MedComplex-Neuro1

Question 1

MS: A chronic, demyelinating disease of the CNS in which there are numerous patches of demyelination throughout the _____ matter.

Answer 1

white

Question 2

The etiology of MS is unknown: experimental and clinical studies have pointed to a possible genetic, immune, and ______ etiology.

Answer 2

infectious

Question 3

Immune factors of MS are related to the histologic appearance of lesions: perivascular _________ and macrophages, with numerous CD4+ and CD8+ T-cells.

Answer 3

lymphocytes

Question 4

_____ virus recently has been studied to cause MS, due to its role in initiating demyelination in the CNS. (agent causing Progressive Multifocal - Leukoencephalopathy (PML).

Answer 4

JC

Question 5

You’ll see a question on that What is the hallmark of MS on gross pathology?

Answer 5

the plaque

Question 6

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

Answer 6

Variable, smooth…white

Question 7

MS exhibits a preference for the optic nerves and chiasm and uniformly localizes to the __________ white matter. Can also involve WHICH THREE AREAS?

Answer 7

periventricular… cerebellum, brainstem, and spinal cord

Question 8

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.

Answer 8

3rd or 4th

Question 9

What is often the presenting complaint of MS?

Answer 9

-Blurred vision, or the loss of vision in one eye,

Question 10

When the initial MS lesion is in the ________, the most troubling early symptoms are double vision and vertigo.

Answer 10

brainstem

Question 11

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.

Answer 11

spinal cord

Question 12

MS: Patients usually die of _______ paralysis or ______’s in terminal coma…Most pt’s survive ___ - ____ yrs after the onset of symptoms

Answer 12

respiratory or UTI’s…20-30 years

Question 13

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.

Answer 13

Substantia Nigra

Question 14

PD: Typically appears in the ___ - ___ decades of life, and more than __% of the population in N. America eventually develop the disease.

Answer 14

6th - 8th decades….2%

Question 15

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 __.

Answer 15

SEX….4

Question 16

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

Answer 16

viral

Question 17

PD: The substantia nigra relays information to the ______ through dopaminergic synapses.

Answer 17

basal ganglia

Question 18

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.

Answer 18

NORMAL…80 years

Question 19

PD: Gross examination reveals a loss of PIGMENTATION in the Substantia Nigra AND the ________.

Answer 19

Locus Ceruleus (midbrain)

Question 20

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 ________

Answer 20

MELANIN (the end result of dopamine)…Lewy Bodies

Question 21

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. (______)

Answer 21

voluntary…pill-rolling

Question 22

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.

Answer 22

Levodopa…years

Question 23

KNOW: other causes of a Parkinson-like symptoms: Drugs: ________ and _______

Answer 23

Pheno-thi-az-ines and Hal-dol

Question 24

KNOW: other causes of a Parkinson-like symptoms: ____ or _______ poisoning.

Answer 24

CO or Manganese (Mn) (NOT Mg)

Question 25

KNOW: other causes of a Parkinson-like symptoms: Bilateral infarcts of _________

Answer 25

Basal Ganglia

Question 26

KNOW: other causes of a Parkinson-like symptoms: Hydro_______

Answer 26

cephalus

Question 27

KNOW: other causes of a Parkinson-like symptoms: Tumors near the _________

Answer 27

Basal Ganglia

Question 28

KNOW: other causes of a Parkinson-like symptoms: Cerebral ______

Answer 28

TRAUMA