MSP I Exam 2 Study Guide - Units 3 and 4

Flashcards for MSP I Exam 2 Units 3 and 4

Fear Avoidance Beliefs Questionnaire Purpose

Assesses patients’ beliefs about how PA and work affect their pain

Fear Avoidance Beliefs Questionnaire Use

Identifies fear-avoidant behaviors that might contribute to chronic pain and disability

Pain Catastrophizing Scale (PCS) Purpose

Measures the extent of catastrophic thinking related to pain

Pain Catastrophizing Scale (PCS) Use

Detects exaggerated negative mental set during actual or anticipated painful experiences

PHQ-2

Quick initial depression screening

PHQ-9

Detailed assessment of depression severity

OSPRO-YF

Screen for yellow flags; psychosocial risk factors in pts with MSK pain

Oswestry Disability Questionnaire

Measures disability and functional impairment due to LBP; Quantifies impact of back pain on daily activities and quality of life

SCOFF Questionnaire

Screens for eating disorders

Constitutional Symptoms

Symptoms that indicate an underlying systemic illness rather than a localized problem

Babinski Reflex Test

Tests the integrity of the corticospinal tract (UMN function)

Clonus Test

Detects hyperactive stretch reflexes, indicating a UMN lesion

Rinne Test

Assesses hearing loss and distinguishes between conductive and sensorineural hearing loss

Weber Test

Detects unilateral hearing loss and helps differentiate between conductive and sensorineural hearing loss

FAST (Stroke)

Face drooping, Arm weakness, Speech difficulty, Time to call 911

BEFAST (Stroke)

Balance issues, Eyesight changes, Face drooping, Arm weakness, Speech difficulty, Time to call 911

Positive Clonus Response

Rhythmic, involuntary muscle contraction

Abnormal Babinski Response

Extension of great toe and fanning of others

Positive Hoffmann’s Sign

Flex and add of the thumb and/or flexion of the index finger

Side Effects of Steroids

Immunosuppression, weight gain, hyperglycemia, osteoporosis, mood changes

Opioids Mechanism of Action

Block pain through mu/kappa receptors

Anxiolytics Mechanism of Action

Enhance GABA

SSRIs Mechanism of Action

Serotonin goes up by inhibiting their reuptake into the presynaptic neuron

SNRIs Mechanism of Action

Serotonin + norepinephrine goes up by inhibiting their reuptake into the presynaptic neuron

TCAs Mechanism of Action

Serotonin + norepinephrine goes up by inhibiting their reuptake into the presynaptic neuron

MAOIs Mechanism of Action

Prevents enzyme from breaking down neurotransmitters so more available

Other Uses for Opioids Aside From Pain Relief

Cough suppressant, Anti diarrhea , Acute pulmonary edema, Manage opioid dependence

Strong Agonists

Treat severe pain, high affinity for MU receptor

Mild to Moderate Agonists (Partial)

Treat moderate pain, lower affinity and efficacy

Mixed Agonists – Antagonists

Provide analgesia effect with less risk of respiratory depression and dependence

Antagonists

Used to reverse opioid overdose and to treat opioid use disorder; Block all opioid receptors (mu)

Diazepam Mechanism of Action

Centrally acting, enhances GABA receptor on alpha motor neuron

Cyclobenzaprine Mechanism of Action

Spinal and supraspinal sedation

Baclofen Mechanism of Action

Inhibits GABA B which inhibits alpha motor neuron

Gabapentin Mechanism of Action

Inhibits calcium entry which reduces excitatory neurotransmitters

Tizanidine Mechanism of Action

Agonist of alpha 2 adrenergic, stimulates alpha 2 receptor pathway which inhibits alpha motor neuron activity

Dantrolene Sodium Mechanism of Action

Directly reduce muscle contraction

Risks of Anticoagulants

Increased risk of bleeding

Heparin Induced Thrombocytopenia (HIT)

Immune reaction to heparin

Aspirin

Treat and prevent ischemic stroke or TIA; DO NOT use in hemorrhagic stroke as it causes internal bleeding

Glycoprotein IIb-IIIa Receptor Blocker

Best platelet inhibitors; used in cardiac procedures

Indications for Fibrinolytics

CVAs, Acute ischemic stroke (3 hours), Acute MI (12 hours)

Poliomyelitis Pathophysiology

Infection by the polio virus, transmitted through the fecal-oral route (contaminated food or water); Virus destroys motor neurons (anterior horn) in the SC and brainstem, causing muscle weakness and acute flaccid paralysis.

