MedComplex-Neuro1 Flashcards
MS: A chronic, demyelinating disease of the CNS in which there are numerous patches of demyelination throughout the _____ matter.
white
The etiology of MS is unknown: experimental and clinical studies have pointed to a possible genetic, immune, and ______ etiology.
infectious
Immune factors of MS are related to the histologic appearance of lesions: perivascular _________ and macrophages, with numerous CD4+ and CD8+ T-cells.
lymphocytes
_____ virus recently has been studied to cause MS, due to its role in initiating demyelination in the CNS. (agent causing Progressive Multifocal - Leukoencephalopathy (PML).
JC
You’ll see a question on that What is the hallmark of MS on gross pathology?
the plaque
Since the hallmark of MS is the plaques, they are ______ size with ______ rounded contour….Usually situated in the ______ matter, but occasionally breech the gray-white junction
Variable, smooth…white
MS exhibits a preference for the optic nerves and chiasm and uniformly localizes to the __________ white matter. Can also involve WHICH THREE AREAS?
periventricular… cerebellum, brainstem, and spinal cord
MS has its onset during the ___ or ____ decades, with periods of exacerbations, which is the expression of the formation of new plaques of demyelination, and remissions, disease free intervals.
3rd or 4th
What is often the presenting complaint of MS?
-Blurred vision, or the loss of vision in one eye,
When the initial MS lesion is in the ________, the most troubling early symptoms are double vision and vertigo.
brainstem
MS Plaques within the _______ are reflected in weakness of one or both legs and sensory symptoms in the form of numbness in the lower extremities.
spinal cord
MS: Patients usually die of _______ paralysis or ______’s in terminal coma…Most pt’s survive ___ - ____ yrs after the onset of symptoms
respiratory or UTI’s…20-30 years
PD: A neurologic disorder characterized pathologically by the loss of neurons in the _________ and clinically by tremors at rest, muscular rigidity, expressionless face and emotional lability.
Substantia Nigra
PD: Typically appears in the ___ - ___ decades of life, and more than __% of the population in N. America eventually develop the disease.
6th - 8th decades….2%
PD: No ___ or racial differences are apparent.
Genetic factors do not play a role, save for a rare, autosomal dominant, early-onset form, due to a point mutation of chromosome __.
SEX….4
The vast majority of PD cases are idiopathic, but the disease has been recorded after ____ encephalitis (von Economo encephalitis) and after the intake of a toxic chemical
viral
PD: The substantia nigra relays information to the ______ through dopaminergic synapses.
basal ganglia
Parkinson disease, it has been suggested, is an acceleration of ______ age-related changes, but this does not account for the declining incidence after ___ y.o.a.
NORMAL…80 years
PD: Gross examination reveals a loss of PIGMENTATION in the Substantia Nigra AND the ________.
Locus Ceruleus (midbrain)
PD: Microscopically, pigmented neurons are scarce with small extracellular deposits of ______, from necrotic neurons….Residual atrophic nerve cells contain spherical, granular, eosinophilic cytoplasmic inclusions called ________
MELANIN (the end result of dopamine)…Lewy Bodies
PD is Clinically characterized by a slowness of all ______ movements and a muscular rigidity throughout the entire range of movement, and most patients have a course tremor of the distal extremities. (______)
voluntary…pill-rolling
Tx of PD: In early Parkinsonism, substitution therapy with _______ (Carbidopa, Sinemet) is beneficial, but it does not rectify the underlying disorder and with the passage of several ______, becomes ineffective.
Levodopa…years
KNOW: other causes of a Parkinson-like symptoms: Drugs: ________ and _______
Pheno-thi-az-ines and Hal-dol
KNOW: other causes of a Parkinson-like symptoms: ____ or _______ poisoning.
CO or Manganese (Mn) (NOT Mg)
KNOW: other causes of a Parkinson-like symptoms: Bilateral infarcts of _________
Basal Ganglia
KNOW: other causes of a Parkinson-like symptoms: Hydro_______
cephalus
KNOW: other causes of a Parkinson-like symptoms: Tumors near the _________
Basal Ganglia
KNOW: other causes of a Parkinson-like symptoms: Cerebral ______
TRAUMA
