Patho Final

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Which of the following is a nuerohormone? (GH, ACTH, ADH, T3T4)

ADH

mixed UMN and LMN disorder; progressive disorder

ALS

cortical atrophy and loss of neurons mainly in parietal and temporal lobes; amyloid-containing neuritic plaques and neurofibrillary tangles are present

Alzeimer disease

continuous, worm-like twisting and turning motions

Athetosis

Neurogenic inflammation involves release of chemical mediators by ___ nerve fibers, and these chemicals cause (vasodilation, vasoconstriction) of blood vessels that lead to (acute, chronic) pain

C vasodilation chronic

blocks release of ACH, food poisoning agent

Clostridium botulinum toxin

rare transmittable form of dementia caused by an infective protein called a prion; degeneration of pyramidal and extrapyramidal tracts; mad cow disease

Creutzfeldt-Jacob disease

increaded levels of FBG or insulin requirements between 5-9am without preceding hypoglycemia

Dawn phenomenon

recessive single-gene trait on X chromosome defective dystrophin protein fails to provide normal attachment site for contractile proteins with the CM

Ducheene MD

child is in a wheelchair with a progressive genetic disorder

Duchenne MD

"repair hormone" but excluded from brain because of blood brain barrier

GH

decreases peripheral use of glucose

GH

primary anabolic hormone

GH

prolonged increase induces glucose resistance

GH

sequence of loss of hormones

GH to LH/FSH to TSH to ACTH

Which of the following is (are) not tropic? (LH, FSH, ACTH, GH, MSH)

GH, MSH

found in all tissues; doesn't require insulin for its action; used to transport glucose into nervous system cells

GLUT-1

transporter of glucose into beta cells of pancreas and liver cells

GLUT-2

insulin-dependent glucose transporter of skeletal muscle of adipose tissue

GLUT-4

promotes gluconeogensis/glycogenolysis

Glucagon, cortisol

nervousness, irritability, weight loss, tachycardia, sweating, heat intolerance, exopthalamos

Graves disease

acute immune-mediated polyneuropathy characterized by progressive limb weakness and loss of tendon reflexes; linked to infections with bacterial and/or viral agents

Guillan-Barre syndrome

autoimmune disorder, most common type of hypothyroidism and goiter in children and adults

Hashimoto disease

hereditary disease with chronic progressive chorea, psychological changes and dementia; loss of GABA-secreting neurons; autosomal dominiant

Huntington disease

Injury to the right (C7, T3, L4) spinal nerve by a herniated disk is most likely to lead to leg weakness and pain to the (right, left) leg

L4 left

innervate skeletal muscle fibers

LMN

The polio virus is likely to destroy (UMNs, LMNs) causing (spastic, flaccid) paralysis and (atrophy, hypertrophy) of muscles

LMN flaccid atrophy

normal GH levels but have a genetic defect in IGF production; treated with IGF-1 replacement

Laron-type dwarfism

demyelinating disease of CNS

MS

autoimmune disorder; ab-mediated destruction of ACH receptors and abnormal T-lymphocyte function; fewer ACH receptors are present causes muscle weakness and fatigue

Myasthenia gravis

Which of the following hormones is not produced by the hypothalamas? (TRH, GHIH, CRH, PRL, ADH)

PRL

When blood Ca2+ is low, (calcitonin, PTH) is produced

PTH

increases blood calcium

PTH

degenerative disorder of basal nuclei; destruction of nigrostriatal pathway that produces dopamine

Parkinson disease

frontal and temporal lobe affected; neurons contain Pick bodies; atrophy

Pick disease

cycle of insulin-induced posthypoglycemia episodes; see compensatory increase in glucagon, epinephrine, cortisol and GH with development of hyperglycemia

Somogyi effect

elevates body T

T3/T4

project from motor cortex to brainstem or spinal cord; exert control over the lower motor neurons

UMN

wet brain; vitamin b-12 deficiency; results from chronic alcoholism; weakness of extraocular muscles, nystagmus, ataxia, confusion, unsteady gait, impaired recent memories and cofabulations