Multiple Sclerosis Pathophysiology

A CNS, autoimmune, demyelinating disorder. A major cause of disability in young adults.

Guillan Barre Pathophysiology

Acute autoimmune attack on peripheral nerves/myelin; Usually triggered by infection, leading to demyelination and/or axonal damage in peripheral nerves

Alzheimers Disease Pathophysiology

Progressive neurodegenerative disease characterized by the accumulation of amyloid plaques and neurofibrillary tangles in the brain; Leads to synaptic loss and neural death, especially in the hippocampus and cortex

Myasthenia Gravis (MG) Pathophysiology

Autoimmune disorder causing antibodies against acetylcholine receptors at the neuromuscular junction; Leads to impaired neuromuscular transmission and muscle weakness

Parkinson's Disease Pathophysiology

Neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the basal ganglia; Results in dopamine deficiency, affecting motor control circuits.

UMN Signs and Symptoms

Increased muscle tone, clonus, spasticity, increased DTR

LMN Signs and Symptoms

Reduced or absent muscle tone, reduced DTR, flaccid paralysis

MCA Damage Impact

Contralateral hemiparesis, sensory deficits; Arm more involved than legs

ACA Damage Impact

Contralateral hemiparesis, sensory deficits; Legs more involved than arms

PCA Damage Impact

Memory deficits, Visual agnosia, Contralateral homonymous hemianopia

Receptive Aphasia (Wernickes)

Unable to understand

Expressive Aphasia (Brocas)

Unable to create language; Able to understand

Brief Psychotic Disorder

Sudden onset of psychotic symptoms; delusions, hallucinations, disorganized speech or behavior

Delusional Disorder

Persistent, non-bizarre delusions lasting more than 1 month

Panic Disorder

Recurrent unexpected panic attacks with worry about future attacks

Schizoaffective Disorder

Symptoms of schizophrenia concurrent with a major mood episode (depression or mania)

Schizophrenia

At least 2 of the following: delusions, hallucinations, disorganized speech, grossly disorganized behavior, negative symptoms

Bipolar I

Mania and depression

Bipolar II

Hypomania and depression

Concussion

Caused by blow to head, brain moves rapidly inside skull; No structural damage

Open Head Injury

Meninges have been breached, brain is exposed

Closed Head Injury

No skull fracture or laceration of the brain; Brain hits skull

Penetrating Head Injury

Vascular injury; disruption of the vessels; Can lead to aneurysms or pseudoaneurysms; Object enters brain

Alcohol Effects

Can mimic cognitive changes linked with normal aging and Alzheimer’s disease; Reduces REM sleep and stage 3 and 4 of non REM sleep

Caffeine

Prevents brain activity from slowing down

Nociceptive Pain

Real pain

Nociplastic Pain

Cannot explain the pain

Neuropathic Pain

Nerve related pain, tingling, numbness, burning like pain

Paraplegia

Legs/paralysis below the chest (lower body only)

Hemiplegia

One side of the body (arm + leg)

Tetraplegia

All four limbs and trunk

Diplegia

Mostly legs affected bilaterally

Panic Disorder Signs and Symptoms

Sudden panic attacks, palpitations, chest pain

Anxiety Disorder (GAD) Signs and Symptoms

Excessive worry, restlessness, sleep disturbances

Bipolar 1 Signs and Symptoms

Full manic episodes + depression

Bipolar 2 Signs and Symptoms

Hypomania + major depression

Depression Signs and Symptoms

Anhedonia, fatigue, hopelessness

OCD Signs and Symptoms

Intrusive thoughts, compulsive rituals