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Nur-458

Neurmuscular Disorders

TermDefinition
First generation relative increases risk over 20 times MS
Demyelinating disease of the CNS MS
Mainly affects white matter MS
Most common nontraumatic cause of neurological disability in young adults MS
Cause is unknown MS, GBS
Possibly due to an abnormal immune response MS
Most common in cooler northern climates MS
Smoking is a risk factor MS
One symptom is spasticity MS
Fatigue may be made worse by hot temperatures MS
May have problems with memory MS
McDonald's criteria used for diagnosis; gold standard for diagnosis MS
Has different clinical patterns MS
Relapsing-remitting is the most common clinical pattern MS
Acute idiopathic polyneuritis GBS
Affects any age GBS
No ethnic differences GBS
Disease of peripheral nervous system GBS
Rapid onset of symptoms GBS
Paralysis progressing symmetrically up from lower extremities GBS
Decreased deep tendon reflexes GBS
Elevated protein in spinal fluid GBS
History of febrile illness 1-3 weeks prior GBS
History of immunization or vaccine GBS
Usually do not get this more than once GBS
Cardinal signs include rigidity, tremor and bradycardia Parkinson's disease
Shuffling gait, arms at side Parkinson's disease
May result in dementia Parkinson's disease
Lack of dopamine Parkinson's disease
Autoimmune reaction, inflammatory response Lupus (SLE)
Affects all body systems Lupus (SLE)
Renal failure is a leading cause of death Lupus (SLE)
Affects females more than males with average age about 30 years Lupus (SLE)
Affects blacks more than whites Lupus (SLE)
Low grade fever Lupus (SLE)
Butterfly rash Lupus (SLE)
Arthritis-like pain Lupus (SLE)
Abnormal ANA titer Lupus (SLE)
Alopecia Lupus (SLE)
Sores in nose or mouth Lupus (SLE)
Cardiac abnormalities Lupus (SLE)
Deficit of acetylcholine Myasthenia Gravis
Defect at myoneural junction Myasthenia Gravis
Possible autoimmune etiology Myasthenia Gravis
Affects women more than men, ages 20-30 years Myasthenia Gravis
Disease of muscle weakness Myasthenia Gravis
Abnormal skeletal muscle fatigue Myasthenia Gravis
Ptosis, diplopia Myasthenia Gravis
Motor loss but not sensory ALS
Muscle wasting ALS
Rapidly progressive and terminal ALS
May be due to virus, bacteria, environmental toxin? ALS
Onset between 40-70 years of age ALS
Life expectancy is short (generally less than 3 years) ALS
Stephen Hawking is most famous person with this who is still living ALS
Weakness and wasting of upper extremities ALS
Speech, chewing, swallowing obviously affected ALS
Death is often from respiratory failure or aspiration ALS
EMG and SER might be abnormal ALS
Rule-out Lyme disease ALS
Dominantly inherited Huntington's Chorea
Rare genetic disease Huntington's Chorea
Degeneration of basal ganglia and cerebral cortex Huntington's Chorea
Choreiform movements Huntington's Chorea
Progressive movements Huntington's Chorea
Diagnosed between ages 35-45 Huntington's Chorea
Affects both males and females Huntington's Chorea
No lab tests helpful Huntington's Chorea
Signs/symptoms include rapid onset of symptoms, abnormal sensations, decreased or absent deep tendon reflexes GBS
Two treatements for GBS that suppress the body's immune response Plasmapheresis and IV gamma-globulin
Side effects of plasmapheresis Hypotension and mortality
What are the most common deficits of GBS? Fatigue and paralysis
Epstein-barr virus and lack of vitamin D exposure are risk factors for what disease? MS
Where can lesions of MS be located? Brain or spinal cord
How is the expanded disability status scale used? Ranks neurological impairment in someone who has MS
Signs/symptoms include blurred vision, color distortion, loss of vision in one eye, eye pain, speech impediment, tremors, dizziness, ataxia, impaired mobility, paresthesia MS
Signs/symptoms include dysarthria, dysphonia and dysphagia MS
What type of bladder can someone with MS have? Uninhibited, reflexic or areflexic
How is primary-progressive clinical pattern of MS described? A steady increase without flare-ups (10-15%)
