Neuro VIII Flashcards
alzheimers
extracellular B-amyloid plaque
intracranial hemorrhage - A-B amyloid -f rom cleaving APP protein (CH 21)
neurofibrillary tangles
-intracellular - hyperP tau protein - insoluble
apoE2
low risk alzheimers
apoE4
higher risk alzheimers
risk early onset alzheimers
APP
presenilin-1
presenilin-2
down syndrome
risk alzheimers - CH21 - APP protein
frontotemporal dementia
spare parietal lobe and posterior 2/3 superior temporal gyrus
aka picks
silver stain tau aggregate -pick body
lewy body dementia
hallucination
a-synuclein defect - lewy bodies
PrP-c
normal prion - alpha pleated
to abnormal - PrP-sc - beta-pleated
multiple sclerosis
loss vision - marcus gunn pupil
INO - nystagmus
hemiparesis
bowel/bladder incontinent
relapse/remit
live far from equator
findings in MS
oligoclonal bands of IgG - CSF - diagnostic
MRI -gold standard
periventricular plaques - oligodendrocyte loss and reactive gliosis
tx MS
disease modifying - B-IFN, natalizumab
tx acute flare - steroid
guillan barre syndrome
destroy schwann - demyelination
ascending weakness/paralysis
after campylobacter infection
elevated CSF protein with normal cell count
prognosis - recover completely weeks to months
tx - resp support
acute disseminated encephalomyelitis
periventricle inflammation and demyelination
after infection/vaccination
charcot-marie-tooth disease
defective production proteins in structure and fxn of peripheral nerves or myelin sheath
auto dom - with scoliosis and foot deformity
krabbe disease
auto rec
deficient galactocerebrosidase
accumulation of galactocerebroside and psychosine
-destroy myelin sheath
metachromatic leukocystrophy
auto rec
arylsulfatase A deficieny
accumulation sulfatides
impaired production destruction of myelin sheath
progressive multifocal leukencephalopathy
PML
demyelination CNS - destroy oligodendrocytes
JC virus
in AIDS patient
risk fx - rituximab and natalizumab
adrenoleukodystrophy
X-linked genetic - affect male
disrupted metabolism - very long chain FAs
build up NS, adrenals, testes
long term coma/death
and adrenal crisis
partial seizure
focal
affect single area of brain
simple - consciousness intact
complex - loss of consciousness
epilepsy
recurrent seizures
status epilepticus
continuous recurring seizure - 10-30min
generalized seizure
entire brain
absence - petit mal - blank stare myoclonic - quick jerks tonic-clonic - grand mal - stiff and moveing tonic - stiff atonic - drop - fall to floor
cluster HA
unilateral
periorbital pain
lacrimation/rhinorrhea
may induce horner
more in males
with trigeminal neuralgia
tx O2, triptan
tension HA
bilateral - tx analgesic - NSAID, acetaminophen
migraine HA
unilateral
pulsating
photophobia, phonophobia
aura
irritation CN V, meninges, blood vessels
release of substance P, vasoactive peptides
tx of migraine
abortive - triptan, NSAID
prophylaxis - B-block, topiramate, CCB, amitriptyline
peripheral vertigo
inner ear problem
position test - horizontal nystagmus delayed
central vertigo
brain stem lesion
positional test - nystagmus any direction
sturge weber syndrome
developmental problem neural crest - activating mutation in GNAQ gene
port wine stain of face
I/L leptomeningal angioma - seizure/epilepsy, intellect defect
tuberous sclerosis
hamartomas CNS and skin angiofibromas mitral regurg ash leaf spot cardiac rhabdomyoma auto dom mental retard seizure shagreen patch
increased incidence subependymal astrocytomas and ungal fibroma
NF1
von-reckinghausen
auto dom cafe au lait lisch nodule cutaneous neurofibromas -CH 17 - neurofibromin gene
skin tumors - neural crest
von hippel lindau disease
hemangioblastoma
retina, BS, cerebellum, spine
angiomatosis
B/L renal cell carcinoma
pheochromocytoma