Wernicke-Korsakoff syndrome

petit mal; generalized, nonconvulsive events

absensce seizure

removes NT from neuromuscular junction

acetylcholinesterase

due to hypothalamic-pituitary tumor

acquired GH deficiency later in childhood

excessive GH during adulthood; common cause is somatotropic adenoma or excessive GHRH secretion by hypothalamus

acromegaly

hypersecretion of GH (adult)

acromegaly

from tissue damage; characterized by ANS responses

acute pain

destruction of adrenal cortex

addison disease

site of glucocorticoid production

adrenal cortex

site of catecholamine production

adrenal medulla

impaired recognition of normal sensory inputs

agnosia

can alter blood pH

aldosterone

intense pain is associated with light touch

allodynia

pain that follows a non-noxious stimulus to apparently normal skin

allodynia

absence of pain on noxious stimulation or relief of pain without loss of consciousness

analgesia

intermediate-grade

anaplastic astrocytomas

Calcitonin and PTH are (synergists, antagonists)

antagonists

damage to anterior spinal artery and anterior 2/3 of cord; loss of corticospinal motor function, ipsilateral proprioception and contralateral pain and T

anterior cord syndrome

site of TSH production

anterior pituitary

includes neo- and paleospinothalamic tracts

anterolateral pathway

includes tracts for pain, hot, cold, crude trouch

anterolateral pathway

inability to comprehend, integrate, or express language

aphasia

impaired ability to carry out previously learned motor activities

apraxia

control pain because they block enzyme needed for PG synthesis

aspirin/NSAIDS

well-differentiated lesions

astrocytomas

sudden imbalance

ataxia

loss of ability to feel changes in temperature in a limb

athermia

continuous, wormlike, twisting movements

athetosis

akinetic; sudden loss of muscle tone, slackening of jaw

atonic seizure

excessive sweating, salivation, lacrimation

autonomic manifestations

violent, flinging movement of limbs

ballismus

site of PTH action

bone, kidney, and intestines

caused by increased function of basal nuclei inhibitory loop; slowness beginning movement; reduced/absent emotional/facial responses

bradykinesia

slow, shuffling gait, difficulty initiating movements

bradykinesia

irreversible loss of brain function

brain death

promotes osteoblast activity

calcitonin

traveling blood clot lodges within a vessel; affects the middle cerebral artery; most emboli originate in the left ventricle; can originate from fatty plaque within carotid arteries;

cardiogenic embolic stroke

compression-type mononeuropathy of the median nerve; nerve is compressed as it travels through a canal made by the carpal bones and the transverse carpal ligament; can be caused by systemic disease, wrist injury, and with performance of repetitive wrist movements

carpal tunnel

abnormally high growth rate as child approaches normal height for age; occurs after initiation of therapy for GH deficiency or hypothyroidism

catch-up growth

damage to lumbosacral nerve roots

cauda equina syndrome

central gray or white matter is affected

central cord syndrome

decomposition of movements so that each movement component occurs separately instead of being blended together as a smooth. uniform action

cerebellar ataxia

brief, rapid, jerky movements

chorea

sudden, jerky, irregular movements that are coordinated and graceful

chorea

persistent pain that may be accompanied by loss of appetite, depression, sleep disturbances, and other debilitating responses

chronic pain

normal intelligence, short stature, obesity with immature facail features and delayed skeletal maturation

classic GH deficiency

rhythmic contraction/relaxation of limb caused by suddenly stretching a muscle and maintaining the stretched position

clonus

severe, unilateral, supraorbital, or temporal pain lasting 15-180 minutes and is accompanied by conjunctival injection or lacrimation, ipsilateral

cluster headache

ratchet-like movements of arms, form of rigidity

cog-wheel movements

cannot make a purposeful response to stimulation

coma

impaired reabsorption of the CSF from the arachnoid villi to the venous system

communication hydrocephalus

If the spinal cord is severed at T6, from level T7 downward ___ (communication with the brain is lost, spinal cord reflexes are lost, both occur)

communication with the brain is lost

momentary interruption in brain function with or without loss of consciousness

concussion

inattention, disorientation, blunted responsiveness

confusion

causes preventable mental retardation

congenital hypothyroidism

children with moderately short stature, thin build, delayed skeletal and sexual maturity

constitutional short stature

child is taller than peers and is growing at a velocity within the normal range for bone age

constitutional tall stature

bruise to the cortical surface of the brainn due to blunt head trauma

contusion

motor seizure involving the entire body

convulsion

decreases the inflammatory response

cortisol

glucagons, GH, epinephrine and cortisol to maintain or increase maintain or increase blood glucose

