quiz #3- degenerative diseases & toxic/metabolic disorders

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quiz #3- degenerative diseases & toxic/metabolic disorders
2011-04-25 10:58:21
clinical neurology

degenerative disorders: inherited and acquired, and tosic/metabolic disorders
Show Answers:

  1. What are different inherited degenerative disorders?
    • charcot marie tooth disease
    • friedreich's ataxia
    • spinal muscular atrophy
    • muscular dystrophy
    • huntington's chorea
  2. What nerve does charcot marie tooth deal cause atrophy of?
    peroneal nerve
  3. What are symptoms of charcot marie tooth?
    • foot drop
    • steppage gait
    • pain
    • gradual onset in adolescence
    • bilarteral symptoms
  4. How many people are affected and what genes are affected with charcot marie?
    • autosomal dombinant- various genes
    • 1/2500 people
  5. What is fredreich's ataxia (basic)?
    • degenerative changes in the spinal cord
    • the cerebellum isn't getting infro from the spinocerebellar tracts so it can't do its job
  6. How do you get fredreich's ataxia?
    • autosomal recessive, gene 9
    • both parents have to be carriers
  7. When is the onset of fredreich's ataxia?
    • 5-15 years
    • progressive
    • w/c bound by 10 years
  8. What are symptoms of fredreich's ataxia?
    • ataxic gait
    • weakness
    • sensory loss
  9. What are different acquired degenerative disorders?
    • amyotrophic lateral sclerosis
    • parkinsonism
    • alzheimer's
    • multiple sclerosis
    • syringomyelia
  10. Why does syringomyelia usually occur?
    a cyst in the spinal cord- usually over the cervical cord
  11. What are symptoms of syringomyelia and when do they start?
    • pain and weakness in arms
    • onset is 25-40 yo
  12. What are different metabolic disorders?
    • cerebral annoxia
    • hyper/hypo glycemia
    • hyper/hypo natremia
    • hyerp/hypo kalemia
    • hyper/hypo thyroid
    • renal insufficiency
    • diabetes
    • liver failure
    • vitamin deficiency
  13. What are the different levels of anoxia and their significance?
    • 50 mmHg: confusion, decreased visual acuity, uncoordinated
    • 40 mmHg: very ataxic
    • 32 mmHg: loss of consciousness
    • <32 mmHg: decorticate, decerebrate, death
    • (normal is 90-100)
  14. What is affected first in cerebral anoxia, gray or white matter?
    • gray matter
    • cell bodies are attacked first
  15. What is the recovery for cerebral anoxia?
    • 10% of victims recover completely
    • partial recovery w/ myoclonus, intellectual defecits, seizures, motor/sensory defecits
    • persistent vegetative state- no cortical activity
  16. What is more serious in cerebral anoxia- rapid or chronic?
    rapid is more serious
  17. What are the levels for hyper/hypo glycemia
    • hyperglycemia: >120
    • hypoglycemia: <80
  18. What are characteristics of hyperglycemia?
    • occurs in diabetics- extra thirsty
    • can produce encephalopathy/coma
    • can be reversed
    • >120
  19. What are characteristics of hypoglycemia?
    • usually due to insulin overdose
    • progromal symptoms- makes you feel just a little off
    • seizures, delerium, coma
    • can be reversed if treated quickly
    • <80
  20. What are the levels for hyper/hypo natremia?
    • hypernatremia: >145 mEq/L
    • hyponatremia: <135 mEq/L
  21. What are characteristics of hypernatremia?
    • dehydration- can have electrolyte imbalance from vomitting
    • produces myoclonus, chorea, stupor
    • mortality high in elderly
  22. What are characteristics of hyponatremia?
    • causes- kidney failure, CHF, execessive water, medication
    • produces fatigue, nausea, hypotension, coma
  23. What is more severe acute or chronic hypo-hypernatremia?
  24. What are the levels for hyper/hypo kalemia?
    • hyperkalemia: > 4.8 mEq/L
    • hypokalemia: < 3.6 mEq/L
  25. What are causes and symptoms of hyperkalemia?
    • causes: renal failure, crush injury, meds
    • symptoms: cardiac arrhythmia
  26. What are causes and symptoms of hypokalemia?
    • causes: diuretics, renal failure, diarrhea/vomitting
    • symptoms: weakness, constipation, cardiac arrhythmia, muscle cramps
  27. What are characteristics of renal insufficiency (uremic encephalopathy, dialysis dementia, uremic neuropathy, intracranial bleed)?
    • affects central and peripheral nervous system
    • uremic encephalopathy: causes asterixis, hallucinations, reversible by dialysis
    • dialysis dementia: can occur after 3-4 years of dialysis (dialysis will eventually cause brain damage)
    • uremic neuropathy: peripheral axons die, restless leg syndrome, parasthesia
    • intracranial bleed: 25% of patients on dialysis
  28. Diabetes puts you at increased risk for what?
    • CVA: because more likely to get atherosclerosis which increases risk of CVA
    • peripheral neuropathy: 50% of pts have peripheral neuropathy after 25 years of DM
  29. What does hyperthryoidism cause?
    • proximal muscle weakness
    • tremor
    • seizures
    • exopthalamos
    • opthalmoplegia
    • grave's disease
  30. Who does hyperthyroidism effect most often?
    middle age women
  31. What is graves disease?
    • auto-immune disease
    • doesn't get signal you're producing too much from the pituitary gland
    • is hyperthyroid, but when treating graves may cause hypothyroid
  32. What are symptoms of hypothyroidism?
    • nerve entrapment
    • depression
    • mild dementia
    • increased risk of stroke
    • decreased mental function
    • 25% of eldelry have hypothyroid
  33. What can liver failure cause (acute and chronic)?
    • hepatic encephalopathy
    • acute: asterixis, hyperreflexia, seizures, confusion
    • chronic: mood disturbances, asterixis
  34. What type of liver failure do alcoholics develop?
    • chronic liver failure
    • (mood disturbances, asterixis)
  35. What vitamin complex causes significant neurological changes?
    B complex
  36. What are some different toxic agents causing disorders?
    • methanol
    • ethanol
    • heavy metals (mercury and lead)
    • drugs
  37. What does methanol cause?
    damage to optic nerve
  38. What does ethanol cause (acute and chronic)?
    • acute: >100 mg/dl, alcohol poisoning
    • chronic: wernicke-krosakoff syndrome, polyneuropathy, withdrawal
  39. What does mercury cause and where can it be found?
    • chronic exposure leads to nervousness, personality changes, confusion
    • IN FISH
  40. What does lead exposure cause and where can it be found?
    • decreased intellect, lethargy, hyperactivity, ab pain, irritability, insomnia
    • paint/drinking water
  41. What are different drugs that can cause problems and their associated problem?
    • vincristine: tingling, sensory loss in fingers and feet
    • lasix: cranial nerve VIII dysfunction
    • flagyl: sensory loss
    • antiviral: sensory loss (if have shingles or AIDS)
    • cholesterol reducing: sensory loss
    • anti-seizure: sensory loss