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Brain and Behavior Exam 2 > Lec 23 Nutritional and Metabolic Disease of CNS > Flashcards

Lec 23 Nutritional and Metabolic Disease of CNS Flashcards

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1
Q

What are effects of lead poisoning in children vs adults?

A

children: behavioral and IQ impairment, acute encephalopathy
adults: abdominal pain, motor neuropathy [wrist drop], microcytic anemia

burton’s line = discoloration of upper gums due to lead deposition

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2
Q

What is burton’s line?

A

discoloration of upper gums due to lead deposition

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3
Q

What is treatment for lead poisoning?

A

Ca + EDTA

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4
Q

What are effects of mercury poisoning?

A
  • encephalopathy, peripheral neuropathy, seizures, metallic aste

mad hatter syndrome = tremor, red cheeks, irritability

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5
Q

what is treatment for mercury poisoning?

A

Ca + EDTA

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6
Q

What are effects of arsenic poisoning?

A
  • encephalopathy, N/V, renal failure, arrhythmias
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7
Q

What type of poison associated with mad hatter syndrome?

A

mercury

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8
Q

What type of poison associated with wrist drop and ab pain?

A

lead

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9
Q

How do you test for arsenic?

A

urine test [instead of blood test]

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10
Q

What do you get thallium poisoning from?

A

rat poison

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11
Q

What are effects of thalium poisioning?

A
  • vomitting, diarrhea, paresthesis, confusion

- hair loss with chronic exposure

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12
Q

What are effects of manganese poisoning?

A

confusion, tremor [parkinson’s-like], hyperreflexia

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13
Q

What is manganese poisoning associated with?

A

arc welding, steel industry

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14
Q

How do manganese symptoms differ from parkinsons?

A
  • in manganese poisoning have hyperreflexia

this is absent in parkinsons

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15
Q

What is marasmus?

A

undernutrition = balanced starvation, insufficient breast milk

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16
Q

What are signs of marasmus? who do you see it in?

A

occurs in 1st year of life

- causes wasting, mental changes, growth retardation

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17
Q

What is kwashiorkor?

A

protein starvation

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18
Q

what are signs of kwashiorkor? who do you see it in?

A

occurs in 1-3 yo

- causes encephalopathy, muscle wasting

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19
Q

What is pickwickian syndrome?

A

rare complication of extreme obesity

= cardiorespiratory distress

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20
Q

what is sleep apnea? who is at risk?

A
  • at risk = extremely obese

- hypersomnia, oxygen desaturation, arrhythmias, can be fatal

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21
Q

What are neurologic complications of diabetes?

A
  • dementia [due to small vessel disease]
  • increase stroke risk
  • ischemic cranial nerve palsies
  • peripheral neuropathies, blindness
  • loss of limbs
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22
Q

Which cranial neuropathy in particular is found associated with diabetes?

A

painful 3rd nerve palsy that affects extra-ocular muscles but spares the pupil/pupillary reflex

23
Q

What is effect of vitamin A toxicity?

A

due to excessive intake – causes high ICP [pseudotumor cerebri], skin changes, alopecia

as a teratogen: causes cleft palate, cardio abrnomalities

24
Q

What is affect of water intoxication [too much water]?

A

encephalopathy

25
Q

What is effect of pyridoxine [B6] intoxication?

A

peripheral neuropathy

26
Q

What causes eosinophlic myalgia syndrome?

A

contaminated tryptophan

27
Q

What is effect of emetine/ipecac toxicity? who is prone?

A
  • myopathy

- seen in anorexia nervosa/bulimia

28
Q

What are rum fits?

A

early onset convulsions within 12-48 hrs of alcohol withdrawal

29
Q

What is delirium tremens?

A

later onset convulsions from alcohol withdrawal, confusion, agitation, high mortality

30
Q

What are effects of brain atrophy related to alcohol use?

A

have stretching of bridging veins + coagulopathy + more likely to fall over –> more likely to get subdural hematoma

31
Q

What are effects of fetal alcohol syndrome?

