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Chp 13

Fundamentals of Disease

meningitis acute inflammation of the arachnoid membrane and the pia matter
meninges protective membranes surrounding the brain and spinal cord
meningitis is an infectious disease that affects: children and young adults
meningitis can be caused by: a bacterial or viral infection
bacterial meningitis can be: serious and deadly
most people with meningitis recover completely from: viral meningitis
the infectious 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: hyperthermia, chills, N+V, severe cephalagia caused by ICP, stiff neck, rash, seizures, coma
hyperthermia can cause: delirium, convulsions and coma
dx of meningitis: LP AKA spinal tap
the CSF of meningitis will contain: protein, leukocytes, and the infecting organism
tx for meningitis: antibiotic therapy, antipyretics, IV therapy for dehydration
without tx, meningitis can cause permanent brain damage causing: blindness, deafness, paralysis, MR, hydrocephalus, CSF, and death
meningitis is most commonly caused by: meningococcus or pneumoncoccus
Immunizations for meningococcal infections include : Menactra and Menomune
Immunizations for pneumococcal infections include: pneumovax 23 and Pnu-Immune 23
encephalitis: inflammation of the brain usually caused by herpes simplex I, influenza, rubeola, parotitis, rubella, varicella, and arbovirus
Signs/symptoms of encephalitis range from mild to severe and may include: cephalagia, pyrexia, lethargy, personality changes, seizures, paralysis
Risk factors for encephalitis: immunocompromised
Dx of encephalitis: LP
Tx of encephalaitis: controlling pyrexia and ICP, maintain fluid and electrolyte balance, careful monitoring of respiratory and kidney function
Rabies: inflammatory disease of the brain and spinal cord, transmitted through bites and scratches of rabid animals
Animals that commonly contract rabies: Dogs, cats, wolves, raccoons, skunks, foxes, bats, humans
The onset of symptoms for rabies usually appear: 3 weeks to 3 months after exposure
Signs/symptoms of rabies include: pyrexia, pain, mental derangement, rage, convulsions, paralysis, hydrophobia, aphagia, profuse frothy saliva
Tx for rabies: 3 subQ antirabies inj over 3 weeks
Animals infected with rabies exhibit a change in temperament such as: wild animals act tame, followed by a furious stage
Shingles acute and chronic sensory neuritis caused by latency effect of the varicella zoster virus AKA herpes zoster
latency time between exposure and effects
Herpes zoster is the sequela of: varicella zoster (chicken pox)
Signs/symptoms of shingles: painful unilateral vesicular rash, pruritus, scarring
A shingles outbreak lasts: 2-4 weeks
Shingles most commonly occurs in ppl over the age of: 50
An immunization recommended for people over 60 who have had varicella zoster is called: Zostavax
Tx of shingles: antiviral therapy, narcotic analgesics, antipruritics, SAIDS
Activation of the dormant Varicrlla zoster virus is associated with: immunocompromised, poorly controlled stress
Reyes syndrome: encephalopathy associated with the combination of children, viral infections and use of ASA
RS can cause: an increased ICP
Signs/symptoms of RS: vomiting, personality changes, lethargy, confusion, seizures, coma
Tx of RS: controlling cerebral swelling, lowering ICP with SAIDs
With proper treatment (Tx) the recovery rate for Reye syndrome (RS) is: 85-90%
Tetanus: acute infection of motor neurons caused by the tetnaus bacillus that lives in the intestines of animals and humans
Tetanus is found in: fecal material
Tetanus bacilli persist as spores indefinitely in the: soil
Wounds most susceptible to tetanus are: ragged lacerated tissue contaminated with soil
Tetanus produces a powerful toxin that circulates to the: motor neurons
Motor neurons affected with tetanus 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
In tetanus, the neck is stiff and there is: dysphagia
Tetanus has an incubation period of: 1-3 weeks and the toxin travels slowly
Tx of tetanus: debridement of the wound, administration of Td
Multiple sclerosis: Multiple sclerosis (MS) is an idiopathic, autoimmune, chronic, progressive, degenerative disease of the CNS
MS usually effects: adult women between the ages of 20 to 40
The most common form of multiple sclerosis (MS) is called: relapsing-remitting
Signs and symptoms of multiple sclerosis (MS) include: loss of balance, ataxia, tingling and numbness in the extremities, shaking temor, fatigue/muscle weakness, dysphasia, enuresis, blurred vision/diplopia, nystagmus, blindness, cognitive dysfunction, decreased libido, ED, MDD
Tx of MS: Betaseron (interferon) to decrease the severity of symptoms and slw the progression
The risk factor for multiple sclerosis (MS) increases with a : high fat diet and growing up in a cold climate
Amyotropic lateral sclerosis (ALS) is AKA: Lou Gehrig's disease
ALS is an: idiopathic terminal neurological disease causing a progressive loss of motor neurons.
