MS Ch65 Oncologic & Degenerative Neurologic Disorders – Comprehensive Review

These flashcards cover classification, clinical features, diagnostics, treatments, and nursing care for brain and spinal tumors, Parkinson’s disease, Huntington’s disease, ALS, muscular dystrophy, degenerative disc disease, post-polio syndrome, and cervical discectomy. Use them to quiz key facts and reinforce critical concepts for exam preparation.

What distinguishes benign from malignant brain tumors?

Benign tumors grow slowly and rarely spread but can compress brain tissue; malignant tumors grow rapidly, may invade nearby structures, and often require aggressive treatment.

Name three common benign primary brain tumors.

Meningiomas, acoustic neuromas (vestibular schwannomas), and pituitary adenomas.

What are gliomas and give two examples.

Gliomas are primary brain tumors arising from glial cells; examples include astrocytomas and glioblastomas.

Which cancers most commonly metastasize to the brain?

Lung, breast, kidney, and melanoma cancers.

List three classic signs of increased intracranial pressure caused by a brain tumor.

Headache, vomiting, and papilledema with possible altered level of consciousness.

What triad of vital-sign changes suggests Cushing’s response to raised ICP?

Hypertension, bradycardia, and bradypnea.

Which cranial nerve is affected by an acoustic neuroma and what symptoms result?

Cranial nerve VIII (vestibulocochlear); symptoms include hearing loss, tinnitus, and balance problems.

Why is dexamethasone frequently prescribed for brain-tumor patients?

To reduce cerebral edema and relieve symptoms from tumor-related swelling.

What is the primary imaging study for evaluating brain tumors?

MRI of the brain.

State the main goal of craniotomy for brain-tumor removal.

To excise or debulk the tumor while preserving surrounding functional brain tissue.

When is transsphenoidal surgery preferred?

For tumors of or near the pituitary gland that can be accessed via the sphenoid sinus.

Describe stereotactic radiosurgery in one sentence.

A precise, minimally invasive technique that uses 3-D coordinates to deliver focused radiation to a brain lesion.

Why are antiemetics administered before chemotherapy?

To prevent or lessen chemotherapy-induced nausea and vomiting.

Give two priority nursing goals for patients with nervous-system metastases.

Compensating for self-care deficits and reducing anxiety (others include improving nutrition, enhancing family coping, preventing complications).

Differentiate intramedullary and extramedullary spinal cord tumors.

Intramedullary tumors arise within the spinal cord; extramedullary tumors lie outside the cord (often extradural) but within the spinal canal.

List four neurologic deficits commonly produced by spinal cord tumors.

Pain, weakness, loss of motor function or reflexes, and sensory loss below the level of the lesion.

Why is high-dose dexamethasone combined with radiation for spinal tumors?

To quickly reduce spinal cord edema and relieve compression while radiation shrinks the tumor.

Define Parkinson’s disease in terms of neurotransmitter imbalance.

A progressive movement disorder caused by dopamine depletion in the basal ganglia, leading to relative overactivity of acetylcholine.

Name the four cardinal motor symptoms of Parkinson’s disease.

Resting tremor, muscle rigidity, bradykinesia (or akinesia), and postural instability.

Describe a typical Parkinsonian gait.

Stooped posture with small shuffling steps, reduced arm swing, possible festination (rapid short steps), and difficulty initiating or turning.

What is pill-rolling?

A resting tremor of the fingers that looks like rolling small objects between thumb and forefinger, characteristic of Parkinson’s disease.

Give two autonomic dysfunctions seen in Parkinson’s disease.

Orthostatic hypotension and excessive sweating (others: drooling, flushing, gastric or urinary retention).

Why might a raised toilet seat be recommended for Parkinson’s patients?

Muscle rigidity and bradykinesia make it difficult to rise from low surfaces; higher seats facilitate safe transfers.

What medication combination is considered first-line for Parkinson’s disease?

Levodopa combined with Carbidopa (e.g., Sinemet).

Explain Carbidopa’s role when administered with Levodopa.

Carbidopa inhibits peripheral conversion of Levodopa to dopamine, allowing more Levodopa to reach the brain and reducing side effects.

Name three nursing interventions to improve mobility in Parkinson’s disease.

Daily exercise/ROM, rocking to initiate movement, and use of assistive devices or physical-therapy guidance.

What genetic pattern does Huntington’s disease follow?

Autosomal dominant inheritance.

At what age does Huntington’s disease typically present?

Most frequently between 25 and 35 years (±17 years).

Define chorea in Huntington’s disease.

Involuntary, rapid, jerky movements of the limbs, trunk, or face.

List three common cognitive or psychiatric manifestations of Huntington’s disease.

Depression, executive-function deficits, and irritability or aggression (others include anxiety, psychosis, obsessiveness, dementia).

Why should dairy products be limited in advanced Huntington’s disease?

They increase mucus secretions, raising choking risk in patients with dysphagia.

What imaging change is often seen on CT in Huntington’s disease?

Generalized brain atrophy with up to 30% loss of brain weight.

State two medication classes used to manage behavioral symptoms of Huntington’s disease.

Antipsychotics (e.g., haloperidol, olanzapine) and antidepressants (e.g., fluoxetine, sertraline).

Describe amyotrophic lateral sclerosis (ALS) in one sentence.

