Diseases 3

What is dysphasia, and what similarly named problem must it NOT be confused with?

Dysphasia = partial language impairment. Dysphagia = difficulty swallowing.

Which bacteria does the meningitis lecture associate with young children?

Haemophilus influenzae; Streptococcus pneumoniae is also associated with young children and older adults.

Which meningitis organism is called meningococcus and affects children/young adults?

Neisseria meningitidis.

Which meningitis organism is emphasized for young children and the elderly?

Streptococcus pneumoniae.

What is the diagnostic CSF finding emphasized for bacterial meningitis?

Lumbar puncture may show increased CSF pressure and cloudy fluid.

Which type of skull fracture can produce CSF drainage from ears or nose?

Basilar skull fracture at the base of the skull.

What mechanism is associated with basilar skull fractures?

Blunt-force trauma to the forehead/face, e.g. windshield or dashboard impact.

What recovery limitation is emphasized for injured spinal cord nerves?

Spinal cord nerves do not regenerate; mild dysfunction due to bruising/edema can improve.

What is the leading cause of spinal cord injuries according to the lecture?

Motor vehicle accidents (>40% of new injuries in historical slide data).

What distinctive paralysis pattern identifies Guillain–Barré syndrome?

ASCENDING weakness/paralysis beginning in legs and possibly reaching respiratory muscles.

What symptoms distinguish gonorrhea in females?

May be asymptomatic; greenish-yellow purulent cervical discharge, dysuria and pelvic tenderness/pain.

What symptoms distinguish chlamydia in females?

Often asymptomatic; urethritis, cervical/Bartholin infection or purulent discharge; may ascend and cause PID.

What lesion identifies PRIMARY syphilis?

Chancre: a typically painless lesion at the contact site after an incubation period around 3 weeks.

What signs identify SECONDARY syphilis?

Systemic malaise/fever/fatigue and macular/papular rash/lesions often involving palms and soles.

What does the HPV slide call the most common STD?

HPV infection (slide claim; genital warts are a manifestation of certain types).

What is the NORMAL FASTING glucose range emphasized?

70–99 mg/dL after about 8–12 hours without food.

Why does the slide emphasize that standard insulin must be injected?

Insulin protein is broken down in gastrointestinal tract if swallowed; slide shows subcutaneous injections/continuous infusion pump.

How is DKA characterized in the highlighted lecture slide?

Life-threatening medical emergency potentially requiring ICU care.

Which risk factors for goiter are marked in red?

Female sex (especially puberty, pregnancy or menopause), age over 40 and family history.

What is the single most important distinguishing behavior of a BENIGN tumor?

It does NOT metastasize to distant sites.

Which leukemia does the slide emphasize as common in children age 2–6?

Acute lymphoblastic leukemia (ALL), described in the slide as the most common childhood cancer.

Which microscopic cell distinguishes classic Hodgkin from non-Hodgkin lymphoma?

Reed–Sternberg cell; present in Hodgkin lymphoma and absent in typical non-Hodgkin lymphoma.

What is a Reed–Sternberg cell?

An abnormal large lymphoid cell with irregular/multiple nuclei identified in the Hodgkin lymphoma slide.

How are Hodgkin and non-Hodgkin lymphoma distinguished in the lecture?

Hodgkin = Reed–Sternberg positive; Non-Hodgkin = Reed–Sternberg negative.

What inherited mutation is a risk factor for breast cancer in lecture?

BRCA gene mutation.

What brain area controls voluntary movements?

Motor cortex of frontal lobe.

What brain area is involved in planning skilled movement?

Premotor cortex.

What are the main functions of the frontal lobe?

Intellect, personality, planning and voluntary movement; Broca area also supports speech production.

Which lobe primarily processes vision?

Occipital lobe; the visual cortex and visual association areas.

Which brain structure maintains balance, equilibrium and coordination?

Cerebellum.

Which areas are responsible for speech production versus language comprehension?

Broca area = speech production; Wernicke area = language comprehension.

What functions do the pons and medulla help control that matter to RTs?

Vital autonomic functions, especially breathing regulation.

Which brain lobe is associated with hearing and memory?

Temporal lobe.

Which spinal cord nerve levels supply the diaphragm?

