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USU: MSN 570 WEEK 4
Anterior Cerebral Artery
Contralateral paralysis of lower limb
Contralateral loss of sensation in lower limb
1 min
Middle Cerebral Artery
Contralateral paralysis upper limb and face
Contralateral loss of sensation of upper limb and face
Affects Wernicke's area and Broca's area
Aphasia if Lesion in Dominant (Left) Hemisphere
Hemineglect if lesion in nondominant (right) hemisphere
1 min
Multiple Sclerosis Features and Mechanisms
Features
More Common in Women
Presents in 20's and 30's
Northern Europeans
Mechanism
Unknown mechanism, genetic factor
HLA-DRB1
Autoimmune Demyelination of CNS
White Matter of Brain and Spinal Cord
T Cell Mediated Inflammation
2 mins
Multiple Sclerosis Symptoms and Diagnosis
Symptoms
Optic Neuritis
Internuclear Ophthalmoplegia
Scanning Speech
Urinary and Fecal Incontinence
Motor Issues (Intention Tremor, Paresis)
Numbness and Pain
Depression
Relapsing Symptoms
Diagnosis
Gold Standard = Plaques on MRI
Increased CSF Immunoglobulins (IgG)
Oligoclonal Bands
4 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
2 mins
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
1 min
Causes of Dementia
Reversible Causes
Intoxication or Medications
Depression
Normal Pressure Hydrocephalus
Vitamin B12 Deficiency
Metabolic Conditions
Irreversible Causes
Lewy Body Dementia
Prion Disease
Pick's Disease
AIDS Dementia
Alzheimer's Disease
Multi-infarct (Vascular) Dementia
2 mins
5 A's of Alzheimer's Disease
Agnosia
Anomia
Aphasia
Apraxia
Amnesia
1 min
Alzheimer's Disease Assessment (Early Symptoms)
Risk Factors
Advanced Age
Early Signs and Symptoms
Poor Judgment and Decision-Making
Difficulty Having a Conversation
Inability to Manage a Budget
Losing Track of the Date or Season
Misplacing Things
1 min
Alzheimer's Disease Assessment (Late Symptoms)
Late Signs and Symptoms
Memory Impairment
Wandering Behavior
Confabulation
Perseveration
Lack of Abstract Thinking
Severe Cognitive Decline
1 min
Alzheimer's Disease Interventions
Diagnostic Tests
PET Scan and CT
Mini-Mental State Examination
Interventions
Drug Therapy
Safe Environment
Moderate Exercise
Behavioral Modification
Assistance with Functional Independence
Assistance and Support for Caregiver
2 mins
Parkinson's Disease Assessment
Assessment
Decreased Dopamine
Older Adult
Cogwheel Rigidity
Bradykinesia
Shuffling Gait
Resting Tremor
Pill-Rolling
Mask-Like Face
Cognitive Decline
2 mins
Parkinson's Disease Interventions
Medications
Levodopa/Carbidopa (Sinemet)
Entacapone (Comtan)
Selegiline (Eldepryl)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Benztropine (Cogentin)
Considerations
Allow Extra Time
Ensure Patient Safety
Surgery As Last Resort
2 mins
Amyotrophic Lateral Sclerosis (ALS)
Assessment
Progressive Muscle Weakness
Systemic Muscle Wasting
Fasciculations
Spasticity
Fatigue
Considerations
Riluzole (Rilutek)
Stretching
Little to No Cognitive Decline
Respiratory Support
Palliative Care
2 mins
Huntington's Disease
Pathophysiology
Autosomal Dominant
Trinucleotide Repeat
CAG Repeats
Chromosome 4
Anticipation
Caudate
Decrease of ACh
Decrease of GABA
Signs and Symptoms
Chorea
Dementia
Depression
Glutamate Toxicity
Neuronal Death via NMDA Binding
3 mins
Normal Pressure Hydrocephalus
Mechanism
Elderly
Idiopathic
Decreased Absorption of CSF
Ventricular Enlargement
Symptom Triad
Urinary Incontinence
Ataxia (Gait)
Cognitive Dysfunction
2 mins
Essential Tremor
Characteristics
Most Common Tremor in Adults
Positive Family History
Clinical Findings
Bilateral Upper Extremities
Worse with Physical and Psychological Stress
Better with Rest and Alcohol
Management
Beta Blockers
Primidone
1 min
Intention Tremor
More Apparent With Goal-Directed Movements Such as Using Eating Utensils
High-Amplitude, Low-Frequency
More Apparent as Extremity Approaches Target
Overshooting and Undershooting
Pathogenesis
Ipsilateral Cerebellar Damage
Diagnosis
Neurologic Exam
MRI
Treatment
Physical or Occupational Therapy
3 mins
Neurofibromatosis Type 1
Pathophysiology
Autosomal Dominant
Chromosome 17
Signs and Symptoms
Neurofibromas
Optic Glioma
Lisch Nodules
Hamartomas
Cafe Au Lait Spots
Scoliosis
Pheochromocytoma
4 mins
Neurofibromatosis Type 2
Pathophysiology
Autosomal-Dominant
Chromosome 22
Signs and Symptoms
Vestibular Schwannoma
Meningioma
Ependymoma
Cafe Au Lait Spots
Cataracts
2 mins
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