A progressive neurodegenerative disorder that destroys upper and lower motor neurons, causing muscle weakness, atrophy, and eventual respiratory failure.

Which three key features characterize ALS?

Progressive limb weakness/atrophy, fasciculations with spasticity, and respiratory muscle impairment.

Why are ALS patients at high risk for aspiration pneumonia?

Bulbar muscle weakness leads to dysphagia and potential inhalation of food or liquids into the lungs.

Name two major priority problems in late-stage ALS.

Respiratory insufficiency and swallowing difficulties (others: immobility complications, communication impairment).

What is the primary treatment focus in ALS?

Symptom management and quality-of-life preservation, as no cure exists.

Define muscular dystrophy.

A group of incurable genetic disorders characterized by progressive weakness and wasting of skeletal (voluntary) muscles.

What is the most common form of muscular dystrophy and how is it inherited?

Duchenne muscular dystrophy, inherited as an X-linked recessive trait.

Explain degenerative disc disease in simple terms.

Age- or trauma-related breakdown of intervertebral discs, often causing back pain and possible nerve compression.

What condition does radiculopathy refer to?

Pain or neurologic symptoms arising from compression or irritation of a spinal nerve root (pinched nerve).

List two typical indications for cervical discectomy surgery.

Cervical disc herniation causing radiculopathy or spinal stenosis producing myelopathy after failed conservative therapy.

During pre-op assessment for cervical discectomy, what bilateral symptom raises concern for spinal cord compression?

Bilateral arm weakness, numbness, or loss of coordination.

Name two serious postoperative complications unique to cervical discectomy.

Hematoma causing airway or cord compression, and recurrent/persistent nerve pain due to residual compression or scar tissue.

Which postoperative findings after cervical discectomy require immediate action?

Neck swelling with stridor or sudden neurological deficit indicating possible hematoma.

Give three nursing goals for a cervical-discectomy patient.

Relieve pain, improve mobility, and prevent postoperative complications while enhancing self-care knowledge.

What is post-polio syndrome?

New muscle weakness, fatigue, and pain occurring decades after initial poliomyelitis infection.

Outline three conservative treatments for degenerative disc disease.

Rest, NSAID/analgesic medications, and physical therapy or activity modification.

Why is advance-directive counseling important for brain-tumor patients?

Cognitive decline may occur; establishing wishes early guides family and providers once decision-making capacity is lost.

Which diagnostic test detects abnormal brain metabolism to evaluate tumor activity?

Positron emission tomography (PET) scan.

What seizure medication is frequently ordered for brain-tumor patients and why?

Phenytoin, to prevent or control tumor-related seizures.

List four nursing strategies to maintain adequate nutrition in neurologic cancer patients.

Provide oral hygiene before meals, schedule meals when rested, offer preferred foods/dietary supplements, and monitor daily weight/intake.

Define stereotactic radiosurgery’s main advantage.

Delivers high-dose radiation precisely to a small target, sparing surrounding brain tissue.

What major motor pathway degenerates in Parkinson’s disease?

The dopaminergic nigrostriatal pathway from substantia nigra to striatum.

Describe orthostatic hypotension and name a disorder where it is common.

A drop in blood pressure upon standing causing dizziness; common in Parkinson’s disease due to autonomic dysfunction.

What term describes rapid, short, accelerating steps in Parkinson’s patients?

Festination (or festinating gait).

Why might a Parkinson’s patient with continued mask-like facies despite Levodopa need medication review?

Persistent hypomimia indicates Levodopa/Carbidopa is no longer adequately controlling symptoms, requiring adjustment.

Explain the purpose of hospice referral in advanced brain-tumor care.

Provides comfort-focused, end-of-life care, pain control, and family support when curative treatments are no longer effective.

What neurotransmitter excess contributes to muscle rigidity in Parkinson’s disease?

Relative excess of acetylcholine due to dopamine deficiency.

Define dysphagia and cite two disorders where it is prevalent.

Difficulty swallowing; common in Parkinson’s disease and ALS.

Which upper-motor-neuron sign is often present in ALS?

Spasticity with brisk deep-tendon reflexes.

State one approved medication shown to modestly slow ALS progression.

Riluzole (not detailed in notes but relevant); primary concept is symptomatic care.

Why is genetic counseling recommended before pregnancy in Huntington’s families?

To discuss the 50% inheritance risk and reproductive options given the autosomal dominant gene.

What does ‘amyotrophy’ literally mean in ALS pathology?

Muscle wasting due to lack of nerve stimulation.

Explain the term ‘sclerosis’ in amyotrophic lateral sclerosis.

Formation of hardened scar tissue replacing degenerated motor neurons in the spinal cord.

Identify two broad nursing priorities across all degenerative neurologic disorders.

Maximizing functional independence and preventing complications such as falls, aspiration, or pressure injuries.

Why is thickened liquid often prescribed for dysphagic patients?

To reduce aspiration risk by slowing fluid flow, making swallowing safer.

What is the purpose of ankle weights in Huntington’s patients?

Improve stability and reduce choreic movements, helping prevent falls during ambulation.

State one reason respiratory therapy is crucial in ALS management.

Progressive respiratory muscle weakness can lead to hypoventilation; early interventions (e.g., cough assist, BiPAP) prolong survival.

What does radiculopathy commonly cause in degenerative disc disease?

Radiating pain, numbness, or weakness along the affected nerve root distribution.