Fundamentals of Disease

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meningitis

acute inflammation of the arachnoid membrane and the pia matter

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meninges

protective membranes surrounding the brain and spinal cord

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meningitis is an infectious disease that affects:

children and young adults

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meningitis can be caused by:

a bacterial or viral infection

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bacterial meningitis can be:

serious and deadly

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most people with meningitis recover completely from:

viral meningitis

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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

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symptoms of meningitis include:

hyperthermia, chills, N+V, severe cephalagia caused by ICP, stiff neck, rash, seizures, coma

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hyperthermia can cause:

delirium, convulsions and coma

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dx of meningitis:

LP AKA spinal tap

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the CSF of meningitis will contain:

protein, leukocytes, and the infecting organism

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tx for meningitis:

antibiotic therapy, antipyretics, IV therapy for dehydration

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without tx, meningitis can cause permanent brain damage causing:

blindness, deafness, paralysis, MR, hydrocephalus, CSF, and death

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meningitis is most commonly caused by:

meningococcus or pneumoncoccus

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Immunizations for meningococcal infections include :

Menactra and Menomune

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Immunizations for pneumococcal infections include:

pneumovax 23 and Pnu-Immune 23

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encephalitis:

inflammation of the brain usually caused by herpes simplex I, influenza, rubeola, parotitis, rubella, varicella, and arbovirus

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Signs/symptoms of encephalitis range from mild to severe and may include:

cephalagia, pyrexia, lethargy, personality changes, seizures, paralysis

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Risk factors for encephalitis:

immunocompromised

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Dx of encephalitis:

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Tx of encephalaitis:

controlling pyrexia and ICP, maintain fluid and electrolyte balance, careful monitoring of respiratory and kidney function

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Rabies:

inflammatory disease of the brain and spinal cord, transmitted through bites and scratches of rabid animals

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Animals that commonly contract rabies:

Dogs, cats, wolves, raccoons, skunks, foxes, bats, humans

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The onset of symptoms for rabies usually appear:

3 weeks to 3 months after exposure

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Signs/symptoms of rabies include:

pyrexia, pain, mental derangement, rage, convulsions, paralysis, hydrophobia, aphagia, profuse frothy saliva

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Tx for rabies:

3 subQ antirabies inj over 3 weeks

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Animals infected with rabies exhibit a change in temperament such as:

wild animals act tame, followed by a furious stage

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Shingles

acute and chronic sensory neuritis caused by latency effect of the varicella zoster virus AKA herpes zoster

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latency

time between exposure and effects

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Herpes zoster is the sequela of:

varicella zoster (chicken pox)

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Signs/symptoms of shingles:

painful unilateral vesicular rash, pruritus, scarring

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A shingles outbreak lasts:

2-4 weeks

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Shingles most commonly occurs in ppl over the age of:

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An immunization recommended for people over 60 who have had varicella zoster is called:

Zostavax

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Tx of shingles:

antiviral therapy, narcotic analgesics, antipruritics, SAIDS

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Activation of the dormant Varicrlla zoster virus is associated with:

immunocompromised, poorly controlled stress

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Reyes syndrome:

encephalopathy associated with the combination of children, viral infections and use of ASA

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RS can cause:

an increased ICP

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Signs/symptoms of RS:

vomiting, personality changes, lethargy, confusion, seizures, coma

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Tx of RS:

controlling cerebral swelling, lowering ICP with SAIDs

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With proper treatment (Tx) the recovery rate for Reye syndrome (RS) is:

85-90%

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Tetanus:

acute infection of motor neurons caused by the tetnaus bacillus that lives in the intestines of animals and humans

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Tetanus is found in:

fecal material

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Tetanus bacilli persist as spores indefinitely in the:

soil

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Wounds most susceptible to tetanus are:

ragged lacerated tissue contaminated with soil

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Tetanus produces a powerful toxin that circulates to the:

motor neurons

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Motor neurons affected with tetanus cause the muscles to become rigid with:

painful spasms and convulsions

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The first muscles to be affected by tetanus are located in the jaw, hence the name:

lockjaw

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In tetanus, the neck is stiff and there is:

dysphagia

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Tetanus has an incubation period of:

