure) 2.Maintain fluid and electrolyte balance 3.Careful monitoring of respiratory and kidney function
Rabies is an inflammatory disease of the brain and spinal cord
Rabies is transmitted through bites and scratches of rabid animals
Animals that commonly contract rabies are 1.Dogs 2.Cats 3.Wolves 4.Raccoons 5.Skunks 6.Foxes 7.Bats 8.Humans
The onset of symptoms for rabies usually appear 3 weeks to 3 months after exposure
Signs & symptoms of rabies include 1.Pyrexia(fever) 2.Generalized pain 3.Mental derangement(insanity) 4.Rage 5.Convulsions 6.Paralysis 7.Hydrophobia(fear of water 8.Aphagia(inability to swallow) 9.A production of a profuse sticky frothy saliva(foam at the mouth)
Once visible symptoms develop, the mortality rate for rabies is almost 100%
Treatment (Tx) for rabies include 3 subQ antirabies injections over 3 weeks(1 injection per week)
Animals infected with rabies exhibit a change in temperament such as 1.Wild animals may act tame 2.The tameness is followed by a furious stage where the animal bits everything
In the final stage of rabies there is foaming at the mouth and death
Shingles is an acute(sudden) and Chronic(reaccuring) sensory neuritis caused by the letency(time between exposure & symptoms) effect of the varicella zoster(chicken pox) virus
Shingles is AKA herpes zoster
Herpes zoster is the sequela(afermath) of varicella zoster(chicken pox)
Signs & symptoms of shingles include 1.A painful unilateral(one-side) vesicular(blisters) rash 2.Pruritus(itching) 3.Scarring(cicatrices)
An outbreak of shingles commonly lasts 2-4 weeks
Shingles most commonly occurs in people over the age of 50
An immunization that is 50% effective and recommended for people over age 60 who have had varicella zoster(chicken pox) is called Zostavax
Tx of shingles includes 1.Antiviral therapy(Zovirax) 2.Narcotic analgesics(vicodin) 3.Antipruritics(Caladryl) 4.SAIDs(steriodal anti-inflammatory drugs) THERE IS NO CURE
Activation of the dormant VZV(Varicella Zoster Virus) is associated with 1.A compromised immune system 2.Poorly controlled stress
Reye's Syndrome(RS) is an encephalopathy(disease condition of the brain) associated with the combination of children, viral infections and the use of ASA(aspirin)
RS(Reye's Syndrome) can cause an increased ICP (IntraCranial Pressure)
Signs & symptoms of Reye's Syndrome (RS) include 1.Persistent vomiting 2.Personality changes 3.Lethargy(mental sluggishness) 4.Confusion 5.Seizures 6.Coma(unconsciousness without response to stimuli)
Rx for Reye's Syndrome(RS) includes 1.Controlling cerebral swelling 2.Lowering ICP(IntraCranial Pressure) with the use of steroidal anti-inflammatory drugs(SAIDs){Decadron}
With proper Tx the recovery rate of Reye's Syndrome (RS) is 85-90%
Tetanus is an acute(sudden) infection of motor neurons caused by the tetanus bacillus that lives in the intestines of animals and humans
Tetanus is found in fecal material
Tetanus bacilli persist as spores indefinitely (40+ years) in the soil
Wounds most susceptible to tetanus are ragged lacerated(cut or torn) tissue contaminated with soil
Tetanus produces a powerful toxin that circulates to the motor neurons(nerve cells)
Affected motor neurons cause the muscles to become rigid with painful spasms and convulsions
The first muscles to be affected by tetanus are located in the jaw, hence the name "lockjaw"
These muscles cannot relax and the mouth is tightly closed
The neck is stiff and there is dysphagia(difficulty swallowing)
If muscles of ventilation(breathing) are affected asphyxiation(suffocation) can occur
Tetanus has an incubation period of 1 to 3 weeks and the toxin travels slowly