Symptoms of amyotropic lateral sclerosis (ALS) include: atrophy of the muscles in arms and legs, muscular dysfunction of mouth/throat, muscular twitching
Death from amyotropic lateral sclerosis (ALS) usually occurs: 3-5 yrs after onset of symptoms and generally results from pulmonary failure
Amyotropic lateral sclerosis (ALS) commonly occurs during the: 50-60s
ALS is more common in: men
Dx of ALS: EMG
Parkinsons disease: idiopathic and gradual progressive degeneration of the neurons that control body movements and coordination
Ppl with PD 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 and symptoms of Parkinson’s disease (PD) include: tremors, rigid muscles/myalgia, loss of reflexes, mask-like facial expression, shuffling gait, bradykinesia, stooped posture, dysphagia/drooling, monotone speech, incontinence, constipation, loss of libido, ED, MDD
tx of PD: antiparkinsons meds, PT, tandem bike riding
Alzheimer’s disease (AD) is a: progressive degenerative genetic brain disease causing dementia usually after age 60
Dementia: loss of mental skills affecting daily life
Seven warning signs of AD: asking same questions, repeating themselves, forgetting activites that were easily done, getting lost in familiar surrounds, losing ability to pay/balance bills/checkbook, neglecting to bathe, relying on someone else to make decisions
When Alzheimer’s disease (AD) becomes more severe after dusk, it is called: sundowing
AD can cause: depression, irritability, aggressiveness and delusions
Familial Alzheimer's disease accounts for less than: 5% of cases
AD is dx after age 65 and every 5 years afterwards incidence: doubles
The duration of AD can be: 2-20 years
Increased risk of AD is accociated with: obesity, HTN, and DM
Research suggests Alzheimer’s disease (AD) risk is lowered by: regular mental and physical activity and a healthy diet
AD is dx when other conditions are ruled out with use of a: PET
Common med to tx AD: Aricept
Epilepsy is abnormal electrical activity that spreads over the cerebrum and can manifest itself as a: seizure
Epilepsy can be caused by: brain damage, BT, ETOH and/or drug abuse, uremia, meningitis/encephalitis, toxemia, hyperthermia, heredity
Types of seizures: grand mal seizures, petit mal
Grand mal seizures are characterized by: LOC, tounge bting, hypersalivation, enuresis, tonic clonic movements
Petit mal seizures are more common in: children
Dx of epilepsy is confirmed with an: EEG and MRI
A life threatening persistent seizure lasting more than 30 minutes is called: status epilepticus
Tx for epilepsy includes: antiseizure meds (Dilantin)
Hydrocephalus is an abnormal accumulation of fluid in the brain caused by an obstruction of the normal flow of: CSF
Hydrocephalus causes the brain to be compressed resulting in: MR, failure to grow normally, prominent forehead, bulging eyes, frightened expression, veins of scalp are prominent s
Tx for hydrocephalus: surgical placement of a shunt to relieve ICP
Spina bifida: congenital NTD where one or more vertebrae fail to develop
NTD neural tube defect
SB can be accompanied by one or more of the following: hydrocephalus, cleft lip/palate, club foot, esotropia
Four types of SB: spina bifida occulta, meningocele, meningomyelocele, myelocele
Spina bifida occulta (SBO): causes incorrect posture, inability to walk, incontinence, a tuft of hair over the vertebral defect
Meningocele: A meningocele is characterized by the meninges protruding through the opening in the vertebral defect, corrected by surgery
Meningomyelocele: A meningomyelocele is characterized by the meninges and spinal cord protruding through the opening in the vertebral defect, causes MR, and failure to develop and paralysis
Myelocele: A myelocele is characterized by a disorganized spinal cord that is exposed. A myelocele is usually fatal.
