Demyelinating And Metabolioc Disorders Flashcards

0
Q

MS etiology

A

Initiated by CD4 TH1 and TH17

  • IFNG -> activated macs
  • TH17 -> leuk recruitment
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1
Q

MS epidemiology and susceptibility

A
  • more common in females
  • mostly in ~ 25 y/o
  • HLA DR2 susceptibility
  • associated with IL2/IL7
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2
Q

MS plaque locations

A
  • Typically subependymal and subpial, corticowhite matter junction
  • optic tracts, nerve and chiasm, brain stem, cerebellum and spinal cord
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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
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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
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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
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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
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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
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8
Q

Rapid correction of hyponatremia

A

Central pontine myelinolysis

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9
Q

Brain damage due to chronic alcoholism

A
  • cerebral atrophy
  • cerebellar degeneration: superior vermis
  • wernicke-korsakoff syndrome
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10
Q

Wernicke-korsakoff syndrome

A
  • lesions in the mammillary bodies and hypothalamus

- chronic alcoholism with thiamine deficiency

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11
Q

Oligocclonal bands on electrophoresis

A

Diagnostic for MS

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12
Q

HLA DR2

A
  • MS susceptibility polymorphism
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13
Q

Flat sheets of foamy macs

A

Neuromyelitis Optica

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