Toxic & Metabolic CNS diseases Flashcards

1
Q

How are most autosomal LSDs inherited?

A

autosomal recessive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which LSDs are X linked?

A
fabry disease
hunter syndrome (MPS II)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the definition of a gangliosidoses?

A

type of neuronal storage disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a lysosomal storage disease?

A

accumulation of ‘inert’ substrates/metabolites

cells swell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What population is tay sachs usually seen in?

A

ashkenazi jews

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What chromosome is the gene for tay sachs on?

A

15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the signs and symptoms of tay sachs?

A

psychomotor retardation
blindness
motor incoordination, eventual flaccidity, mental deterioration, eventual decerebrate state
cherry red spot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is stored excessively in tay sachs?

A

Hex A: aB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is stored excessively in sandhoff disease?

A

Hex B: BB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to a tay sachs brain if the patient survives longer than 2 years?

A

gets big

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What microscopic findings are in tay sachs disease?

A

enlarged ballooned neurons filled with PAS positive material/whorled, membranous cytoplasmic bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is deficient in Krabbe’s disease? What does this result in?

A

galactocerebroside B galactosidase

accum of toxic compound (psychosine) that injures oligodendrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is another name for Krabbe’s disease?

A

globoid cell leukodystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are clinical signs and symptoms of Krabbe’s?

A
irritability
tonic spasms
opisthotonic posture
myotonic jerking
optic atrophy, blindness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does Krabbe’s look like on gross exam?

A

atrophic white matter with preservation of U fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is seen histologically with krabbe’s?

A

globoid cells
large multinucleated cells
globoid cells contain crystalloid straight or tubular profiles

17
Q

What is deficient in metachromatic leukodystrophy? What does this result in?

A
aryl sulfatase A
metachromic lipids (sulfatides) accumulate in brain, peripheral nerves and kidney
18
Q

How is metachromatic leukodystrophy diagnosed?

A

enzme deficiency in urine, WBCs or fibroblasts

19
Q

What does metachromatic leukodystrophy look like on gross exam?

A

white matter very firm, gliosis, preservation of U fibers

20
Q

What is seen on histology for metachromatic leukodystrophy?

A

metachromasia of white matter deposits (acidified cresyl violet stain)

21
Q

What is the problem in adrenoleukodystrohpy?

A

decreased activity of very long chain fatty acyl CoA synthetase
(excess of very long chain fatty acid esters in plasma, cultured fibroblasts, CNS, PNS and adrenals)

22
Q

What are the signs/symptoms of the adrenoleukodystrophy classic form?

A

dementia/psychosis, visual/hearing loss, seizures, adrenall insufficiency follows neuro sx

23
Q

What does adrenoleukodystrophy look like on gross exam?

A

gray discoloration of white matter, marked firmness
u fiber preservation
severe demyelination

24
Q

What does adrenoleukodystrophy look like histologically?

A
perivascular inflammation (more specific)
PAS positive macrophages
25
What is the important histologic finding related to hepatic encephalopathy?
alzheimer type II astrocytes
26
What systems are most commonly symptomatic in mitochonidrail disease?
brain & muscle
27
What is the mutation in leigh's disease (subacute necrotizing encephalopathy)?
mutation in nuclear DNA and mitochondrial DNA leading t oenzyme deficiency in pathyway converting pyruvate to ATP decreased activity of cytochrome C oxidase
28
What are the signs and symptoms of leigh's disease?
arrest of development, hypotonia, seizures, extraocular palsies
29
What is seen on gross exam of leigh's patients?
multifocal infarcts that don't correspond to vascular distribution
30
What are signs/sx of fetal alcohol syndrome?
``` growth retardation facial deformities (short palpebral fissue, epicanthal folds, thin upper lip, growth retardation of jaw) cardiac defects delayed develpment and mental deficiency ```
31
What is seen histologically with methotrexate toxicity?
coagulative necrosis with mineralization
32
What would lead you to a dx of sandhoff's over tay sachs?
more severe presentation | PNS and CNS findings