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CMN 577 HIV Study Guide Question Graded A+

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CMN 577 HIV Study Guide Question Graded A+ Down Syndrome - Labs & Imaging - Multiple Marker Screening (MMS) - also known as the triple screenmay be performed between 15 and 20 weeks of gestation. This evaluates for Down Syndrome, neural tube defects (such as spina bifida and anencephaly), multiple fetuses, and to evaluate the pregnancy timeline or progression (is it as far along as it should be). The test evaluates alpha-fetoprotein (AFP), hCG, and estriol. Elevated levels of of AFP are associated with neural tube defects. Abnormal AFP levels raise concerns for trisomy disorders such as Down Syndrome (low AFP) and Trisomy 18 (low AFP). Low estriol is found in both Down Syndrome and Trisomy 18. Inhibin A is elevated in Trisomy 21 and is normal in Trisomy 18. Further confirmatory testing, including amniocentesis, is needed. Cytogenomic analysis should be performed to look for unbalanced translocations. A parent with balanced translocations (an even/equal exchange of genetic material that allows for full functionality without extra or missing information) has a higher risk of having additional children with Down Syndrome. Down Syndrome - Treatment - Surgery as indicated for congenital defects- patients typically do well with this type of intervention. Monitor for hypothyroidism, symptoms of dementia (early or late), and for leukemia. Patients with Down Syndrome have a higher childhood risk for acute lymphoblastic and myeloid leukemias. There may be an impairment of the immune system, therefore increasing the risk for infection(s). Celiac disease and atlanto-axial instability (remember your M/S unit last semester?) are also possible complications that should be monitored. Fragile X - Overview - This genetic disorder has the highest number of mental retardation cases in males other than Down Syndrome. The incidence, according to Hay 23rd edition, is approximately 1 in 1000 males. (Interesting note- Papadakis and McPhee, 2018, states the rate is 1 in 4000 males p. 1693). The occurrence in females is approximately 50% less than males. The FMR1 gene has expanded trinucleotide repetition with more than 200 copies being present. Fragile X - S/S - Males: mental retardation, autism spectrum disorders along with impulsivity, repetitive and aggressive behaviors. After puberty, the testes are enlarged (macro-orchidism). Other physical findings include large ears, a more prominent jaw, and high pitched voice.

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CMN 577 Unit 2 Study Guide 2025/2026
In Lewy body dementia, protein deposits develop in nerve cells in regions of the brain
involved in? - Thinking, memory, and movement

What diagnostic tests are appropriate for Alzheimer's diagnosis? - CBC, CMP, TSH,
B12, RPR, CT Head

What is the name of the prescription medical food that is intended for the clinical dietary
management of the metabolic processes associated with mild to moderate Alzheimer's
disease? - Axona

What are the treatment options for Alzheimer's Disease? - Cholinesterase Inhibitors
(memantine (Namenda)) and antidepressants, diet and exercise

What tests are helpful in evaluating/diagnosing Dementia? - MMSE (not used anymore),
MoCa, SLUMS, and Mini-Cog

The Mini-Cog should be used for initial testing. If (+), then move on to? - MoCa or
SLUMS

What is NPH? - Normal Pressure Hydrocephalus- It is an enlargement of the ventricles
WITHOUT increased ICP- presents in >/= 60 y.o

What is the triad of symptoms in NPH? - Gait changes, Altered thought processes, and
urinary incontinence

What is the treatment of NPH? - Treatment of symptoms-anticholinesterase inhibitors
may be helpful w/ memory loss
Shunt placement- can be considered but must weigh pros and cons

What are some risk factors for stroke? - HTN, DM, CAD, Migraine Headaches,
Hyperlipidemia, Tobacco Abuse, ETOH/drug abuse, personal/family hx of stroke

Ischemic stroke treatment must be initiated within ??? Hours of onset. - 4.5

What medications are indicated for post-stroke treatment? - Anti-coagulant therapy
(may include ASA, Plavix, Aggrenox, Coumadin)

If atrial fibrillation is the underlying cause of the CVA, what anticoagulants may be
considered? - Pradaxa, Xarelto, Eliquis

What is the typical age of onset for Parkinson's disease? - 45-65

What are the symptoms of Parkinson's? - Tremor, rigidity, bradykinesia, and postural
instability- considered "hallmark" features

, First symptom is usually "pill-rolling" tremor unilaterally, that is absent during sleep, with
maximum SXS at rest

If a patient has SXS of Parkinson's, but are younger than 50, what two diseases must
be ruled out? - Huntington's Chorea and Wilson's disease

What is Huntington's Chorea? - Inherited disease with progressive dementia, bizarre
movements, and posture

What is Wilson's disease? - Accumulation of copper in various vital organs

What are some medications that may create Parkinson's-type symptoms? -
Metoclopramide, Reserpine, and Anti-psychotics

Parkinson's related dementia must be diagnosed ??? After the diagnosis of Parkinson's
is made - 2 years

How can I distinguish between essential familial tremors and PD tremors? - Essential
familial tremors are ABSENT at rest and PRESENT with intention- they often affect the
head, have normal movement speed, and are fairly animated—— Also, usually
BILATERAL

In PD, when functional disability w/ cognitive impairment are noted, what should be
used first line? - Sinemet

In PD management, what medication may be appropriate with mild functional debility
and a predominant tremor? - Amantadine

Shirley has just been diagnosed with Myasthenia Gravis. She is 46. She comes into the
clinic today with her husband wanting more information on the disease. What can you
tell them? - Can occur at any age-any time- is a slowly, progressive disease. Symptoms
will be asymmetric limb weakness and muscle fatigue- cranial nerves will be affected.
Treatment beings with an anti holiness erase (mestinon) followed by immunosuppresive
therapy with prednisone x 3 months OR until clinical improvement stops or decline is
seen.

Shirley is on Imuran for her myasthenia gravis. When will she see full effects of this
medication? - 6 months or more

Shirley is on Imuran for her myasthenia gravis. What labs should be routinely monitored
while on this medication? - CBC and LFTs

What is the preferred treatment of benign paroxysmal positional vertigo? - Repositioning
Therapy- Epley Maneuver

What type of seizure occurs almost exclusively between ages 5-18? - Petit Mal

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