Prophylactic tx for SB: 3 month pregravida folic acid supplements of 400 mcg/day
Cerebral palsy (CP) is a non-progressive brain damage resulting in mental and/or motor retardation before the age of" three
Causes of CP: gestational rubella infection, drugs/ETOH during gestation, hypoxia in utero, erythroblastosis fetalis
CVA is AKA stroke
A cerebral vascular accident (CVA) is brain damage commonly resulting from: cerebral aneurysm, cerebral infarction
A cerebral aneurysm can be detected with: cerebral angiography
Risk factors for a cerebral vascular accident (CVA) include: atherosclerosis, chronic HTN, A-fib
Increased risk of CVA has been linked to a deficiency of: vitamin C and folate
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
Signs/symptoms of CVA: dysphasia, blurred vision, ataxia, vertigo, N+V, hemiparesis, hemiplegia, LOC, FAST
Hemiplegia partial paralysis on 1/2 the body
FAST facial drooping, arm weakness, speech dif, time
Dx of CVA: CT
Tx of CVA: tPA therapy is effective within the first 3 hours of the onset of symptoms for a CVA caused by an embolus
A transient ischemic attack (TIA) is AKA: little stroke or mini stroke
A TIA is characterized by: ischemic brain tissue caused by a reduced flow of blood to the brain
Causes of a transient ischemic attack (TIA) include: carotid atherosclerosis, emboli
Signs and symptoms of a transient ischemic attack (TIA) are the same as a cerebral vascular accident (CVA) except: they dont last
Treatment (Tx) of a transient ischemic attack (TIA) includes: prophylactic anticoagulant therapy
Cerebral Concussion (CC): transient brain disorder resulting from a head trauma
Signs/symptoms of a CC: LOC, amnesia about the accident, nausea, vertigo, cephalagia, perseverating (repeating yourself)
Treatment (Tx) of a cerebral concussion (CC) includes: NVS (neurological vital signs) performed every 2 hours
Neurological vital signs (NVS) {“neuro checks”} include: LOC status and orientation of spheres (persons, place, time), PEARRLA (pupils equal and round react to light and accommodation), Gait check
A cerebral contusion refers to a: TBI
Complications associated with a cerebral contusion include: inracranial hemorrhages causing increased ICP, coma, permanent brain damage
Intracranial hemorrhages include: epidural, subdural, subarachnoid
Tx of a intracranial hemorrhage includes: SAIDs, surgery to seal off the bleeding vessels and remove blood
A primary malignant brain tumor (BT) is called a: glioma
Most BTs: metastasize from other sites
Signs and symptoms of a brain tumor (BT) include: cephalagia when bending over, personality changes, amnesia, diplopia, blindness, dysphasia, ataxia, seizures, come
Although benign brain tumors (BTs) are commonly removed surgically, malignant brain tumors (BTs) are usually: inoperable
Treatment (Tx) for a malignant brain tumor (BT) includes: chemotherapy/radiation
migraines: severe cephalagia often accompanied by N+V and photophobia
Migraines are caused by: constriction and dilation of cerebral arteries and the release of serotonin and prostaglandins
Migraine triggers include: stress, food preservatives, weather, menses, fatigue, skipping meals, alterations in normal sleep patterns
Migraine triggers may be: inherited
60-70% of migraines are associated with hormonal fluctuations that occur during the : menstrual cycle
Migraines commonly last from: 4 hrs to 3 days
Migraine meds: Motrin, Aleve, Excedrin Migraine, Ergomar, Calan
Created by: RBarnes86