counter-regulatory hormones

impact injury from mechanical forces where brainn bounces against skull

coup-contrecoup

preventable mental retardation

cretinism

acts on postsynaptic side of NM junction to block the depolarizing effect of ACH; results in flaccid paralysis

curare

muscle relaxer that inhibits ACH

curare

bright, sharp, burning pain with origin in skin or subq tissues

cutaneous pain

increase in fluid in intracellular space; primary gray matter

cytoxic edema

With increase BP, ADH secretion (increases, decrease, remains unchanged)

decreases

diffuse, throbbing pain that originates in muscles, bones, and tendons and radiates to the surrounding tissues

deep pain

marked inattentiveness and wither lethargic or agitated

delirium

individual is in a long-term coma and paralyzed following traumatic brain injury

denervation atrophy

hyposecretion of ADH

diabetes insipidus

autoimmune destruction of beta cells; lack of insulin; elevated blood glucose; breakdown of body fats and proteins

diabetes mellitus 1

hyperglycemia, inactive lifestyle and overeating, insulin resistance and impaired suppression of glucose production by liver

diabetes mellitus 11

decreased sensitivity to insulin

diabetes mellitus type 11, gestational diabetes

hyposecretion of insulin

diabetes mellitus, type 1

can cause end-stage renal disease; associated with increased work demands glucose reabsorption and microalbuminemia

diabetic nephropathies

leads to destruction of retinal vascular supply/permeability

diabetic retinopathy

microscopic damage to axons in cerebral hemispheres, corpus callosum and brainstem

diffuse axonal injury

fractured leg immobilized in a caste for two months

disuse atrophy

nonfunctional pituitary tumor

don't secrete hormones

articulation, pitch, or quality of speech is affected

dysarthria

hands on knees, can't rapidly pronote/supinate forearms

dysdiadochokinesia

distortions of somesthetic sensation

dysesthesia

drooling, difficulty swallowing

dysphagia

"wry neck" or torticollis

dystonia

abnormal maintenance of posture; twisting, turning of limbs, neck, trunk,

dystonia

derived from layer of epithelium that lines ventricles and spinal canal

ependymomas

occurs between skull and dura; usually results from tear in an artery; rapid compression of brain occurs due to faster arterial flow

epidural hematoma

recurrent seizures

epileptic seizures

The release of which of the following hormones is controlled directly by the nervous system? ( GH, PRL, T3/T4, PTH, epinephrine)

epinephrine

primary stress response hormone

epinephrine

increases blood pressure

epinephrine, ADH, aldosterone

increases blood sugar levels

epinephrine, glucagon, cortisol

True or False: Glutamate and substance P both inhibit pain.

false

True or False: the PAG region is located in the midbrain and causes pain

false

True or False: Most migraines occur with an aura

false

Acute mechanical and thermal painful stimuli are transmitted along _____ _____ fibers

fast AS

Most of the area of the primary sensor cortex is devoted to the perception of sensations from the (fingers & face, trunk, hips & feet, all body areas have equal coverage)

fingers and face

begin simultaneously in both hemispheres

generalized seizures

tall child of tall parents

genetic tall stature

excessive GH

gigantism

astrocytic and oligodendroglial

glial tumors

least differentiated and most aggressive

glioblastoma multiforme

maintains or raises blood sugar by increasing release of glucose from liver into the blood

glucagon

increase gluconeogeneisis

glucagon and cortisol

increase fat usage

glucagon and epinephrine

promote glycogenolysis

glucagon and epinephrine

excitatory NT released by the AS fibers within the spinal cord. acts quickly but lasts only a few msec

glutamate

vascular injury and bleeding

hematomas

inability to attend to or react to stimuli coming from the contralateral side

hemineglect

spontaneous hemorrhage into brain substance resulting in edema, compression, or vasospasms

hemorrhagic stroke

enlargement of the CSF compartment

hydrocephalus

pain sensitivity is increased

hyperalgesia

excessive hormone production; excessive stimulations and hyperplasia of gland or hormone-producing tumor