Tx of tetanus includes 1.Debridement of the wound 2.Administration of Td(Tetanus & diphtheria booster immunization)
Debridement means thorough cleansing, removal of necrosed tissue, and removal of FBs(foreign bodys)
Multiple Sclerosis(MS) is an idiopathic(unknown cause) autoimmune, chronic(reoccuring) progressive degenerative disease of the CNS(Central Nervous System)
MS(Multiple Sclerosis) usually effects adult women(2/3) between the ages of 20 to 40
The most common form of Multiple Sclerosis(MS) is called Relapsing-Remitting Multiple Sclerosis (RRMS)
Signs & symptoms of MS (Multiple Sclerosis) include 1.Loss of balance 2.Ataxia(no coordination) 3.Tingling/numbness in extremities 4.Shaking tremor 5.Progressive fatigue/muscular weakness 6.Dysphasia(difficulty speaking) 7.Enuresis(loss of bladder control) 8.Blurred vision & diplopia(double vision)
Signs & symptoms of MS (Multiple Sclerosis) continued 9.Nystagmus(involuntary rapid eye movement) 10.Blindness 11.Cognitive dysfunciton(comprehension memory, judgement & reasoning) 12.Decreased libido(sex drive) 13.ED(erectile dysfunction 14.MDD(Major Depressive Disorder)
Tx of MS(Multiple Sclerosis) includes Betaseron(interferon) to decrease the severity of symptoms and slow the progression
The risk factor for Multiple Sclerosis(MS) increases with a high fat diet and growing up in a cold climate
Amyotrophic Lateral Sclerosis(ALS) is AKA Lou Gehrig's disease
ALS(Amyotrophic Lateral Sclerosis) is an idiopathic(unknown disease) terminal(ends in death) neurological disease causing a progressive loss of motor neurons
Symptoms of Amyotropic Lateral Sclerosis(ALS) include 1.Atrophy(no development) of muscles in arms & legs 2.Muscular dysfunction of the mouth and throat 3.Muscular twitching
Death from Amyotropic Lateral Sclerosis(ALS) usually occurs 3 to 5 years after onset of symptoms and generally results from pulmonary failure
Amyotrophic Lateral Sclerosis(ALS) commonly occurs during the 50s or 60s
Amyotrophic Lateral Sclerosis(ALS) is slightly more common in men
Diagnosis(Dx) of Amyotropic Lateral Sclerosis(ALS) is confirmed with an EMG(ElectroMyoGraphy)
Parkinson's Disease (PD) is an idiopathic(unknown disease) and gradual progressive degeneration of the neurons(nerve cells) that control body movement & coordination
People afflicted with PD(Parkinson's disease) produce insufficient amounts of a neurotransmitter in the brain called dopamine
Parkinson's disease(PD) is more common in Caucasian men and the average age of onset is 50
Signs & symptoms of Parkinson's Disease(PD) include(14 total) Tremors/pill-rolling*rigid muscles & myalgia*loss of reflexes*mask-like facial expression*shuffling hurried gait*Bradykinesia(slow movement)*stooped posture*dysphagia(difficult swallowing)*monotone speech*incontinence(inability to control bladder/bowel)
signs & symptoms of Parkinson's Disease(PD) continued constipation(difficult defecation)*loss of libido(sex drive)*ED(Erectile dysfunction*MDD(Major Depressive Disorder)
Tx for Parkinson's Disease(PD) includes 1.AntiParkinsons medications(Sinemet) 2.PT(Physical Therapy) 3.Tandem bike riding(bicycle built for 2)
Alzheimer's Disease(AD) is a progressive degenerative genetic brain disease causing dementia usually after age 60
Alzheimer's Disease(AD) is associated with the build up of a protein in the brain called beta amyloid
Dementia is a deteriorating cognitive(comprehension reasoning, judgment, & memory) abilities
The seven warning signs of AD(Alzheimer's disease) include 1.Asking the same question over & over again 2.repeating the same story, word for word, again & again 3.Forgetting how to cook, make repairs,play cards-activities that were previously done with ease & regularity
