In: Nursing
Multiple sclerosis |
Myasthenia gravis |
Parkinson’s disease |
Alzheimer’s disease |
Caused by immune-mediated, progressive demyelination of central nervous system |
Affects the Peripheral nervous system. It is an autoimmune disorder affects the neuromuscular junction |
Affects CNS Occurs with the deficiency of dopamine due to the destruction of cells in the basal ganglia. |
Alzheimer’s is a progressive, irreversible, degenerative disorder and is the most common cause of dementia. |
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Women are usually diagnosed in 20s-30s Males are usually diagnosed in 70s-80s |
- Idiopathic |
Early-onset and Late-onset (after 65) are present. |
-Signs and Symptoms occurs depends on the location of the
lesions. -Cognitive impairment |
-Ocular symptoms saw the dropping of an eyelid
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Cardinal Manifestations T: Tremor R: Rigidity A: Akinesia /Bradykinesia P: Postural disturbances Other signs and symptoms are -Excessive sweating -Flushing -Orthostatic hypotension -Urinary retention -Constipation -Sexual dysfunction -Cognitive /psychiatric changes -Dysphonia -Dysphagia - infection risks: respiratory infection, urinary tract infections, skin breakdown, falls |
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In MS weakness is often associated with changes in sensation. For a person with new onset of weakness, a doctor will assess whether it's accompanied by changes in sensation, which doesn't usually occur in myasthenia gravis but often appears in MS. To diagnose MS the criteria includes a detailed neurological exam, medical history, spinal fluid analysis and magnetic resonance imaging, or MRI, of the brain and spinal cord. |
No change in sensations occurs with weakness. Presence of antibodies against the acetylcholine receptor or another antibody called anti-MuSK. electrical measurement of muscle-nerve interaction. testing after use of a drug to enhance acetylcholine aids in diagnosis.
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Definitive: post-mortem exam of brain tissue EEG MRI CT PET Blood tests: CBC, chemistries Mini-Mental Status Exam |
How can disorders of coagulation cause ischemia, thrombosis, and bleeding?
Any threat or injury to the body will trigger the coagulation mechanism. As a result, the coagulation proteins travel to the injury site to arrest the bleeding process. The abnormal activation of the coagulation factors throughout the body can lead to the development of DIC. The causes can be inflammation, infection, or cancer.
Disseminated intravascular coagulation (DIC) is a disorder characterized by systemic activation of blood coagulation leads to generation and deposition of fibrin, leading to microvascular thrombi in various organs and contributing to multiple organ dysfunction syndromes (MODS).
In cases like DIC small blood clots form in the blood vessels and some of these clots can clog the vessels and cut off the normal blood supply to the vital organs like the liver, brain, or kidneys. Lack of blood flow can cause ischemia and cause major injury to the organs. The clotting factors in the blood are consumed and impose a high risk of serious bleeding, even from a minor injury or without injury. The bleeding may start spontaneously also. This coagulation disorders also cause the healthy red blood cells to fragment and break up when they travel through the small vessels that are filled with clots.
The derangement of the fibrinolytic system further contributes to intravascular clot formation or accelerated fibrinolysis and may cause severe bleeding. The patient with DIC can present with a simultaneously occurring thrombotic and bleeding problem.
DIC itself is not a specific illness, rather occurs as a complication or an effect of the progression of other illnesses.
The hematologic derangements in DIC result from the following simultaneously occurring mechanisms like:
- TF-mediated thrombin generation
- Dysfunctional physiologic anticoagulant mechanisms as seen in a depression of anti-thrombin and protein C system, which causes the imbalance in thrombin generation
- Depression of the fibrinolytic system causes impaired fibrin, usually caused by high circulating levels of plasminogen activator inhibitor type 1 (PAI-1) or in some cases fibrinolytic activity may be increased and contribute to bleeding
- Inflammatory activation