hyperfunction

increase in resistance to rapid muscle stretch

hyperotonia

exaggerated response to moderate painful stimulus

hyperpathia

syndrome where sensory threshold is raised

hyperpathia

increases metabolic rate and oxygen consumption; increases use of metabolic fuels and increased sympathetic nervous system responsiveness (tachycardia)

hyperthyroidism

absence/impaired development of gland

hypofunction

Hypersecretion of insulin results in (hyperglycemia, hypoglycemia)

hypoglycemia

decreased secretion of pituitary hormones; affects many other endocrine glands

hypopituitarism

site of vasopressin production

hypothalamus

site of neurohormone production

hypothalamus, adrenal medulla

decrease in metabolic rate, myxedema in connective tissues and elevates serum cholesterol (short and mental retardation)

hypothyroidism

reduced excitability; ranges from postural weakness to total flaccid paralysis

hypotonia

lowers blood sugar by moving glucose into body tissues

insulin

secreted with increase blood glucose

insulin

difficulty tracing back of left shin with toes of right foot

intention tremor

early activation of hypothalamic-pituitary-gonadal axis

isosexual precocious puberty

fats broken down in the liver and converted to ketones

ketoacidosis

small, located deeper within brain or in brainstem; caused by embolism, hypertension, small vessel occlusion, hemorrhages, vasospasms, hemotologic abnormalities; cause pure motor or pure sensory hemiplegia and dysarthria with clumsy hand syndrome

lacunar infarcts

shock-like tingling down back and legs and leads to neck flextion

lhermitte symtom

provides an emotional response to pain

limbic cortex

site of insulin action

liver

coronary artery disease, stroke, and peripheral vascular supply insufficiencies

macrovascular complications

insecticide that binds to ACHase extending ACH action

malathion

lack of facial expression

masklike face

1st order neurons travel from spinal cord to medulla

medial lemniscal pathway

allows you to discriminate between a paperclip and a key

medial lemniscal pathway

permits proprioception

medial lemniscal pathway

slow-growing and well-circumscribed; usually benign and can be completely removed if surgically accessible

meningiomas

insulin resistance, hyperglycemia, 'syndrome X,' obesity, increase plasma triglycerides, decrease high density lipoproteins. hypertension, systemic inflammation, abnormal fibrinolysis, macrovascular disease, abnormal function of vascular endothelium

metabolic syndrome

pituitary tumor that is primary or secondary

metastatic

pulsating, throbbing, unilateral headache lasts 1-2 days and is aggravated by physical activity; may be accompanied by nausea and vomiting

migraine headache

carpal tunnel syndrome

mononeuropathy

muscle cells decrease in diameter and weaken due to lack of use

muscle atrophy

progressive degeneration and necrosis of skeletal muscle

muscular dystrophy

muscle weakness resulting from auto immune disease that destroys ACH receptors

myasthenia gravis

involuntary muscle contractions induced by stimuli of cerebral origin; jerky muscles, generalized or confined to face, trunk, or extrmetity

myoclonic seizures

accumulation of hydrophilic mucopolysaccharide substance

myxedema

inhibits ACHase extending ACH action

neostigmine

inhibits action of ACHase allowing ACH to persist in NM junction; used in myasthenia gravis treatment

neostigmine

FPG< 100mg/dL

normal

constant readjustment of eye movement

nystagmus

eyes constantly readjusting

nystagmus

cannot be fully aroused

obtundation

doll's head eye movement

oculocephalic reflex

cold water in ear canal to elicit nystagmus

oculovestibular reflex

miss touching fingertip to nose with eyes closed

over-/under- reaching

missing of target when reaching and overcorrecting

over/under-reaching

responsible for milk letdown

oxytocin

deficiency of all anterior pituitary hormones

panhypopituitarism

arm function still present; loss of function in thoracic, lumbar, or sacral segments of spine

paraplegia

Which of the following is (are) not influenced by the anterior pituitary? (thyroid, parathyroid, adrenal cortex, adrenal medulla)

parathyroid, adrenal medulla

weakness

paresis

spontaneous, unpleasant sensations seen with severe irritation

paresthedia

return of sensation after your foot falls asleep

paresthesia

begins in a specific or focal area of one cerebral hemisphere

partial seizures

Intense stimulation of virtually all types of sensory receptors can lead to pain. This is a statement of the (pattern, specificity) theory of pain