The seven warning signs of AD(Alzheimer's disese) continued 4.Losing one's ability to pay bills or balance one's checkbook 5.Getting lost in familiar surroundings, or misplacing household objects 6.Neglecting to bathe,wearing the same clothes over &over again 7.Relying on someone else to make decisions/answer ?'s
When Alzheimer's disease (AD) becomes more sever after dark, it is called sundowning
Alzheimer's diease(AD) can cause depression, irritability, aggressiveness & delusions(false beliefs(
Eventually a person with AD(Alzheimer's disease) will need complete care
Familial Alzheimer's Disease(FAD) accounts for less than 5% of cases
Alzheimer's Disease(AD) is usually diagnosed after age 65 & every five years afterwards the incidence doubles
The duration of Alzheimer's Disease(AD) can be 2 to 20 years
Alzheimer's disease(AD) affects more women(1 in 4) then men(1 in 6)
Increased risk of Alzheimer's disease(AD) is associated with obesity, chronic HTN(hypertension) and DM (diabetes mellitus)
Alzheimer's disease (AD) is diagnosed when other conditions are ruled out and with the use of a PET(Positron emission tomography)
Research suggests Alzheimer's Disease(AD) risk is lowered by regular mental & physical activity & a health diet
A common medication used to treat Alzheimer's disease(AD) is Aricept
Epilepsy is abnormal electrical activity that spreads over the cerebrum & can manifest itself as a seizure
Epilepsy can be caused by 1.Brain damage 2.BT(Brain Tumor) 3.EOTH(alcohol) and/or drug use 4.Uremia(azotemia--excessive nitrogenious waste in the blood) 5.Meningitis or encephalitis 6.Toxemia(eclampsia) 7.Hyperthermia(body temp>104oF) 8.Heredity
Types of seizures include: 1.Grand mal seizures(convulsions) 2.Petit mal(absence) seizures
Grand mal seizures are characterized by a.LOC(Loss of Consciousness) b.Tongue biting c.Hypersalivation d.Enuresis(loss of bladder control) e.Tonic-clonic movements
Tonic-clonic movements are rapid contractin & relaxation of the muscles
Petit mal(absence) seizures are characterized by a.Eyelid fluttering, lip smacking, & chewing motions b.Loss of awareness(10-30 seconds) c.No memory of seizure
Petit mal(absence) seizures are more common in children
A warning sign or symptom of an impending seizure is called an aura
Seizures can be followed by a confused and lethargic(mental sluggishness) state of mind lasting 5-30 minutes called a postictal state(post/after, ict/o-seizure)
Diagnosis(Dx) of epilepsy is confirmed with an EEG(ElectroEncephaloGram) and MRI(Magnetic Resonance Imaging)
A life threatening persistent seizure lasting more than 30 minutes is called status epilepticus
Treatment(Tx) for epilepsy includes antiseizure medications(Dilantin)
Hydrocephalus is an abnormal accumulation of fluid in the brain caused by an obstruction of the normal flow of CSF(Cerebral Spinal Fluid)
Hydrocephalus causes the brain to be compressed resulting in 1.Mental retardation(low intelligence quotient(IQ)) 2.Failure to grow normally 3.Prominent forehead 4.Bulging eyes 5.Frightened expression 6.Veins of the scalp are prominent
Tx for hydrocephalus includes surgical placement of a shunt(detour) to relieve the ICP(IntraCranial Pressure)
Spina Bifida(SB) is a congenital(developed while in the womb/not genetic) NTD(Neural Tube Defect) where one or more vertebrae fail to develop
Spina Bifida(SB) can be accompanied by one or more of the following(usually does not see SB all by itself) a.Hydrocephalus(abnormal accumulation of fluid in the brain caused by an obstruction of the normal flow of CSF(CerebralSpinal Fluid). b.Cleft lip and/or cleft palate c.Club foot d.Esotropia(crossed eyed)