A
  • learning difficulties, mental retardation, behavioral difficulties, growth impairment, cataracts, small head/philtrum/maxilla
32
Q

What are effects of alcoholic hepatic encephalopathy?

A

asterixis, confusion, coma due to buildup of ammonium / hepatic failure

33
Q

What are effects of alcoholic peripheral neuropathy?

A

length-dependent sensory or sensorimotor neuropathy

pain invariable

34
Q

What is effect of thiamine deficiency?

A

rapid progressing peripheral neuropathy

35
Q

What is wernicke’s encephalopathy triad?

A
  • ataxia + opthalmoplegia + confusion
  • usually due to impaired absorption [bariatric surgery] or low thiamine [alcoholism], HIV
  • typically have nystagmus
36
Q

What is korsakof’s psychosis?

A

associated with alcoholism

- have demented state – retrograde/anterograde amnesia, confabulation [make up stores], apathy

37
Q

What type of myopathy in alcoholism?

A

cardiomyopathy

38
Q

What is marchiafava-bignami disease?

A

associated with alcoholism

  • demyelination of corpus callosum
  • causes rapid psychosis, stupor, coma
39
Q

What is central pontine myelinolysis?

A

associated with overly virgorous correction of alcoholism, hyponatremia, liver disease, or malnutrition

get brain swelling that causes focal myelinolysis of the pons

  • have severe paralysis, locked in syndrome, difficulty swallowing/speaking
40
Q

What is alcoholic cerebellar degeneration?

A

superior cerebellar vermis atrophies –> causes loss of purkinje cells

  • pts present with truncal ataxia
  • irreversible, does not respond to treatment
41
Q

What type of vitamin deficiency should you consider if painful distal neuropathy?

A

thiamine

42
Q

What type of lesions lead to wernicke’s encephalopathy?

A
  • lesions of thalamic nuclei, mammillary boides, PAG, brainstem nuclei, superior cerebellar vermis
43
Q

What happens if untreated wernickes?

A

can lead to korsakoff’s psychsosi

44
Q

What is pathology of korsakoff’s?

A

neuronal loss and gliosis

hemorrhage into mammillary bodies

45
Q

What are 3 types of manifestations of B6 [pyridoxine] deficiency?

A
  1. neuropathy [due to insufficient NT synthesis]
    - -> irritability, somnolesence, peripheral neuropathy
  2. pellagra [due to low niacin]
    - -> dermatitis, diarrhea
  3. anemia [due to low porphyrin]
    - -> microcytic anemia
46
Q

What are pyridoxine dependent seizures?

A

can be seen in newborn, will not respond to antieplipetic

for all children with seizure < 18 mo give B6 if you don’t know the cause

47
Q

What should you give all children < 18 mo with seizures of unknown etiology?

A

B6 supplement! [pyridoxine]

48
Q

What is required for vit B12 absorption?

A
  • terminal ileum absorption

- intrinsic factor + Ca needed

49
Q

What is etiology of B12 deficiency?

A
  • congeital pernicious anemia [lack of intrinsic factor]
  • inadequate intake or diretary deficiency
  • inhibition of B12
  • vit b12 malabsorption from intestinal disease
50
Q

What is disease of B12 [cobalamin] deficiency?

A
  • damage to peripheral nerves caused by demyelination and irreversible nerve cell death

symptoms:

  • paresthesias [pin/needles] of hands/feet
  • loss of position sensation + Romberg but loss of reflexes
  • progressive spastic + ataxic weakness
  • optic atrophy, irritability
  • diffuse/symmetric myelopathy
51
Q

What are signs of posterolateral column disease?

A
  • due to B12 deficiency

- romberg +, reflexes lost or hypo/hyper; + babinksi, superimposed peripheral neuropathy

52
Q

What is effect of vit E defiency?

A
  • progressive spinocerebellar syndrome + posterior column degeneration, peripheral neuropathy + hemolytic anemia
53
Q

Abuse of NO can mimic what disease?

A

posterolateral column disease

54
Q

What are signs of NO intoxication?

A
  • same as subacute combined degeneration due to B12 deficiency

Brain and Behavior Exam 2 (21 decks)

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