Phrenic nerve from C3–C5; high cervical cord injuries threaten ventilation.

Why can a cervical spinal cord injury require mechanical ventilation?

Damage can interrupt signals to the diaphragm and respiratory muscles.

Which spinal cord levels are emphasized as sympathetic outflow?

T1–L2; related to heart, blood vessel and temperature functions.

Which lower-spinal functions are associated with parasympathetic pathways?

Bowel, bladder and external genital functions (shown in the spinal cord diagram).

What determines which body functions a spinal cord injury disrupts?

Level and extent of spinal cord damage; functions below the damaged level may be impaired.

What pattern of neurological deterioration is shown for decreasing level of consciousness?

Lethargy → confusion → unresponsiveness to verbal stimuli → coma.

What does “oriented ×3” assess?

Awareness of person, place and time.

What are the defining signs of coma in the lecture?

No response to painful or verbal stimulation, no awareness of self/environment and no voluntary movement.

What separates a vegetative state from coma in the lecture?

Loss of awareness with no response to speech, but sleep–wake cycles may still occur.

What defines brain death in the lecture?

Cessation of brain function, absent brainstem reflexes, absent spontaneous breathing on appropriate testing and no cerebral blood flow.

What does the brain-death imaging diagram contrast?

A brain with cerebral blood flow versus one with no cerebral blood flow.

Brain injury classically causes weakness on which side?

Contralateral—opposite the side of injury—because of corticospinal tract crossing.

Spinal cord injury is associated with weakness on which side in the slide?

Ipsilateral—same side below the level of damage.

What is the distinction between paresis and paralysis?

Paresis = reduced/limited muscle movement; paralysis = loss of voluntary muscle function.

What posture identifies decorticate response?

Abnormal flexion: arms drawn toward the chest with flexed elbows/wrists; extended legs and plantar-flexed feet.

What GCS motor score is decorticate posturing?

M3.

What injury region does the lecture associate with decorticate posture?

One or both corticospinal tracts.

What posture identifies decerebrate response?

Abnormal extension: elbows extended, forearms pronated, legs extended with plantar-flexed feet; possible neck/back arching.

What GCS motor score is decerebrate posturing?

M2.

What structure does the lecture associate with decerebrate posturing?

Upper brainstem; damage may have major respiratory implications.

What vision loss follows a lesion of one optic nerve?

Complete loss of vision in the same-side eye only.

What visual-field loss is characteristic of optic chiasm damage?

Bitemporal loss of peripheral vision in both eyes; may occur with a pituitary tumor pressing on the chiasm.

What visual-field loss follows damage to the left optic tract?

Loss of the right half of the visual field in both eyes (right homonymous field loss).

What visual-field loss can follow partial damage of the optic radiations?

A quarter of the visual field in both eyes may be lost (quadrantanopia; “pie in the sky” example).

Which lobe is the primary visual-processing center indicated in the diagram?

Occipital lobe.

What is aphasia?

Broad language impairment; inability or difficulty processing language, which may be partial or complete.

A patient understands you but says “Want…water” slowly. What aphasia?

Broca (nonfluent/expressive) aphasia.

Where is the lesion in Broca aphasia, and what does speech sound like?

Left frontal lobe/Broca area; slow, effortful, short phrases with missing linking words; comprehension relatively preserved.

Can Broca aphasia affect writing or understanding complex sentences?

Yes; writing can be impaired and complex sentences may be difficult despite relatively preserved comprehension.

A patient speaks fluidly but makes meaningless sentences and does not understand questions. What aphasia?

Wernicke (fluent/receptive) aphasia.

What causes Wernicke aphasia and what is distinctive about the speech?

Damage to left posterior superior temporal region; fluent speech with wrong/invented words and poor comprehension, sometimes without awareness of errors.

What is global aphasia?

Severe impairment in BOTH language comprehension and expression, affecting speech, reading and writing.

What injury pattern is associated with global aphasia?

Extensive damage to the dominant hemisphere language network; some automatic phrases may remain.

What is the difference between a seizure and a convulsion?

Seizure = abnormal/excessive electrical activity in the cerebral cortex; convulsion = involuntary violent muscle contractions/jerking during some seizures.

What causes or triggers seizures according to the slides?

