AHN 447 Exam 5, Top Exam Questions and answers. VERIFIED.

AHN 447 Exam 5, Top Exam Questions and answers. VERIFIED. Primary parkinsons - --idiopathic -most common Secondary parkinsons - --occurs at 5o y/o -only 2-10% -caused by tumors, brain surgery, anti-psychotic medications PD classic symptoms - --bradykinesia (slow movement) -akinesia (no movement or freezing) -muscle rigidity/stiffness -mask-like face -tremors Parkinsons dx - --eliminate other diagnoses -early s/s of sleep behavior disorder, constipation, depression/anxiety, loss of smell Dopamine - --controls movement -affects learning and memory -assists in focusing -regulates perception & pleasure -produces fight or flight -aids in problem solving/stimulates creativity Dopamine agonists - --may cause orthostatic hypotension, hallucinations, sleepiness -effective first 3-5 years -fewer dyskinesia's -less wearing off Levodopa-Carbidopa - --GOLD STANDARD DRUG -less expensive -better at controlling movement/symptoms -watch for dyskinesia COMTs - --prolong action of levodopa MAO-B - --control early/mild symptoms -avoid tyramine (cheese, meats, red wine, beer) for up to 2 weeks after d/c -decreases freezing episodes PD patients should AVOID these drugs - --pimavanerin -quetiapine -clozapine -meperidine -tramadol -droperidol -methadone -compazone -reglan -phenergam -inapsine -amoxapine Systemic lupus erythematosus (SLE) - --chronic & progressive -remissions & flare ups -S/S: butterfly rash, myostitis, raynaud's, joint inflammation, nephritis -Dx: rule out other causes -Labs: CBC (pancytopenia), anti-RO-antismith antibody test -Tx: lifelong chronic steroids & immunosuppressive therapy, skin protection, cortisone for skin lesions Multiple sclerosis - --affects myelin sheath & conduction pathway - S/S: muscle weakness/spasticity, intention tremors, dysmetria, parasthesias, hypalgesia -symptoms increased by fatigue, overexertion, hot or cold -Dx: abnormal protein in CSF, elevated WBC, plaque in white matter -Tx: steroids, immunosuppressants, antispasmodics, biologic response modifiers, therapy Relapsing/remitting MS - --most common -develop symptoms then resolution in weeks-months Progressive/relapsing MS - --frequent relapses make progressively worse Primary progressive - --steady decline -no remission Secondary progressive - --start with relapsing/remission then steady decline Amyotrophic lateral sclerosis - --progressive & degenerative -S/S: atrophy of tongue (early), hands, forearms, & legs, paralysis, facial twitching -NO MENTAL OR COGNITIVE IMPAIRMENT -will be on hospice with ventilator Guillain Barre syndrome - --acute autoimmune disorder associated with acute illness -inflammation of axons & myelins in PNS -S/S: symmetrical facial weakness, flaccid paralysis, respiratory compromise, labile blood pressure, dysrhythmias -Causes: campylobacter bacteria, HIV, pneumonia, surgery URI, SLE, Hodgkins, vaccinations, drugs -Dx: lumbar puncture, leukocytosis, EMG -will have normal MRI -Tx: immunoglobulin, plasmapheresis Initial phase GBS - --1-4 weeks from first s/s Plateau phase - --2 days -2 weeks after initial symptoms Recovery phase - --4-6 months Miller Fisher GBS - --paralysis of eye muscles -areflexia (minimum to absent reflexes -severe ataxia -rare respiratory complications Myasthenia gravis - --chronic disease -remissions & flare ups -caused by antibodies to acetylcholine (hyperplasia of thymus gland) -weakness/fatigue of respiratory, facial, & skeletal muscle -S/S: muscle weakness that improves with rest, poor posture, ocular palsies, ptosis, diplopia, loss of bladder/bowel control, resp. compromise, fatigue -Dx: EMG, thyroid studies (hyperthyroidism), AcH receptor antibodies, serum protein electrophoresis, CT, MRI, tensilon testing -Tx: immunosuppressants, anti-cholinesterase agents, plasmapheresis, thymectomy -patient needs to avoid heat, crowds, stress, sleep deprivation, & maintain medication regimen Eaton-Lambert Syndrome - --small cell carcinoma of lung -effects muscle of shoulders, pelvic girdle, & trunk -muscle strength may improve with movement Tensilon testing - --test for Myasthenia gravis -administer drug to patient -muscle strength improvement -can cause vfib - must be closely monitored -antidote: atropine