Demyelinating And Metabolioc Disorders Flashcards
0
Q
MS etiology
A
Initiated by CD4 TH1 and TH17
- IFNG -> activated macs
- TH17 -> leuk recruitment
1
Q
MS epidemiology and susceptibility
A
- more common in females
- mostly in ~ 25 y/o
- HLA DR2 susceptibility
- associated with IL2/IL7
2
Q
MS plaque locations
A
- Typically subependymal and subpial, corticowhite matter junction
- optic tracts, nerve and chiasm, brain stem, cerebellum and spinal cord
3
Q
Plaque types
A
- active: around small veins, breaks down with macs
- inactive: little or no myelin is found with redux in oligodends
- shadow: border between active and inactive
4
Q
Clinical features/tests of MS
A
- unilateral visual impairment
- brain stem lesion (cranial nerve deficits)
- MRI detection of lesions (silent)
- elevated Ig and leukocytes
- oligocclonal bands on electrophoresis
5
Q
Neuromyelitis optica
A
- necrotic lesions: spinal cord, optic nerve and chiasm
- women more often than men
- mean age - 34
- histologically: flat sheets of foamy macs
6
Q
ADEM (acute demyelinating encephalomyelitis)
A
- diffuse monoplastic demyelinating disease
- receded by viral infection
- 20-30% mortality
- lymphocyte reaction against MBP (can be detected in blood and spinal fluid)
- edematous tissue with petechial hemorrhages
7
Q
Central pontine myelinolysis
A
- butterfly lesion in basal pons: bilateral motor below head
- rapidly evolving quadriplegia
- common in alcoholics, also liver disease, burns, malnutrition, anorexia
- rapid correction of hyponatremia
8
Q
Rapid correction of hyponatremia
A
Central pontine myelinolysis
9
Q
Brain damage due to chronic alcoholism
A
- cerebral atrophy
- cerebellar degeneration: superior vermis
- wernicke-korsakoff syndrome
10
Q
Wernicke-korsakoff syndrome
A
- lesions in the mammillary bodies and hypothalamus
- chronic alcoholism with thiamine deficiency
11
Q
Oligocclonal bands on electrophoresis
A
Diagnostic for MS
12
Q
HLA DR2
A
- MS susceptibility polymorphism
13
Q
Flat sheets of foamy macs
A
Neuromyelitis Optica
