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Neuro self-leaning
Ch 15-17: Temp regulation, sleep, alt in movement, alt in neuro dysfxn
| Question | Answer |
|---|---|
| A progressive, inflammatory, demyelinating disorder of the CNS, w/ an onset between ages 20 - 40, that is relapsing & remitting, is what neurological disorder? | multiple sclerosis |
| What are the types of multiple sclerosis? | mixed, spinal, cerebellar |
| Symptoms of multiple sclerosis include (there are 8): | diplopia, nystagmus, vertigo, memory & mood changes, bladder & bowel problems, fatigue, weakness, depression |
| Triggers of multiple sclerosis include (there are 3 examples given): | pregnancy, trauma, infection/fever |
| Acquired inflammatory disease causing demyelination of the peripheral nerves w/ relative sparing of axons describes what neurological disorder? | Guillain-Barre Syndrome |
| Guillain-Barre Syndrome has what type of onset? what type of paralysis? | acute onset; ascending motor paralysis (starts in the legs, works up to trunk, may cause quadriplegia & vent dependence, aspiration risk) |
| Guillain-Barre Syndrome may be preceded by what type of infection? | viral or bacterial infection |
| How long do Guillain-Barre symptoms last? | weakness peaks ~1 month & usually receded completely |
| Lou Gehrig disease is officially known as: | classic amyotrophic lateral sclerosis (classic ALS) |
| What neurological disorder diffusely affects upper & lower motor neurons of the cerebral cortex, brain stem, & spinal cord (corticospinal tracts & anterior roots)? | amyotrophic lateral sclerosis (ALS) |
| Amyotrophic lateral sclerosis (ALS) leads to... | progressive weakness leading to respiratory failure & death |
| What affect does amyotrophic lateral sclerosis (ALS) have on intellectual & sensory function? | none. patient has normal intellectual & sensory function until death |
| Chronic autoimmune disease where IgG antibody is produced against ACh receptor (anti-ACh receptor antibodies) describes what disease? | myasthenia gravis |
| What is the treatment for myasthenia gravis? | anticholinesterases (increase ACh levels) |
| How is myasthenia gravis diagnosed? | Tensilon test |
| What is a Tensilon test? | anticholinesterase drug, which will demonstrate an immediate improvement of symptoms for 5~10 minutes |
| Symptoms of myasthenia gravis are (there are 6): | diplopia, ptosis, difficulty chewing, talking, swallowing, drooling |
| Hyperkinesia is defined as: | excessive movement |
| Chorea is defined as: | non-repetitive muscular contractions, random, irregular, involuntary, disappears w/ sleep, increases w/ stress |
| Tardive dyskinesia is defined as: | involuntary movement of face, trunk, extremities (chewing, lip smacking, facial grimacing) associated w/ Parkinson's Disease |
| Tardive dyskinesia is a side effect of what 2 drug classes/types? | phenothiazine drugs & haldol |
| What is Huntington's disease? Onset? Causes? | autosomal dominant hereditary-degenerative disorder; onset 30-50; severe degeneration of the basal ganglia & frontal cerebral cortex, depletion of GABA |
| What is the treatment for Huntington's disease? | no known treatment |
| What are the manifestations of Huntington's disease? | choreiform movements beginning in face & arms, progressive dementia |
| Severe degeneration of the basal ganglia (corpus striatum, sometimes called substantia nigra) involving the dopaminergic nigrostriatal pathway describes what neurological disorder? | Parkinson's disease |
| What are the 4 manifestations/diagnosis of Parkinson's disease? | resting tremor, bradykinesia, cogwheel rigidity, postural instability |
| What cannot be given to people w/ Parkinson's Disease? | do NOT give dopaminergic antagonists (droperidol, reglan, compazine, & possibly alfentanil) |
| What is the treatment for Parkinson's Disease (there are 3)? | L-dopa & other dopamine agonists & precursors; anticholinergic drugs; antihistamines, amatadine |
| What is the etiology of Parkinson's Disease? | idiopathic; secondary d/t: post-encephalitis, drugs (neuroleptics, antiemetics, antiHTN, designer drugs), traumatic (Mohammed Ali), & arteriosclerotic |
| 4 sites of core temperature are: | esophagus, nasopharynx, tympanic membrane, & pulmonary artery |
| 3 sites of peripheral temperature are: | skin, oral & axilla |
| The body's thermostat is: | hypothalamus |
| Neonates _____ (can/cannot) shiver | cannot |
| Metabolism of _____ in neonates is called _____ (aka non-shivering thermogenesis) | brown fat; chemical thermogenesis |
| What is defined as: Heat loss through electromagnetic waves from one warm surface (body) to a cooler surface (environment), but does not require actual contact | radiation |
