Unit 2: Inflammatory, Metabolic, Nutritional, and Toxic Diseases

Question 1

L1: What is the most common CNS inflammatory disease?

Answer 1

Multiple Sclerosis

Question 2

L1: What pathologic process? Rapid correction or overcorrection of hyponatremia

Answer 2

Central Pontine Myelinolysis

Question 3

L2: What are the effects of methanol intoxication?

Answer 3

Putamen hemorrhagic necrosis

Question 4

L2: What is the affect of acute alcohol intoxication on the CNS?

Answer 4

Severe cerebral edema

Question 5

L2: What is the nutritional deficiency in Wernicke’s encephalopathy?

Answer 5

thiamine (Vitamine B1)

Question 6

L2: What is the pathogenesis of Wilson’s disease?

Answer 6

Defect in copper metabolism

Question 7

L2: What is the treatment for acute attacks in MS?

Answer 7

high dose corticosteroids, plasmapheresis (severe)

Question 8

L2: What is the treatment for Wilson’s Disease?

Answer 8

Copper-chelating agents

Question 9

L2: What is the typical age of presentation for MS?

Answer 9

15-45 years

Question 10

L2: What part of the brain is affected by thiamine deficiency in Korsakoff Syndrome?

Answer 10

Dorsomedial nucleus of the thalamus

Question 11

L2: What part of the brain is most commonly affected in Wernicke’s encephalopathy?

Answer 11

Mamillary bodies

Question 12

L2: What pathologic process? Abnormalities in Myelin Basic Protein, leading to demyelination of the CNS

Answer 12

Cobalamin (Vitamin B12) Deficiency

Question 13

L2: What pathologic process? Astrocytes with swollen, vesicular nuclei and minimal visible cytoplasm

Answer 13

Hepatic encephalopathy

Question 14

L2: What pathologic process? Autosomal recessive disorder of copper metabolism

Answer 14

Wilson’s Disease

Question 15

L2: What pathologic process? Caused by strict vegtarian diet, pernicious anemia, or gastric neoplasms

Answer 15

Cobalamin (Vitamin B12) Deficiency

Question 16

L2: What pathologic process? CNS disturbances in electrolytes, pH, water, and neurotransmitter regulation

Answer 16

Hepatic encephalopathy

Question 17

L2: What pathologic process? Confusion, ophthalmoplegia, ataxia

Answer 17

Wernicke’s encephalopathy

Question 18

L2: What pathologic process? Degeneration of superior cerebellar vermis, cerebral cortex white matter loss and dendritic reduction, meningeal fibrosis

Answer 18

Chronic alcoholism

Question 19

L2: What pathologic process? dysarthria, gait disturbances, limb incoordination, involuntary movements, dystonias, intelligence deterioration, flapping tremor, spasticity

Answer 19

Wilson’s Disease

Question 20

L2: What pathologic process? Early paresthesias, monocular loss of vision, gait problems, weakness, diplopia, Lhermitte’s paresthesias down the spine with neck flexion, urinary urgency/frequency, constipation

Answer 20

MS

Question 21

L2: What pathologic process? Edema, demyelination, necrosis, neuron loss, gliosis

Answer 21

Wernicke’s encephalopathy

Question 22

L2: What pathologic process? Flapping tremor, confusion, forgetfulness, drowsiness, and eventually stupor or coma

Answer 22

Hepatic encephalopathy

Question 23

L2: What pathologic process? Involvement of mammillary bodies almost always, walls of third ventricle, periaqueductal tissue, inferior colliculi, floor of fourth ventricle, thalamus

Answer 23

Wernicke’s encephalopathy

Question 24

L2: What pathologic process? Late fatigue, sexual dysfunction, depression, pain, dysphagia, seizures and hearing loss in rare cases

Answer 24

MS

Question 25

L2: What pathologic process? memory loss due to thiamine deficiency in the dorsomedial nucleus of the thalamus

Answer 25

Korsakoff Syndrome

Question 26

L2: What pathologic process? Paresthesias, ataxia, abnormal reflexes, diminished vibration sensation and proprioception in lower extremities

Answer 26

Cobalamin (Vitamin B12) Deficiency

Question 27

L2: What pathologic process? Putamen hemorrhagic necrosis

Answer 27

Methanol intoxication

Question 28

L2: What pathologic process? Severe cerebral edema

Answer 28

Acute acohol intoxication

Question 29

L2: What pathologic process? Thiamine deficiency

Answer 29

Wernicke’s encephalopathy

Question 30

L2: Which subtype of MS is more commonly diagnosed?

Answer 30

Relapse-Remitting (RRMS)

Question 31

L3: What genetic mutations/markers are associated with MS? (3)

Answer 31

HLA-DR2, IL-2, IL-17

Question 32

L4: Name the four first-line immunotherapies for MS?

Answer 32

Avonex, Betaseron, Copaxone, Repif

Question 33

L4: What are the three effects of chronic alcoholism on the CNS?

Answer 33

Degeneration of superior cerebellar vermis, cerebral cortex white matter loss and dendritic reduction, meningeal fibrosis