What is the most common cause of status epilepticus? | Sudden withdrawal of anticonvulsant medication |
What is the postictal period? | Period after a seizure |
Which conditions can cause a seizure? | Elevated temperature
Drug use
Electrolyte imbalance
Brain tumors
Brain infection
Epilepsy |
What is the most common type of seizure? | Tonic-Clonic |
What is the aim of drug therapy for seizures? | Prevention; there is no cure |
What kind of hygiene is important when receiving long term phenytoin therapy? | Oral hygiene; edematous and enlarged gums |
Patient with the first signs and symptoms of MS have which type of immune cell in their spinal fluid? | Gamma delta T cells |
What do the T cells do in the body of a person with MS? | T cells attack the body |
At what ages does the onset of MS occur? | 15-50 years |
What is not a common symptom of MS? | Pain |
What is damaged in a person with MS leading to progressive deterioration in neurologic function? | Myelin sheath |
Involuntary rhythmic movement of the eye is called __________. | Nystagmus |
What kind of infection is a major problem in MS? | Urinary tract infection |
What kind of diet is recommended for a patient with MS? | High-protein with supplemental vitamins |
What can increase fatigue in a patient with MS? | Heat; avoid hot baths |
What is the average life expectancy after onset of symptoms of MS? | 25 years |
What is the underlying cause of parkinsonism? | Damage or loss of the dopamine producing cells |
Symptoms of Parkinson's disease occurs at what age? | After 50 years |
A firm diagnosis of Parkinson's disease can be made when the patient has at least 2 signs of the classic triad: | Tremor
Rigidity
Bradykinesia |
What is the ultimate confirmation of Parkinson's disease? | Positive response to a low dose trial of antiparkinsonian medication (Sinemet) |
The tremor of someone with Parkinson's is described as a ___________ motion of the fingers | Pill-rolling |
What part of the brain primarily experiences neuronal damage in a person with Alzheimer's disease? | Cerebral cortex |
Which antioxidant-rich foods lower the risk of developing Alzheimer's disease? | Citrus fruits
Dark greens
Tomatoes
Brown rice
Sweet potatoes & Carrots |
What does the term "sundowning" refer to? | Increased confusion and agitation in the late afternoon or evening |
What is the first drug approved for treatment of moderate to severe Alzheimer's disease? | Memantine (Namenda) |
__________ _________ is an autoimmune disease of the neuromuscular junction | Myasthenia Gravis |
Patients with myasthenia gravis have ____ as many acetylcholine receptors as normal | one-third |
What is myasthenia gravis characterized by? | Fluctuating muscle weakness of certain skeletal groups |
Myasthenia gravis is thought to be triggered by what? | Antibodies that attack acetylcholine receptor sites (at the neuro muscular junction) |
What are the signs and symptoms of ocular myasthenia gravis? | Diplopia (double vision)
Ptosis (drooping eyelid) |
Which muscles are not as affected in general myasthenia gravis? | Distal muscles |
Which drug can be used to help with sleep problems in someone with Alzheimer's disease, but may cause hypotension? | Trazodone |
What is the simplest test for myasthenia gravis? | Have the patient look upward for 2-3 minutes |
Name at least 3 drugs contraindicated in a person with myasthenia gravis? | Anesthetics
Antidysrhythmics
Antibiotics
Quinine
Antipsychotics
Barbiturates
Opioids
Sedatives
Thyroid preparations |
Excision of the _____ reduces symptoms of myasthenia gravis in many patients | Thymus |
In myasthenia gravis, death results from _________. | Respiratory failure |
What is the major pathologic change in ALS? | Loss of upper and lower motor neurons |
Death results from ALS within how many years? | 2 to 6 years |
Which drug helps protect motor neurons damaged by ALS and can add 3 months or more to the persons life? | Riluzole (Rilutek) |
What is the greatest cause of death in ALS? | Respiratory failure |
The offspring of a person with Huntington's disease have a ___% chance of inheriting it | 50% |
The person with Huntington's disease has excess ________. | Dopamine |
What are the caloric requirements of a person with Huntington's disease? | 4000 to 5000 |