| What is defined as: heat lost through air (or liquid) currents, primarily this means body heat lost to the surrounding air; cold OR ambient temperatures; bair huggers | convection |
| What is defined as: water lost from either sweating, exhaling or open body cavities; circuit humidifiers | evaporation |
| What is defined as: direct surface to surface heat loss or gain, body to OR table; warm blankets | conduction |
| Which age group produces sufficient body heat but is unable to conserve heat produced? | Pediatrics (d/t small body size & high body surface area to weight ratio; thin SQ layer) |
| Which age group has slow blood circulation, vasocostrictive response, & metabolic rate? | elderly |
| Which age group has decreased sweating & perception of heat & cold? | elderly |
| What occurs at 41 degrees Celsius (105.8 F)? | nerve damage produces convulsions |
| What occurs at 43 degrees Celsius (109.4 F)? | death |
| Forms of hyperthermia are: | heat cramps, heat exhaustion, heat stroke |
| Malignant hyperthermia is precipitated by: | administration of volatile anesthetics & depolarizing neuromuscular blocking agents |
| Malignant hyperthermia causes ______ (increased/decreased) calcium release or _____ (increased/decreased) calcium uptake w/ muscle contraction | increased calcium release; decreased calcium uptake w/ muscle contraction |
| In malignant hyperthermia, the most sensitive indicator is: | unanticipated rise in EtCO2 |
| A late sign in malignant hyperthermia is: | hyperthermia |
| What rate may temperature climb during malignant hyperthermia? | may climb at rate of 1-2 degrees Celsius every 5 minutes, up to 43.3 degrees C |
| What lab data is seen in malignant hyperthermia? | metabolic & respiratory acidosis, hypercarbia (PaCO2 >60; base deficit >8; pH <7.25); hyperkalemia, K >6; myoglobinuria, serum >170, urine >60; elevated CK, CK >10,000 |
| How are acidosis & hypoxia treated in malignant hyperthermia/ | hyperventilate w/ 100% oxygen, bicarbonate to treat acidosis |
| What drug class is dantrolene? What makes dantrolene "unique"? | a muscle relaxer that reduces the release of calcium from the skeletal muscle sarcoplasmic reticulum; "unique" b/c it does not work at the neuromuscular junction |
| Hypothermia is defined as: | body temp less than 35.5 degrees C or 96 degrees F |
| In anesthesia, what affects does post-op hypothermia have on drug biotransformation | drug biotransformation slows, delaying awakening, recovery from muscle relaxants |
| In anesthesia, what affects does post-op hypothermia have on the heart, myocardium & SVR? | Bradycardia, conduction defects, vfib may occur; Myocardial depression & increased SVR |
| In anesthesia, what affects does post-op hypothermia have on platelets & coagulation? | platelet function depressed, coagulation slows, greater intraop blood loss |
| In anesthesia, what affects does post-op hypothermia have on immune function & wound healing? | immune function dampened, greater wound infection risk |
| In anesthesia, what affects does post-op hypothermia have on the oxyhemoglobin dissociation curve? | Oxyhemoglobin dissociation curve shifts left |
| In anesthesia, what affects does post-op hypothermia have on oxygen demand? | shivering may double or triple oxygen demand |
| What is accidental hypothermia? | commonly the result of sudden immersion in cold water or prolonged exposure to cold |
| Groups most at risk for hypothermia under anesthesia are (there are 5): | pediatric, geriatric, hypothyroid, hypothalamic lesions, burns |
| What is the purpose of therapeutic hypothermia? | used to slow metabolism & preserve ischemic tissue during surgery or limb reimplantation |
| What are some side effects of therapeutic hypothermia? | may lead to v-fib & cardiac arrest |
| In therapeutic hypothermia, between 37-30 degrees C metabolism __________ | decreases 7% for each degree Celsius |
| Periods of apnea during sleep without discernable respiratory efforts is called _____ | central apnea, which is thought to lack normal central nervous system drive to breathe |
| People may have normal body habitus in ____ (Central apnea/obstructive sleep apnea) | central apnea |
| Physical airway obstruction (tonsils, adenoids, retrognathia, macroglossia) can be the cause of _____ (Central apnea/obstructive sleep apnea) | obstructive sleep apnea |
| Sleep apnea is characterized by _______. With sleep apnea there is an increased risk of (there are 5): | characterized by poor quality sleep; increased risk of HTN, heart disease, pulmonary HTN, stroke, MVAs |
Created by:
Thommy413
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