USA PCM3 Final SG Exam With Complete Solutions.

What deficits occur with a stroke to the frontal lobe? Impulse control Attention Organizing Planning movement (Apraxis) What central gyrus controls motor? Pre-central What central gyrus controls sensory? Post-central gyrus What deficits occur with a stroke to the parietal lobe? Orientation in space Lateropulsion (pushers syndrome) Limb position during movement (apraxia) What is apraxia? Loss of the ability to execute or carry out learned (familiar) movements, despite having the desire and the physical ability to perform the movements After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 1.) Demonstrating Lateropulsion (pusher's) a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe D. Parietal After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 2.) Hemiplegia a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe B.) Precentral Gyrus After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 3.) Has difficulty with spatial organization? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe D.) Parietal lobe After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 4.) Demonstrate impulsive behavior? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe A.) Frontal After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 5.) Difficulty planning movement? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe A&D.) Frontal/Parietal lobe After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 6.) Decreased sensation a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe C.) Postcentral gyrus After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 7.) Decreased attention span? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe A.) Frontal lobe After a Left MCA CVA, Match the appropriate impairment with its corresponding lobe: 8.) Apraxia? a.) Frontal b.) Precentral gyrus c.) Postcentral gyrus d.) Parietal lobe D.) Parietal lobe What is Broca's area? motor speech area Where is Broca's area located? frontal lobe What does damage to Broca's area cause? expressive aphasia Expressing words verbally. Where is Wernicke's area located? temporal lobe What does damage to Wernicke's area cause? receptive aphasia Can speak but can't understand. What is the difference of an UMN versus LMN of the facial (CN7) nerve? UMN lesion - spares the forehead. LMN = full sided facial weakness. What is uremia? Uremia is the condition of having high levels of urea in the blood. Normally eliminated from the body from normal functioning kidneys. What is another word for uremia? azotemia (azot, "nitrogen" + -emia, "blood condition") What are symptoms of Uremia? Nausea, vomitting, anorexia, lethargy, sensory/motor neuropathy. What is asterixis? Involuntary jerking movements of the hands. "Flapping-like motion when you lift the hand. What is glomerular filtration? Glomerular filtration is the process by which the kidneys filter the blood, removing excess wastes and fluids. What is Glomerular filtration rate (GFR)? Amount of blood that passes through the kidneys per minute. What is the normal GFR? 90 mL/min What GFR may signify kidney disease? 60 ml/min What GFR signifies kidney failure? 15ml/min What physically happens to the kidneys that explains theor the decrease in value of GFR? Surface area of the kidneys (functional space where blood is filtered) is reduced. During kidney failure, does calcium or phosphate increase sin the blood? Which subsequently decreases. Increased = Phosphate Decreased = Calcium What physiological even occurs when the body detects a decrease in calcium in the blood? Parathyroid hormone secretion (From the parathyroid gland) Releases Ca2_ from bone via demineralization. What are the cardiovascular manifestations of End stage renal disease (ESRD)/kidney failure? CAD HTN CHF PE DYSPNEA PERICARDITIS What are the S/S of cardiovascular manifestations of ESRD/kidney failure? Chest pain Nausea SOB Sweating What are the musculoskeletal manifestations of ESRD/Kidney failure? Renal osteodystrophy - (Osteomalacia or rickets in children) -Osteitis Fibrosis (Weak bones due to hyperparathyroidism) Both are dec bone mineralization with reduced calcium absorption from the gut and compensatory hyperparathyroidism. What is the first step in the development of heart failure? Injury to the myocardium (ischemic episode) or valve. What happens to the left or right ventricle during heart failure? Hypertrophy. How does the body initially compensate for the reduced cardiac output during CHF? Renin-angiotensin-aldosterone system (RAAS) and other sympathetic stimulation helps restore cardiac output. Is RAAS beneficial or harmful in consideration to long term? Harmful. They cause damage to the myocardium over time, causing other cellular and molecular reactions such as apoptosis, remodeling and inflammatory cytokines. What is the initial medical treatment for the beginning stages of heart failure? Rx RAAS blockers ACE inhibitors Beta blockers Aldosterone antagonist Blocks initial compensations of the myocardium. What are some clinical signs of HF? Dyspnea with exercise Fatigue Cough Swelling in limbs Elevated jugular venous pressure Bilateral lung crepitations, 3rd heart sound gallop. What is the ejection fraction of patients with HF? 55-70%. What happens to the cardiac output with left sided HF? Decreases Where does the blood go with L sided HF? L ventricle backs up to the L atrium backs up into the lungs. What symptoms of the lungs occurs with blood backing up into it from the L atrium? SOB and coughing. What increases with R sided HF? Increased PA pressure