The symptoms of Huntington's disease are opposite of ___________. | Parkinson's disease |
A stroke is also called a __________. | Brain attack |
What is the most common disease of the nervous system? | Stroke |
Stroke risk can be reduced up to 42% with treatment of __________. | Hypertension |
When do symptoms of a thrombotic stroke usually occur? | During sleep or soon after arising |
Stoke resulting from thrombosis is seen in which age group? | 60 - 90 years |
Recurrent rupture is a risk __ to __ days after hemorrhage. | 7 to 10 |
When do most TIA's resolve? | Within 3 hours |
40% of patients that have a TIA will have a stroke within __ to __ years | 2 to 5 |
A stroke affecting Broca's area of the brain results in ________ aphasia. | Expressive aphasia |
Receptive aphasia results when the stroke affects which part of the brain? | Wernicke's area |
What medication should be started within 96 hours of bleeding with subarachnoid hemorrhage? | Calcium channel blocker; Nimodipine (Nimotop) |
How long should Nimodipine (Nimotop) be continued to prevent vasospasm? | 21 days |
Patients experiencing acute ischemic stroke benefit from which medication? | Thrombolytics; TPA |
What can be performed to remove blood clots up to 8 hours after acute stroke onset? | Endovascular embolectomy |
Why may fluids be restricted for the first few days after a stroke? | Prevent edema of the brain |
How long does a trigeminal neuralgia attack last? | 2 to 3 minutes |
Describe the pain of trigeminal neuralgia: | Kinfelike, or lightning-like shock in the lips, gums, cheek, forehead, or side of nose |
Absolute alcohol injected into the branches of the trigeminal nerve provide relief by: | Damaging the nerves |
Bell's palsy is caused by inflammation involving which nerve? | Facial nerve (cranial nerve VII) |
Reactivation of ____ may be involved in the majority of Bell's palsy cases. | Herpes simplex virus (HSV) |
What kind of medication should be started immediately in a patient with Bell's palsy? | Corticosteroids; Prednisone |
How long does it take people with Bell's palsy to recover? | 3 to 6 months |
What is the first sign of improvement in Bell's palsy? | Recovery of taste |
GBS is an autoimmune reaction involving the peripheral nerves following what kind of infection? | Respiratory or gastrointestinal |
The myelin sheath is composed of what kind of cells? | Schwan cells |
In GBS the antibodies attack the ________ cells, causing the myelin sheath to break down. | Schwan |
In GBS, where do signs of weakness, tingling, and numbness begin? | In the legs |
What are NOT causes of GBS | Surgery
Epstein-Barr virus
Viral immunizations |
In what order does recovery of GBS occur? | Reverse order of how it began |
Meningitis is classified as ______ or ______. | Viral (aseptic) or Bacterial (septic) |
What are the 2 abnormal signs that occur with meningitis? | KERNIG'S SIGN- inability to extend legs without extreme pain
BRUDZINSKI'S SIGN- flexion of hip and knee when neck is flexed |
What type of isolation is required for a patient with meningitis? | Respiratory isolation |
In meningitis, bacteria colonizes in the __________. | Nasopharynx |
Acute inflammation of the brain, usually caused by a virus is called: | Encephalitis |
How is epidemic encephalitis transmitted? | Mosquitos and ticks |
What is the most common form of viral encephalitis? | HSV |
What medications are used to control cerebral edema? | Osmotic diuretics (Mannitol)
Corticosteroids (Dexamthasone) |
What is the preferred treatment of HSV encephalitis? | Acyclovir |
What is the principal route of human infection of West Nile virus? | Bite of an infected female mosquito |
What is the incubation period of WNV? | 2 to 14 days |
What is the gold standard for insect repellant? | DEET |
An abnormal benign or malignant mass is called a ________. | Neoplasm |
The removal of part of the skull without replacement is called: | Craniectomy |
How many head injuries occur annually in the US? | 1.7 million |
Fractures in what part of the skull are more serious? | Base of the skull; near the medulla |
What does a Battle's sign usually indicate? | Fracture of the lower skull |
What medication is given to a patient if seen within 8 hours of a spinal cord injury? | High-dose methylprednisolone |