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QUIZ 3 NSG 555 NEURO MODULE 7 + HEM MODULE 8 QUESTIONS WITH COMPLETE VERIFIED ANSWERS GRADED A++ $12.09   Add to cart

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QUIZ 3 NSG 555 NEURO MODULE 7 + HEM MODULE 8 QUESTIONS WITH COMPLETE VERIFIED ANSWERS GRADED A++

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QUIZ 3 NSG 555 NEURO MODULE 7 + HEM MODULE 8 QUESTIONS WITH COMPLETE VERIFIED ANSWERS GRADED A++ ALS lou gehrig's disease incurable progressive muscle weakness and eventually death affects upper motor neurons and lower motor neurons. age 55-75 is typical onset sporatic, 5-10% familial...

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  • November 23, 2024
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QUIZ 3 NSG 555 NEURO MODULE 7 + HEM MODULE 8

QUESTIONS WITH COMPLETE VERIFIED ANSWERS GRADED A+

+


ALS

lou gehrig's disease

incurable progressive muscle weakness and eventually death



affects upper motor neurons and lower motor neurons.



age 55-75 is typical onset



sporatic, 5-10% familial. thought to be known gene mutation

pathophysiology of ALS

unknown. gene mutation SOD1 or C9orf72

may be due to oxidative stress/free radicals. eventually leads to denervation and

atrophy of muscles b/c motor neurons in brainstem and spinal cord die

presentation of ALS

neuro exam is essential.

ASYMMETRIC weakness in limbs first (usually arms)

foot drop, difficulty walking, weakness in liftin garms.

UMN (upper motor neuron) s/s: hyperreflexia, sapsticity, babinski signs, incoordination

,and weakness

LMN (lower motor neuron) s/s: weakness, atrophy, fasciculations (twitching)

BULBAR s/s ALS: dysarthria, dysphagia, siallorhea, tongue atrophy and fasciculations



dementia may appear first.

bowel and bladder are spared

dx ALS

widespread UMN, LMN s/s and absense of any other disease process, absence of

neuroimaging evidence of other disease.



should get labs to rule out heavy metal poisoning, lyme disease, HIV, hereditary d/o.



MRI, ESR, protein, immunofixation electrophoresis, CSF analysis, b12, CK, EMG, nerve

cond. studies and MRI, chem, liver, thyroid tests

awaji-shima criteria

criteria for ALS diagnostics

EMG+clinical abnormalities (s/s LMN degeneration by clinical, electrophys and

neuropath exam, s/s UMN by clinical exam, progression of motor syndrome within a

region)

riluzole

for ALS, improves survival

antiglutamate slows progression of ALS

, s/e: asthenia, dizzy, gi distress, low WBC, elevated liver enzymes (check labs first and

then q 3mos)

Edaravone

free radical scavenger to reduce oxidative stress: decreases functional decline so

reduces symptoms progression)

INFUSION daily X14 days, then 14 days off, then daily X 10 days, 14 off, then repeat

s/s: contusion from injection, HA, gait change

SSRI, SNRI for ALS

improve depression, anxiety, and sleep s/s

SARI (trazadone). can improve emotional lability. Benzos may also be used and may

help with spasticity and muscle cramps

anticholinergics for ALS

TCAs, glycopyrrolate, atropine



for sialorrhea (saliva increase), depression, anxiety, sleep and pain

other meds for ALS

ALS: muscle relaxants (tizanidine, baclofen), dextromethorphan/quinidine for emotional

lability

modafinil--stimulant for fatigue

oxybutynin--bladder spasms

Bells Palsy

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