CNS Path of Nutritional Disorders - Parks

Question 1

what groups of pts are at risk of nutritional based CNS path?

Answer 1

1. alcoholics
2. Cancer patients–hyperemesis, can’t keep food down, won’t eat
3. gastric bypass– loss of IF production from stomach, impaired B12 absorption, low B12 intake
4. early pregnancy, need folate
5. Alzheimers

Question 2

Beriberi is a def of which b vitamin?

Answer 2

b1 thiamine

Question 3

what are the symptoms of beriberi?

Answer 3

WERNICKE'S ENCEPHALOPATHY
wt. loss
muscle waisting and pain
edema
neuropathy
cardiac dilation and high output cardiac failure
OPTHALMOPLEGIA

Question 4

What are the Sx of Wernicke’s?

Answer 4

Opthalmoplegia
Cerebellar ataxia
mental impairment: confused and disoreinted

Question 5

What is the pathological change in Wernicke’s?

Answer 5

Foci of hemorrhage and necrosis in the mamillary bodies and walls of the thrid and fourth ventricles

Question 6

What is the clinical presentation of Wernicke-Korsakof?

Answer 6

new memory impaired so people confabulate

Question 7

Where do we see more degeneration in Wernicke-Korsakoff?

Answer 7

neurons in the walls of the fourth ventricle and medial thalamic nuclei

Question 8

Why do the mamillary bodies show up on CT in WE?

Answer 8

increased blood from hemorrhage, edema, and INCREASED VASCULARITY

Question 9

Thiamine deficiency produces a diffuse decrease in cerebral utilization of…

Answer 9

glucose

Question 10

Decrease in cerebral utilization of glucose leads to damage of which cellular structure?

Answer 10

mitochondria

Question 11

How do you treat WE?

Answer 11

IM or IV thiamine

Question 12

What gastric disorders besides bypass will result in b vitamin def?

Answer 12

chronic gastritis
gastric carcinoma
persistent emesis

Question 13

How do you make a diagnosis of WE?

Answer 13

Imaging of the mamillary bodies on CT and clinical findings

Question 14

High methylmalonic acid indicates a deficiency of which vitamin?

Answer 14

vitamin b12

Question 15

V. b12 deficiency has what types of symtpoms?

Answer 15

loss of vibrational and position sense

Question 16

Loss of vibration and position sense is damage to which column?

Answer 16

posterior columns

Question 17

Loss of pain and temp sensation is damage to which column

Answer 17

lateral

Question 18

what is the path caused by a b12 def?

Answer 18

demyelination of the neurons

Question 19

Patients with b12 deficiency have what type of spinal cord deterioriation?

Answer 19

subactue combined demyelinating degeneration

Question 20

T/F: combined demyelination of the cord is irreversible if not treated quickly

Answer 20

true

Question 21

where is IF produced?

Answer 21

parietal cells of the fundus of the stomach

Question 22

WHere is b12 absorbed?

Answer 22

distal ileum when bound to IF

Question 23

When will we see b12 def?

Answer 23

1. pernicious anemia aka atrophic gastritis, gastrectomy for cancer of stomach, ulcers, etc.
2. impaired malabsorption from intestines
3. bariatric surgery for obesity
4. poor diet from vegetarianism

Question 24

Depletion in Vit. D may result in muscle pain because….

Answer 24

2ry hypocalcemia

Question 25

What are the seven important factors in nutrition that can prevent Alzhemier’s?

Answer 25

1. minimize sat. fats
2. lots of veggies
3. vitamin E from foods not supps
4. lots of b12; check levels regularly
5. DON’T USE IRON OR COPPER IN YOUR MULTIVITAMIN
6. limit aluminum intake
7. include aerobic exercise

Question 26

which b vitamins slow Alzheimer’s progression?

Answer 26

folic acid
b6
b12