pattern

affect both ANS and somatic NS, due to demyelinating effect of long-term uncontrolled DM

peripheral neuropathies

prolongs coma, loss of all cognitive functions, unaware of self and surroundings, reflex and vegetative functions remain

persistent vegetative state

hyposecretion of GH (child)

pituitary dwarf

can be primary or secondary and may be functional or nonfunctional

pituitary tumor

paralysis; lost of movement

plegia

excessive thirst

polydipsia

paralysis traveling from legs to upper body following a viral infection

polyneuropathy

excessive hunger

polyphagia

excessive urination

polyuria

site of ADH release

posterior pituitary

originate in target gland

primary defects

pinpoints specific location of pain

primary somatosensory cortex

active insulin is formed from a larger molecle

proinsulin

released from inflamed tissues enhance the sensitivity of pain endings but they don't directly stimulate them

prostaglandins

seen in emotionally deprived children; GH function can return to normal after removal from bad environment

psychosocial dwarfism

normal GH, decrease somatomedins

pygmy

originates in a visceral organ but is perceived elsewhere in the body wall that is innervated by neurons entering the same segment of the nervous tissue

referred pain

diskinesias

rhythmic, repetitive, bizarre movements; causes grimacing, pursuing of lips, sticking out tongue

increased resistance to movements in all direction

rigidity

defective levels of stimulation or releasing factors

secondary defects

functional pituitary tumor

secrete hormones

provides a meaning/context for the pain

sensory association area

declining levels of GH in the elderly

somatopause

inhibits the release of insulin and glucagons

somatostatin

sudden complete transaction of cord; loss of motor, sensory, reflex, and autonomic function below the level of energy

spinal cord shock

seizures that do not stop spontaneously or occur in succession

status epilepticus

remain in a sleeplike state

stupor

between dura and arachnoid layer; usually due to tear in small bridging veins; develops more slowly because of slow venous flow; can be acute, subacute, or chronic

subdural hematoma

released more slowly and increases in concentration over seconds/minutes

substance P

repetitive, bizarre movements of face

tardive dyskinesia

dull, aching, diffuse, nondescript headaches occurring in a hatband distribution around the head; may result from oromandibular dysfunction, stress, anxiety, depression, overuse of analgesics or caffein

tension headache

results from hypothalamic dysfunction

tertiary disorders

impaired/lost motor or sensory function following cervical spine injury

tetraplegia

generalized awareness of hurt or pain

thalamus

usually occur in atherosclerotic vessels at bifurcations; affect cortex and cause aphagia or neglect and visual field defects

thrombotic stroke

crisis form of thyrotoxicosis; see high fever, extreme cardiovascular effects and CNS dysfunction; precipitated by stress, trauma

thyroid storm

repetitive winking of eyelids, abnormal facial movements

tic

sudden, irregular contraction; particularly evident in face

tix

grand-mal; vague warning precedes seizure activity; sharp tonic contractions followed by clonic phase of rhythmic bilateral contractions/relaxation of extremities; person is unconscious until RAS begins to function again

tonic-clonic seizures

focal ischemic deficits that last for less than one hour can be warning sign of impending stroke

transient ischemic attacks

single or multiple; associated with head injury

traumatic intracerebral hematomas

"pill-rolling" movements of PD

tremor

involuntary, oscillating contractions of opposing muscle groups around a joint

tremors

True or False: GH and T3/T4 act as synergists

true

True or False: Migraines and tension-type headaches are primary or chronic headaches

true

True or False: Tension-type headaches may be caused by caffeine withdrawls

true

True or False: prostaglandins tend to enhance pain

true

True or False: the NRM is located in the medulla and is thought to inhibit pain

true

can't stand with a steady posture

truncal ataxia

difficulty/inability to maintain steady posture of trunk

truncal ataxia

results from cerbrovascular disorders; cognitive impairment that vary with location and extent of underlying pathology; impaired ability to organize thought, time, materials, belonging, initiating tasks, focusing on task

vascular dementia

fluid escaped into ECF that surrounds brain cells

vasogenic edema

diffuse, poorly-defined pain that results from stretching, distention, or ischemia of tissues in a body organ

visceral pain

genetic short stature

well-proportioned; heigh close to mid-parental height

T3/T4 secretion is generally higher during (summer, winter) months

winter


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