FNP NEURO QUESTIONS WITH CORRECT ANSWERS GRADED TO PASS

Pt. Is suddenly unable to close eye, facial assymetry, smooth forehead on 1 side, tearing in 1 eye. Which disorder is this and what cn does it involve? - bell's palsy Cn7 facial nerve How do you diagnose bell's palsy? - by clinical symptoms Also draw a lyme titer Emg or ct only if other causes have been ruled out first What is the treatment for bell's palsy? - prednisone Antivirals In eyes, consult opthomologist with corneal abrasions Tape eye shut, eye drops Goal is to recover nerve function What are some causes of bell's palsy? - lyme Epstein-barr Cytomegalovirus Adenovirus Rubella Mumps Htn What is the typical course of bell's palsy? - a few weeks with recovery by 6 weeks May start as pain in 1 ear (rule out ear issues) In 48-72 hours, will have paralysis of face What is a special eye concern with bell's palsy? - make sure eyes stay lubricated if they don't close all the way, consult an eye care professional What are the 4 types of ms? - 1. Relapsing- most common Episodes resolve with good neuro function in between 2. Primary progressive- there is no full recovery, and effects are cumulative 3. Secondary progressive 4. Progressive-relapsing What are some symptoms of ms? - visual issues Nystagmus Neck/back/trigeminal pain Unsteady gait Bowel/bladder dysfunction What is the most common age group for ms? - 20-40 year olds, women more than men What are risk factors for ms? - family history Northern europeans The presence of other autoimmune diseases including ibs What does an lp show for ms? - pleocytosis, monocytes and abnormal protein levels. Increased igg, oligoclonal bands and increased myelin basic protein What is the treatment for ms? - high dose corticosteroids Treat underlying illness Interferon Immunosuppresives-novantrone Monoclonal antibodies- natalizumab When a person is on ms medications, what organ must be monitored closely? - liver What is the main pathophysiologic cause of parkinsons? - alteration of dopamine-containing neurons in the midbrain, specifically the pars compacta of the substantia nigra. What is the typical age parkinson's begins? - 60+ What are the 6 cardinal signs of parkinsons? - asymetrical resting tremor Rigidity, bradykinesia Flexed posture Loss of postural reflexes Mask-like facies Cogwheel and lead pipe rigidity **at least 2 of these must be present to diagnose What medications are ordered for parkinson's - domapine agonists: Requip/ropinarole Mirapex/pramipexole Levodopa Sinemet Symmetrel/amantadine, which is an antiviral Anticholinergics/cogentin to help with tremor Catechol o-methyltransferase inhibitors/comt/tasmar Mao-b/eldepryl What is the maximum time recommended for amantadine/symmetrel to be used? - 1 year What is an injectable medication that can be used for parkinson's? - apomorphine/apokyn It is a rescue therapy for the treatment of hypomotility What disorder is characterized by "on" and "off" periods? - parkinson's What may cause an "off period" in parkinson's? - when meds like sinemet are wearing off. What is an uncontrolled writhing movement of a limb with parkinson's? - choreiform What is deep brain stimulation that can help with tremor, rigidity, bradykinesia, and dyskinesias when medications aren't working? It also helps to make the "off" periods more like the "on" periods. - pallidotomy What is a fluctuating weakness of voluntary muscles, producing diplopia, ptosis, and difficulty swallowing? These fluctuations can occur throughout the day. Sensation and reflexes remain intact. - myasthenia gravis