Toxic/Metabolic/Nutritional Disease Flashcards
What are the morphological correlates of hypglycemia, hyperthermia, hypothermia?
Hypoglycemia – pathology similar to anoxiaischemia
except Purkinje cells of cerebellum
are relatively spared
• Hyperthermia – pathology similar to anoxiaischemia
• Hypothermia – few pathologic changes
What are the morphological signs of abuse of methanol?
Hemorrhagic necrosis of the putamen
What are the morphological signs of abuse of ethyl alcohol?
acutely: cerebral edema
Chronically: Cerebellar degeneration (neuronal loss)-especially in the superior vermis, cerebral atrophy (white matter in early disease)
What are the symptoms of fetal alcohol syndrome?
hyperactivity, poor
motor skills, learning difficulties; severely
affected kids have mental retardation
What are some neurological complications of liver damage?
Elevation of blood ammonia leads to hepatic encephalopathy.
What are some symptoms of hepatic encephalopathy?
Confusion
Affects deep basal ganglia, leading to asterixis
What are some pathologies of hepatic encephalopathy?
- Edema
- Alzheimer type II cells
- Cortex
- Basal ganglia
What happens to astrocytes with too much ammonia?
Pushes them to recycle way more neurotransmitters
What is Wilson’s disease?
Inability to metabolize copper, leading to liver cirrhosis. Manifests with movement disorder (basal ganglia) due to liver issues and high serum copper.
What happens to the brain with protein-caloric malnutrition?
Kwashiorkor- with edema due
to hypoproteinemia, ascites, hepatomegaly with
hepatic steatosis
Marasmus-Caloric deficiency yields marasmus with extreme cachexia and growth failure
Apathy, lack of activity; effect glial formation,
synaptic branching, myelin formation
Brain is small, can’t form myelin in developing brain.
What is vitamin B1 deficiency?
Wernicke-Korsakoff syndrome
oculomotor abnormalities and mental symptoms, nystagmus, ataxia, confusion
Most common in alcoholics with hyperemesis
What is Wernicke’s encephalopathy?
B1 deficiency
• Mammillary bodies involved in almost all
cases
– Hypothalamus, medial thalamus,
periaqueductal grey, floor of 4th ventricle
– Histology varies with stage and severity
– Edema, necrosis, demyelination, neuron
loss, gliosis
What are the symptoms of B12 deficiency?
Dysfunction may cause incorporation of abnormal fatty
acids into biological membranes, resulting in myelin
instability
May also affect DNA synthesis
Vitamin B12 deficiency variably causes megaloblastic
anemia and/or neurological complications, cognitive
deficits, subacute combined degeneration –patients
may not have more than one feature
What are the causes of B12 deficiency?
Main dietary sources are animal products such as
meat and dairy
• In stomach vitamin B12 is bound to “intrinsic factor” a
glycoprotein produced by the parietal cells of the
stomach
• Combined vitamin B12-intrinsic factor complex
transported to terminal ileum where it binds to
receptors and is absorbed
• Therefore patients with autoimmune disorders in which
antibodies develop against gastric parietal
cells/intrinsic factor can result in vitamin B12
deficiency: pernicious anemia
• Without intrinsic factor, less than 1% of dietary B12
absorbed
What is spinal cord disease?
characterized by involvement of
ascending (sensory) and descending tracts (motor) in
the spinal cord
• Symptoms develop over weeks, usually with initial
slight ataxia, numbness, and tingling in lower
extremities; Can progress rapidly to spastic weakness
or even complete paraplegia
