Friday 4 - Krafts - Demyelinating disorders Flashcards
Does MS wax and wane?
yup. sometimes patients have patterns, but Sx can be sporatic and diverse
HLA - DR2
what does it stand for
DR2 is related to what disease
human leukocyte antigen - mutations in these gene put people at risk for autoimmune disorders
similar to MHC.
variation on this is associated with MS
Do B cells play a role in MS
yup. don’t know what it is.
What is the significance of “oligoclonal bands”
show up in “gamma” region of a electrophoresis of CSF
It means you have a population of B cells each making the same type of antibody. We dont know why it happens, but it is diagnostic of MS.
you need to see them in the CSF and not a significant about in the blood to diagnose MS.
what is left after an MS plaque becomes inactive?
Gliosis, or a collection of astrocytes. they are trying to reestablish the neuropil and the BBB
Monophasic demyelination disorders
NOT MS
these diseases do not wax and wane
in MS plaques, what darkly staining cells hang out around the vessels?
lymphocytes
how can you tell astrocytes apart from oligodendrocytes?
astrocytes are larger and have a more see through cytoplasm
one Sx you should remember for MS
unilateral vision loss
acute disseminated encephalomyelitis
ADEM
diffuse monophasic demyelinating disorder following viral infection, usually in children
rapid onset headache, lethargy, coma
acute necrotizing hemorrhagic encephalomyelitis
May be hyperacute ADEM
SUPER rare
central pontine myelinolysis
patient presents with hyponatremia (lack of salt in blood) that is corrected too fast.
oligodendrocytes in the pons are most susceptible to salt.
patients get flaccid paralysis turning into spastic paralysis days after Tx