1-3 weeks and the toxin travels slowly

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Tx of tetanus:

debridement of the wound, administration of Td

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Multiple sclerosis:

Multiple sclerosis (MS) is an idiopathic, autoimmune, chronic, progressive, degenerative disease of the CNS

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MS usually effects:

adult women between the ages of 20 to 40

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The most common form of multiple sclerosis (MS) is called:

relapsing-remitting

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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

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Tx of MS:

Betaseron (interferon) to decrease the severity of symptoms and slw the progression

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The risk factor for multiple sclerosis (MS) increases with a :

high fat diet and growing up in a cold climate

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Amyotropic lateral sclerosis (ALS) is AKA:

Lou Gehrig's disease

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ALS is an:

idiopathic terminal neurological disease causing a progressive loss of motor neurons.

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Symptoms of amyotropic lateral sclerosis (ALS) include:

atrophy of the muscles in arms and legs, muscular dysfunction of mouth/throat, muscular twitching

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Death from amyotropic lateral sclerosis (ALS) usually occurs:

3-5 yrs after onset of symptoms and generally results from pulmonary failure

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Amyotropic lateral sclerosis (ALS) commonly occurs during the:

50-60s

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ALS is more common in:

men

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Dx of ALS:

EMG

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Parkinsons disease:

idiopathic and gradual progressive degeneration of the neurons that control body movements and coordination

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Ppl with PD produce insufficient amounts of a neurotransmitter in the brain called:

dopamine

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Parkinson’s disease (PD) is more common in Caucasian men and the average age of onset is:

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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

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tx of PD:

antiparkinsons meds, PT, tandem bike riding

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Alzheimer’s disease (AD) is a:

progressive degenerative genetic brain disease causing dementia usually after age 60

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Dementia:

loss of mental skills affecting daily life

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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

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When Alzheimer’s disease (AD) becomes more severe after dusk, it is called:

sundowing

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AD can cause:

depression, irritability, aggressiveness and delusions

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Familial Alzheimer's disease accounts for less than:

5% of cases

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AD is dx after age 65 and every 5 years afterwards incidence:

doubles

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The duration of AD can be:

2-20 years

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Increased risk of AD is accociated with:

obesity, HTN, and DM

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Research suggests Alzheimer’s disease (AD) risk is lowered by:

regular mental and physical activity and a healthy diet

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AD is dx when other conditions are ruled out with use of a:

PET

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Common med to tx AD:

Aricept

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Epilepsy is abnormal electrical activity that spreads over the cerebrum and can manifest itself as a:

seizure

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Epilepsy can be caused by:

brain damage, BT, ETOH and/or drug abuse, uremia, meningitis/encephalitis, toxemia, hyperthermia, heredity

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Types of seizures:

grand mal seizures, petit mal

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Grand mal seizures are characterized by:

LOC, tounge bting, hypersalivation, enuresis, tonic clonic movements

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Petit mal seizures are more common in:

children

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Dx of epilepsy is confirmed with an:

EEG and MRI

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A life threatening persistent seizure lasting more than 30 minutes is called:

status epilepticus

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Tx for epilepsy includes:

antiseizure meds (Dilantin)

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Hydrocephalus is an abnormal accumulation of fluid in the brain caused by an obstruction of the normal flow of:

CSF

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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

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Tx for hydrocephalus:

surgical placement of a shunt to relieve ICP

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Spina bifida:

congenital NTD where one or more vertebrae fail to develop

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NTD

neural tube defect

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SB can be accompanied by one or more of the following:

hydrocephalus, cleft lip/palate, club foot, esotropia

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Four types of SB:

spina bifida occulta, meningocele, meningomyelocele, myelocele

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Spina bifida occulta (SBO):

causes incorrect posture, inability to walk, incontinence, a tuft of hair over the vertebral defect

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Meningocele:

A meningocele is characterized by the meninges protruding through the opening in the vertebral defect, corrected by surgery

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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

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Myelocele:

A myelocele is characterized by a disorganized spinal cord that is exposed. A myelocele is usually fatal.

