Lecture #11, Exam 2

Question 1

Multiple sclerosis causes…

Answer 1

demyelination of axons that over time results in scarring of white matter called sclerotic plaque. the body’s immune system attacks myelin (immune mediating disorder), which alters the ability of the axon to move an action potential.

Question 2

When does MS onset occur?

Answer 2

in young or middle adulthood although 5% of cases are jeuvenile.

Question 3

What are the risk factors?

Answer 3

being female, being farther from the equator, having a first degree relative, having a monozygotic twin (25% chance).

Question 4

Having a monozygotic twin with MS increases your risk by 25%. What does this mean?

Answer 4

that there are significant environmental factors at play.

Question 5

Your risk of developing MS is set by what age?

Answer 5

15

Question 6

Name an MS hot and cold spot.

Answer 6

Iceland is a hotspot and Indigenous Arctic peoples (like the Inuit) are a coldspot.

Question 7

What environmental factors increase your risk of MS?

Answer 7

exposure to Epstien-Barr, cigarette smoking and vitamin D levels.

Question 8

What are the subtypes of MS?

Answer 8

relapsing remitting, primary progressive, and secondary progressive.

Question 9

MS symptoms primarily depend on what?

Answer 9

the area of the brain and spinal cord being attacked.

Question 10

What are the possible symptoms of MS?

Answer 10

optic neuritis of one eye 
urinary incontinence
contralateral hemiparesis
sensory symptoms like dizziness and vertigo( from damage to the vestibulocochlear nerve.) 
fatigue
memory dysfunction
general slowing of cognition (Bradyphrenia.) 
depression (Primary and secondary)

Question 11

what are the three kinds of intervention for MS?

Answer 11

disease modifying (Avonex, and Copaxane) symptom modifying (meds for incontinency, fatigue or pain), and relief of flareups (steroids.)

Question 12

What are the requirements for a presumptive MS diagnosis?

Answer 12

2 separate episodes fo symptoms w each having neural imaging mapping 2 separate affected areas of the brain, along with evidence of inflammation in white matter.

Question 13

What are the roles of a neuropsychologist in MS?

Answer 13

quantifying and verifying presence of cognitive function
outlining strengths and impairments
family education
rehabilitation including memory aides, psychotherapeutic services to minimize depression and anxiety and prolong quality of life.

Question 14

What are neoplasms?

Answer 14

brain tumors

Question 15

what are the two categories of neoplasms?

Answer 15

Primary and Secondary

Question 16

What are the primary neoplasms?

Answer 16

meningiomas
glioblastomas
oligodendrogliomas
astrocytoma
ependymomas
choroid plexus carcinomas
cranial nerve tumors
schwannoma (PNS)
acoustic neuroma
pituitary body tumors
pineal body tumors
cerebellar tumors

Question 17

What are the secondary neoplasms?

Answer 17

from metastasizing cancers found elsewhere, ex: breast cancer tumors in the brain.

Question 18

What is a glioblastoma multiforma?

Answer 18

bad. rapidly progressing with a life expectancy of 11 months from diagnosis to death. It varies with age. 20 year old’s have a 62% 5 year survival rate whereas 75 year old’s have a 6% 5 year survival rate.

Question 19

What are the symptoms of a GBM?

Answer 19

headaches, nausea, vomiting, cognitive changes, confusion or disorientation, new onset of seizure disorder after middle age.

Question 20

How are Neuropsychologist involved in the treatment of GBM?

Answer 20

they delineate cognitive and emotional changes
provide rehab
use psychotherapeutic techniques
engage in long term follow up
is not empathic with family, but appropriately optimistic and capable of designing interventions as effective as possible.

Question 21

What are the two gradients in synaptic transmission?

Answer 21

electric and concentration

Question 22

What are the three types of channels?

Answer 22

electrically gated, mechanically gated, and chemically gated, which can be further divided into direct and indirect subtypes.

Question 23

Explain the unequal distribution of ions inside and outside the cell.

Answer 23

Na+ is 10x more concentrated outside than inside
K+ is 35x more concentrated inside than outside
Ca++ has more outside then inside.