How is relapse-remitting clinical pattern of MS described? Acute attacks that are well-defined; can be followed by full recovery or residual deficit (85%)
How is progressive-relapsing clinical pattern of MS described? Steady decline since onset; progress clinically with acute relapses (5%)
How is secondary-progressive clinical pattern of MS described? Long-term outcome of relapsing-remitting; gradual worsening of the disease that is independent of continued exacerbations (50% of those presenting with relapsing-remitting)
What are the combination of therapies used to treat MS? Disese-modifying therapies, management of acute relapses, symptomatic treatments, and rehabilitation management
What are used to treat the symptoms of MS? Steroids, immunosuppressants, antispasmodics, bowel and bladder medications
What is amantidine (Symmetrel) used to treat in MS? Tremor and rigidity
What is propanolol used to treat in MS? Tremors
What disease-modifying agents are used to treat MS? Betaseron (interferon beta 1b), Rebif (interferon beta 1a), Avonex (interferon beta 1a), Copaxone (glatiramir acetate), and Novantrone (mitoxantrone)
For what clinical pattern(s) of MS is Betaseron used? Relapsing-remitting
For what clinical pattern(s) of MS is Rebif used? Relapsing forms
For what clinical pattern(s) of MS is Copaxone used? Relapsing-remitting
For what clinical pattern of MS is Avonex used? Relapsing form and single clinical episode
What type of drug is Novantrone? Antineoplastic
For what clinical pattern(s) of MS is Novantrone used? Rapidly worsening relapsing-remitting and progressive-relapsing or secondary-progressive
What is a motor paralytic bladder? Can have motor function but not sensory function
What is a medication used for Parkinson's disease? Levadopa
What medications are used to treat lupus? Corticosteroids for the inflammation, as well as NSAIDs and aspirin
What two diseases share the characteristic of a mask-like expression? Parkinson's disease and myasthenia gravis
Myasthenia gravis can be fatal if it affects what muscles? Intercostal and diaphragm muscles
What medication is used to treat Myasthenia Gravis? Mestinon
What is the most common genetic disorder seen in rehab? Huntington's chorea
What neurotransmitter is found in increased levels in the serum and spinal fluid of someone with ALS? Glutamate
What does EMG assess with regards to ALS? Electromyography test that assesses muscle weakness
What medication is the drug of choice to treat ALS that has been approved by the FDA? Riluzole
What medications make-up the three drug cocktail used to treat ALS? Riluzole, minocycline (antibiotic), and nimodipine (calcium channel blocker)
What medication should be used with caution (or not used) to treat ALS? -statins
What is the most important nursing intervention in regards to ALS? Emotional support
For which neurologic disease is genetic counseling needed? Huntington's chorea
For which neurologic disease is the care plan similar to that for Alzheimer's? Huntington's chorea
For which neurologic disease is there no effective cure or treatment? Huntington's chorea
For which neurlogic disease is there no cure but you treat the symptoms? ALS
What class of medications are used to treat Myasthenia Gravis? Anticholinesterase drugs
How long does someone with Myasthenia Gravis need to take their medication (Mestinon)? The rest of their lives
Which of the neurological disorders are autoimmune-mediated disorders? GBS and MS
Which of the neurological disorders are degenerative disorders? Parkinson's disease, ALS, and Huntington's chorea
What muscle relaxants can be used to treat spasticity in neurological disorders? Baclofen, and dantrolene sodium (Dantrium)
What benzodiazepines can be used to treat spasticity in neurological disorders? Diazepam (Valium)
What anticonvulsants can be used to treat spasticity in neurological disorders? Gabapentin (Neurontin)
What antiviral medication is used to treat fatigue related to neurological disorders? Amantadine (Symmetrel)
What central nervous system stimulant is used to treat fatigue related to neurological disorders? Methylphenidate (Ritalin)
Created by: ssbourbon