Pathoma: Trauma and Demyelinating Disorders Flashcards
Why do you need an arterial injury to have an epidural hematoma?
Because the dura mater is tightly bound to the skull and requires a high pressure source to separate it
Explain why “lucid intervals” can happen in those with epidural hematomas.
The arterial blood continues to pour into the hematoma, thereby increasing its pressure. At a certain pressure point, the sides of the hematoma will abruptly expand and can lead to herniation.
What direction will the affected eye point in an uncal herniation?
“Down and out” –just like a deadbeat uncle
What is the most common leukodystrophy?
Metachromatic leukodystrophy –a defect in the enzyme arylsulfatase which leads to accumulation of myelin in the lysosomes
Krabbe disease results from a disorder in which enzyme?
Galactocerebroside beta galactosidase (the crab galaxies)
Which cells are destroyed in multiple sclerosis?
Oligodendrocytes
What is the main environmental associate with MS?
Being farther from the equator (Miles from the Sun)
Explain the pathophysiology of internuclear ophthalmoplegia.
The medial rectus receives innervation from the 3 nerve (oculomotor) as well as the 6th nerve (abducens); the 6th nerve passes its axons through a bundle called the medial longitudinal fasciculus. MS often targets the MLF, so when you try to look to one direction, the eye on the side of the body opposite to the direction of looking will remain forward.
Although MRI is the gold standard for MS diagnosis, what CSF labs are elevated in someone with MS?
Oligoclonal IgG bands
Lymphocytes
Myelin basic protein
What drugs are given to those with MS during acute attacks and to prevent future progression?
Acute attacks: high dose steroids
Progression: interferon-beta
What is SSPE and what virus causes it?
Subacute sclerosing panencephalitis
A slowly progressing encephalitis caused by measles; infects white matter and gray matter
Progressive multifocal leukoencephalopathy is caused by ______________.
latent JC virus that is stimulated in an immunocompromised patient
How does central pontine myelinolysis present?
Acute paralysis (except for the eyes!)
