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Histo & Neuro Part 2 > CC5: Demyelinating Disorders > Flashcards

CC5: Demyelinating Disorders Flashcards

1
Q

diseases of mylein can be categorized:

A

myelinoclastic or dysmyelinating

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2
Q

destruction of normal myelin

A

myelinoclastic

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3
Q

metabolic abnormality,
breakdown abnormal myelin

A

dysmyelinating

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4
Q

chronic, demyelinating, autoimmune disease of the brain and spinal cord, usually characterized by recurrent attacks and remission of neurologic dysfunction

A

multiple sclerosis

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5
Q

MS gene pathogenesis:

A

HLA-DRB1

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6
Q

MS virus pathogenesis:

A

EBV, HHV, chlamidia, measles

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7
Q

MS metabolic pathogenesis:

A

vit d, obesity

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8
Q

MS can cause:

A

axonal injury, focal demylinated lesions, phagocytic microglia, lymphocytes, gliolisis, wallerian degneration

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9
Q

severe eye pain left eye, sees black spot

A

MS

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10
Q

higher in females and white people

A

MS

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11
Q

most common MS signs

A

optic neuritis
brainsten syndrome
cerebellar
transverse myelitis

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12
Q

optic neuritis is common for

A

MS

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13
Q

esions of the medial longitudinal fasciculus (MLF). Paresis of adduction on lateral gaze & associated nystagmus in the abducting eye

A

Internuclear ophthalmoplegia

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14
Q

Patients present with unilateral intense paroxysmal pain of the electrical discharge type (“painful flashes”)

A

Trigeminal Neuralgia

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15
Q

what are cerebellar syndromes?

A

coordination difficulty: ataxia, gait, tremor, dysarthia

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16
Q

May be the initial presentation of MS:

A

transverse myelitis

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17
Q

MS diagnosis is based on:

A

history and physical finding were there is history or evidence of at least two attacks separated in space and time of at least one month that can’t be explained by one single lesion

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18
Q

5 Key principles in the diagnosis of MS

A
  1. Identification of a syndrome “typical” of MS-related demyelination
  2. Objective evidence of CNS involvement
  3. Demonstration of dissemination in space
  4. Demonstration of dissemination in time
  5. “no better explanation” other than MS
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19
Q

what is the McDonald criteria

A

2010-Diagnostic Criteria for MS

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20
Q

what is Schumacher Criteria 1965

A

older 5 key principles of MS diagnosis

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21
Q

expalin Mcdonald ceiteria

A

diagnosis MS-no better explanation
possible MS-not all criteria met
not MS-another better diagnosis

22
Q

where can you find lesions in MS mri?

A

T2 lesions around lateral ventirvle, brainstem and cerebellum

23
Q

Neurodegenerative lesions appear on mri as

A

black holes

24
Q

MS lab studies:

A

CSF
IgG, oligoclonal bands, BMP

25
Q

Measures, in time, the response of a sensory tract, nucleus and/or cortical area to an external stimuli

A

Evoked potentials

26
Q

Visual evoked potentials VEP is sensitive to

A

optic neuritis P100

27
Q

Worsening of a sign or symptom with exercise of increased temperature

A

Uthhoffs phenomenon

28
Q

Sudden sensation of electric shock down spine and arms when patient flexes neck

A

Lhermitte’s sign

29
Q

can MS relapse?

A

yes. relapsing remmiting MS.

30
Q

Mediated by lymphocytes & stimulated by exposure to infectious agents.

A

adaptive immunity

31
Q

Protection that relays on mechanisms that exist before infection, capable of rapid response, react essentially the same way to repeated infections.

A

innate immunity

32
Q

what guide innate immunity

A

microglia, monocytes, dendritic cells

33
Q

what guides adaptive immunity

A

t cells, b cells

34
Q

Earliest expression of MS

A

CIS clinically isolated syndrome

35
Q

Earliest expression of MS

A

CIS clinically isolated syndrome

36
Q

the best choice to support the clinical diagnosis of MS

A

MRI
DIS and DIT

37
Q

the most important diagnostic CSF study

A

CSF qualitative assessment for oligoclonal bands (OCBs)

38
Q

Once known as Devic’s Disease

A

Neuromyelitis Optica Spectrum Disorder (NMOSD)

39
Q

Characterized by a combination of bilateral ON and cervical
myelopathy

A

Neuromyelitis Optica Spectrum Disorder (NMOSD)

40
Q

neuromyelitis optica antibodies:

A

astrocytes and oligodendroyctes IgG

41
Q

neuromylelitis opctica clinical presentation:

A

relapsing, area postrema vomiting, Optic Nerve and myelopathy occur, MRI lesions

42
Q

NMOSD mri findings

A

diencephalic lesions and cerebral syndrome

43
Q
  • AQP-4-IgG diagnostic
A

2 or more clinical core characteristics
* 1 must be ON, acute myelitis, or area postrema syndrom

44
Q

NMO vs. MS

A

NMO is more severe,
MRI has longer bands
bilateral ON
medullary lesion-vomit
CSF
IgG-astrocyte

45
Q

Uniphasic syndrome occurring is association with an immunization or vaccination or systemic viral infection

A

Acute disseminated encephalomyelitis (ADEM)

46
Q

Usually develops after URTI, EBV, CMV, mycoplasma, HIV

A

ADEM

47
Q

ADEM is more common in

A

children

48
Q

ADEM can present in two forms:

A

encephalitic and myelitic

49
Q

ADEM features

A

preceding events of vaccine
multifocal or diffuse CNS signs
vessel damage

50
Q

can ADEN relapse

A

no, rapid recovery

Histo & Neuro Part 2 (13 decks)

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