May be idiopathic or secondary to inflammation, hypoxia, bleeding or trauma; can be focal or generalized.

What sequence characterizes a generalized tonic-clonic (grand mal) seizure?

Loss of consciousness → tonic body stiffening → clonic rhythmic jerks → postictal confusion/drowsiness/recovery.

What is the TONIC phase of a tonic-clonic seizure?

Sudden sustained stiffening/rigidity of body and limbs.

What is the CLONIC phase of a tonic-clonic seizure?

Rhythmic, violent and rapid jerking of limbs/body.

Why is a generalized tonic-clonic seizure an RT concern?

Airway obstruction and hypoxia may occur; the lecture mentions recovery position, airway support and oxygen when needed.

What is the postictal phase?

Period after the seizure marked by confusion, drowsiness and recovery.

What symptom pattern best distinguishes an absence (petit mal) seizure?

Sudden blank stare and activity pause, possibly small lip/eyelid movements, followed by immediate return to activity without typical postictal confusion.

What age group is emphasized for absence seizures?

Children approximately 4–12 years old; some outgrow episodes in adolescence.

What subtle movements may accompany an absence seizure?

Eyelid flutter, lip smacking or small hand movements.

Why can an increase in brain volume elevate ICP?

The skull is rigid; extra tissue/blood/CSF volume increases intracranial pressure.

What can elevated ICP do to cerebral blood flow?

Restrict arterial blood flow, causing ischemia and infarction.

How can hypoxia worsen intracranial pressure?

Hypoxia causes cerebral vasodilation, increasing blood volume and swelling.

Which agent is listed to help reduce cerebral swelling?

Mannitol.

What signs suggest rupture of a cerebral aneurysm?

Severe sudden headache, vomiting, possible loss of consciousness; photophobia and nuchal rigidity may occur.

What is nuchal rigidity?

A stiff neck associated in the lecture with irritation of spinal nerves/meninges.

What rupture mortality figures does the cerebral aneurysm lecture quote?

35% with initial rupture and an additional 15% within weeks (historical lecture figures).

What treatments are listed for cerebral aneurysm?

Surgical clipping/tie-off (preferably before rupture when indicated), ICP monitoring and external ventricular drainage.

What is the purpose of clipping a cerebral aneurysm?

Isolate the aneurysm from blood flow to prevent bleeding/rebleeding.

What is an external ventricular drain (EVD)?

Temporary ventricular catheter draining CSF from lateral ventricles into an external reservoir.

What two indications for EVD insertion are emphasized?

Divert infected CSF/permit intrathecal therapy, and reduce ICP from excess or obstructed CSF.

What procedure places an EVD catheter through the skull into a ventricle?

Ventriculostomy.

What does the ventriculostomy equipment diagram show?

A ventricular catheter connected to a CSF drainage/pressure-monitoring system; opening or clamping follows prescribed protocol.

What is meningitis?

Inflammation of meninges surrounding the brain and spinal cord.

How can bacteria reach the meninges?

Through blood/septicemia, spread from nasopharynx or sinuses, or direct entry via wounds.

What type of meningitis is highlighted on the introductory slide?

Acute bacterial meningitis.

What is the classic symptom combination of bacterial meningitis?

Sudden severe headache, photophobia, nuchal rigidity, vomiting, and progressive lethargy/stupor/coma; back pain may occur.

What rash/skin bleeding can meningococcal meningitis produce?

Petechiae or ecchymoses.

What procedure collects CSF to diagnose meningitis?

Lumbar puncture into the lumbar subarachnoid space.

What defines traumatic brain injury (TBI) in the lecture?

Nondegenerative/noncongenital injury from external mechanical force with possible cognitive, physical, psychosocial and consciousness impairment.

What head-injury categories are introduced?

Cerebral concussion, subdural hematoma, and abusive head trauma (shaken baby syndrome).

What is a concussion?

Often reversible disruption of brain function following a blow; may cause brief LOC, headache and amnesia.

What recovery statement about concussion is made by the slides?

The lecture says uncomplicated cases often resolve within 24 hours, but repeated high-impact injury can cause lasting damage; clinical recovery can vary.

What historical sports-related TBI incidence figures are highlighted?

71.0% of ED visits among males; 70.5% among ages 10–19 (from slide dataset).