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Prophylactic tx for SB:

3 month pregravida folic acid supplements of 400 mcg/day

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Cerebral palsy (CP) is a non-progressive brain damage resulting in mental and/or motor retardation before the age of"

three

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Causes of CP:

gestational rubella infection, drugs/ETOH during gestation, hypoxia in utero, erythroblastosis fetalis

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CVA is AKA

stroke

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A cerebral vascular accident (CVA) is brain damage commonly resulting from:

cerebral aneurysm, cerebral infarction

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A cerebral aneurysm can be detected with:

cerebral angiography

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Risk factors for a cerebral vascular accident (CVA) include:

atherosclerosis, chronic HTN, A-fib

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Increased risk of CVA has been linked to a deficiency of:

vitamin C and folate

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CVAs usually occur after the age of:

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Cerebral vascular accident (CVA) risk is:

1 in 5 for women over 55 and 1 in 6 for men over 55

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Signs/symptoms of CVA:

dysphasia, blurred vision, ataxia, vertigo, N+V, hemiparesis, hemiplegia, LOC, FAST

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Hemiplegia

partial paralysis on 1/2 the body

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FAST

facial drooping, arm weakness, speech dif, time

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Dx of CVA:

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Tx of CVA:

tPA therapy is effective within the first 3 hours of the onset of symptoms for a CVA caused by an embolus

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A transient ischemic attack (TIA) is AKA:

little stroke or mini stroke

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A TIA is characterized by:

ischemic brain tissue caused by a reduced flow of blood to the brain

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Causes of a transient ischemic attack (TIA) include:

carotid atherosclerosis, emboli

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Signs and symptoms of a transient ischemic attack (TIA) are the same as a cerebral vascular accident (CVA) except:

they dont last

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Treatment (Tx) of a transient ischemic attack (TIA) includes:

prophylactic anticoagulant therapy

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Cerebral Concussion (CC):

transient brain disorder resulting from a head trauma

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Signs/symptoms of a CC:

LOC, amnesia about the accident, nausea, vertigo, cephalagia, perseverating (repeating yourself)

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Treatment (Tx) of a cerebral concussion (CC) includes:

NVS (neurological vital signs) performed every 2 hours

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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

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A cerebral contusion refers to a:

TBI

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Complications associated with a cerebral contusion include:

inracranial hemorrhages causing increased ICP, coma, permanent brain damage

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Intracranial hemorrhages include:

epidural, subdural, subarachnoid

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Tx of a intracranial hemorrhage includes:

SAIDs, surgery to seal off the bleeding vessels and remove blood

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A primary malignant brain tumor (BT) is called a:

glioma

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Most BTs:

metastasize from other sites

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Signs and symptoms of a brain tumor (BT) include:

cephalagia when bending over, personality changes, amnesia, diplopia, blindness, dysphasia, ataxia, seizures, come

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Although benign brain tumors (BTs) are commonly removed surgically, malignant brain tumors (BTs) are usually:

inoperable

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Treatment (Tx) for a malignant brain tumor (BT) includes:

chemotherapy/radiation

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migraines:

severe cephalagia often accompanied by N+V and photophobia

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Migraines are caused by:

constriction and dilation of cerebral arteries and the release of serotonin and prostaglandins

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Migraine triggers include:

stress, food preservatives, weather, menses, fatigue, skipping meals, alterations in normal sleep patterns

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Migraine triggers may be:

inherited

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60-70% of migraines are associated with hormonal fluctuations that occur during the :

menstrual cycle

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Migraines commonly last from:

4 hrs to 3 days

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Migraine meds:

Motrin, Aleve, Excedrin Migraine, Ergomar, Calan

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Created by: RBarnes86

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