case 6

Question 1

glia

Answer 1

insulate support and nourish

Question 2

neurons

Answer 2

sense change convey info and communicate.

Question 3

macroglia

Answer 3

oligodendrocytes, shwann cells, astrocytes (fibrous in white matter, protoplasmic in grey, absorb K glutamate and GABA, radial glial are precursers)

Question 4

microglia

Answer 4

macrophages of CNS

Question 5

axonal transport

Answer 5

movement of proteing from soma to axon by axoplasmic flow. into vesicles by golgi apparatus in soma, kinesin carries it down the path by ATP. movement from soma to axonal end anterograde. Dyenin is used.

Question 6

wallerian degeneration

Answer 6

nerve fibre damaged, degenerates.

Question 7

MS

Answer 7

disease characterised by inflamation demyelination and gliosis. PNS spared.

Question 8

signs and symptoms

Answer 8

tingling, numbness, muscle weakness, ataxia, dysarthria and dysphargia. nystagmus, optic neuritis or dyplopia. pain. bladder difficulties. depression. diplopia may result from internuclear ophthalmoplegia INO or palsy of 6th cranial nerve.

Question 9

epidemiology

Answer 9

more common in women. 1 in 800. 20-40 yrs. inc higher latitudes. Vit D deficiency. HLA on chromasome 6 genetic predisposition. hygiene hypothesis. Herpes and Epstein Barr virus.

Question 10

relapse remitting

Answer 10

remission when symptoms dont worsen. common optic neuropathy brainstem demyelination and spinal cord lesions.

Question 11

inflamation

Answer 11

BBB prevents entry T cells, usually occludin and claudin form tight junctions, in inflamation BBB compromised. allow macrophages and lymphocytes that attack myelin.

Question 12

relapse

Answer 12

mainly TH1 and TH17. IL12 differenciates Th cells into inflam Tcells. Overproduction of IL12 in MS. cant destuinguish normal from problem myelin. lesions most common in ON, CC, cerebellum, BS, BG, SC. TH1 secrete IFNy which activate macrophages. TH17 recruit leukocytes.

Question 13

diagnosis

Answer 13

2 or more episodes that reflect pathology of CNS for 24h seperated by month. MRI, inc in vasc permeability from breakdown of BBB detected by leakage of gadolinium Gd. Evoked potentials test-electrical activity of brain detect slowing. CSF-elevated IgG, oligoclonal bands detected electrophoresis. breakdown products of myelin.

Question 14

treating acute relapse

Answer 14

antiinflamatory, methylprednisolone, 1g/day 3 days. prednisone 500g for 5 days.

Question 15

preventing relapse

Answer 15

B interferon SCI, inhibit prevent block t cells.
Glatiramer acetate/copaxane/copolymer-bind MHC 2, compete MBP, SCI.
Fingolimod/Gilenya-sphingosine 1phosphate receptor modulator, tablet o.5mg, lymphocytes cant leave lymph.Used RR
Natalizumab/tysabri-a4b1 interact with VCAM1, inhibits this so lymphocytes cant bind and enter BBB,
alemtuzumab-anti CD52 monoclonal antibody IV once yearly. depletes T and B cells.
Teriflunomide-blocks pyrimidine synth by inhibit DHODH so T cells.
BG 12-activate Nrf 2 pathway dec inflamation.

Question 16

MDD

Answer 16

have to have one of little interest in doing things, feeling depressed. and 3 other ticks elsewhere. leadaing cause disability. more common in woman. high suicide. neg cognitions of self world and future. recurrence is norm. progressive-kindling hypothesis-episodes more easily triggered.

Question 17

genetics

Answer 17

short/short greater risk. Long long lesser risk. seratonnin reuptake gene.

Question 18

types of neurons

Answer 18

unipolar and pseudopolar are sensory neurons. bipolar are interneurons, multipolar are motor neurons. in PNS sympathetic are myelinated parasympathetic are un. in CNS usually unmyelinated.

Question 19

axonal transport

Answer 19

axoplasmic flow, soma to axon anterograde transport using kinesis. Retrograde transport use dyenin.

Question 20

electronic potential

Answer 20

non propogated. smaller as spreads down membrane.

Question 21

action potentials

Answer 21

propogated. use electronic potentials to trigger. constant amplitude.

Question 22

resting membrane potential

Answer 22

Na K ATPase pump. Dec external Na reduces size of AP but little effect on RMP. Inc external K dec RMP. Ca bind to Na channels, their pos charge alter electrical state of channel altering voltage level to open, Dec Ca inc excitability of nerve.

Question 23

how is GABA terminated

Answer 23

uptake into the pre-synaptic neurone and glial cells

Question 24

how is Dopamine terminated

Answer 24

breakdown by synaptic enzymes, MOA B and COMT and taken up but dat

Question 25

how is seratonin terminated

Answer 25

uptake by presynaptic neuron SERT

Question 26

glutamate termination

Answer 26

uptake into the pre-synaptic neurone and glial cells

Question 27

Ach termination

Answer 27

broken down by synaptic enzymes