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Degen 4

Degen 4

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Published by KoRnflakes

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Published by: KoRnflakes on Jan 21, 2009
Copyright:Attribution Non-commercial


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>unknown>viral infections>a progressive, degenerativediseasecausing destruction of nerve cellsin the basal ganglia of the braindepigmentation of the substantianigra of the BASAL GANGLIAloss of neuronsdec. Dopamine>Pillrolling tremors of the fingers>Rigidity with muscleweakness-bradykinesia/akinesia-cogwheel rigidityabsence of arm swingin normal rhythmic gait>Parkinson’s mask >Drooling of saliva>Dysphagia>Shuffling,festinatinggait>Defects in judgment>Emotional instability-deppression, paranoiaand eventually confusion>Excessive sweating>No intellectualimpairmentDiagnostic Tests:>EEG, CT Scan>No test is diagnostic of Parkinson’s dse.1.Encourage pt to maintainindependence as muchas possible in hygieneand dressing.2.Position to preventcontractures; firm bed,no pillows, prone position when lying in bed, hold hands foldedat the back whenwalking.3.Diet: ↑residue, ↑calorie, softdiet4.Aspiration precaution5.↑ fluid intake to preventconstipation6.Anticholinergics. To reducetremors.Anti_Parkinsonian(Dopaminergics)-improves muscleflexibilityAntiviralAntispasmodicsAntihistamines7.Gradual change of  position,wear elasticstockings to prevent postural hypotension.8.Reddish brown urine harmless.
>transmitted as anautosomal dominanttrait>hereditary, familyhx>affects men andwomen of all races>a chronic, progressive,hereditary disease of thenervous system thatresult in progressiveinvoluntary choreiform(dancelike) movementand dementia.Genetic dse inherited asan autosomal dominanttraitgene is present onchromosome 4the gene encodes a protein known ashuntingtingradually, accumulateswithin brain cells brain cells are damagedwhen levels of huntingtin riseEarly S/Sx:>personality changes>↓ cognitive abilities>irritability, anger or  paranoia>difficulty in decision-making>mild balance problem>clumsiness>involuntary facialmovementsS/Sx as the dse progress:>sudden jerky,involuntary movements(chorea) throughout the body>a wide, prancing gait>severe problems with balance andcoordination>difficulty shiftingyour gaze withoutmoving your head>hesitant, halting or slurred speech>inability to swallow>dementiaDiagnostic Test:>positive family hx>CT Scan and MRI N/I:1.prevent injury2.maintain proper nutrition3.maintain fluid intake4.reduce stress5.employ relaxation techniques6.proper hygiene7.skin care8.encourage exercise9.moral supportTreatment:>management is aimed to controlsigns and symptoms>long-term home careMedications:>tranquilizers>anti-psychotic>anti-depressantDISORDERETIOLOGYPATHOPHYSIOLOGYCLINICALMANIFESTATIONMANAGEMENT
>caused by anacquiredimmunologicabnormality or by agenetic abnormality>between ages 20-50,>↑ in women, youngadults>is an auto immunedisease which ischaracterized byfluctuating, sometimesfatal, muscle weakness.> neuromuscular disorder that results inthe failure to transmitnerve impulses at themyoneural junction>↓ acethylcholinesecretion by the motor end plate>↑ cholinesterase at thenerve ending>specific muscleweakness, particularlyin the eyes, face andneck >dysphagia>dyspnea>↓ physical activity>double vision,strabismus>fatigue>ptosis>diplopia>impaired speech>”snarl smile”(smileslowly)>masklike facialexpression>droolingDiagnostic Test:>EMG>Tensilon Test(EndrophoniumChloride Test)1.Assess swallowing/gag reflex before feeding the client2.Administer medications 20-30mins a.c. to prevent aspiration3.Protect from falls.4.Aspiration precaution5.Star meal with cold beverage.6.Adequate ventilation7.PlasmapheresisMedications:>cholinergics(Anticholinesterase)<Glucocorticoids>AntacidsSurgery:>Thymectomy

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