Four types of Spina Bifida(SB) include 1.(SBO) Spina Bifida Occulta(hidden) 2. Meningocele 3. Meningomyelocele(myel/o-spinal cord)**worst type of Spina Bifida(SB) 4. Myelocele
(SBO) Spina Bifida Occulta(hidden) can cause a.Incorrect posture b.Inability to walk c.Incontinence(loss of bladder and/or bowel control) d.A tuft of hair over the vertebral defect
A meningocele is characterized by the meninges protruding through the opening in the vertebral defect
A menignocele can be corrected by surgery
A meningomyelocele is characterized by the meninges & spinal cord protruding through the opening in the vertebral defect
Meningomyelocele can cause mental retardation(low IQ/intelligence quotient), failure to develop & paralysis
This vertebral defect can be corrected by surgery
A myelocele is characterized by a disorganized spinal cord that is exposed(can see the spinal cord)
A myelocele is usually fatal
Prophylactic(preventive) Tx for (SB) Spina Bifida includes three months pregravida(before pregnancy) folic acid(folate) supplements of 400 mcg/day(micrograms)
Rich sources of folic acid(folate) include broccoli, spinach, asparagus, legumes(beans & peas), strawberries, oranges & bananas
Cerebral palsy(CP) is a non-progressive brain damage resulting in mental and/or motor retardation before the age of three(3)
Causes of Cerebral Palsy(CP) include 1.Gestational rubella(german measles during pregnancy) infection 2.Drugs and/or alcohol(ETOH) during gestation(pregnancy) 3.Hypoxia(deficient oxygen/O2) in utero 4.Erythroblastosis fetalis(Rh incompatibility disease)
Cerebral Palsy(CP) can also be idiopathic(unknown cause)
Cerebral Vascular Accident(CVA) is AKA stroke
A Cerebral Vascular Accident(CVA) is brain damage commonly resulting from 1.Cerebral aneurysm(weakness in an arterial septum) 2.Cerebral infarction(obstruction/occlusion of an artery)
A cerebral aneurysm can be detected with cerebral angiography(process of recording the cerebral arteries)
Risk factors for a Cerebral Vascular Accident(CVA) include 1.Atherosclerosis(hardening of the arteries caused by fatty plaque) 2.Chronic HTN(HyperTeNsion) 3.A-fib(artial fibrillation)
Atrial fibrillation(A-fib) is an arrhythmia associated with thrombus(clot) formation
Increased risk of CVA(Cerebral Vascular Accident) has been linked to a deficiency of vitamin C and folate(folic acid)
Cerebral Vascular Accident (CVAs) usually occur after the age of 55
Cerebral Vascular Accident(CVA) risk is 1 in 5 for women over 55 and 1 in 6 for men over 55
African-Americans are ____ as likely to have a Cerebral Vascular Accident (CVA) than caucasians twice
Signs & symptoms of a Cerebral Vascular Accident(CVA) include 1.Dysphasia(difficult swallowing 2.Blurred vision 3.Ataxia(No coordination) 4.Vertigo(dizziness) 5.N&V(nausa & vomitin) 6.Hemiparesis 7.Hemiplegia 8.LOC(Loss of Consciousness) 9.FAST(Facial drooping, Arm weakness, Speech difficulty, Time
Dx of a Cerebral Vascular Accident(CVA) is confirmed with a CT(Computerized Tomography)
Tx of a Cerebral Vascular Accident(CVA) includes 1.Thrombolytic(clot buster) therapy(Activase) is effective within the first 3 hours of the onset of symptoms for a CVA caused by an embolus (floating clot) 2.Antihypertensives(Tenormin) 3.Anticoagulants(Coumadin)
Once the brain tissue necroses(dies) it will not regenerate(repair)
Rehabilitation for a Cerebral Vascular Accident(CVA) entails teaching non-damaged parts of the brain to perform the duties of the necrosed brain tissue
Hemiparesis means sensory or motor nerves on either right or left side of the body are paralized
Hemiplegia means can't feel/sense or move/ paralysis on one side of the body)
Created by: Patti Belfi Reed Patti Belfi Reed