4th Exam: Neurologic Disease Flashcards Preview

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Flashcards in 4th Exam: Neurologic Disease Deck (37)
1

Meningococcal Meningitis:

Carriers have nasopharyngeal bacteria, often in epidemics, outbreaks, young adults and kids, DIC = intravascular thrombosis (caps) (skin, adrenal lesions), can be fatal

2

Meningitis with WFS:

Adrenal gland hemorrhage = insufficiency, meningitis assoc w inflammation, inflammation → leaky vessels→ edema, seizures, confusion, coma, WFS: numerous skin hemorrhages

3

WFS sf:

Waterhouse-Friderichsen Syndrome

4

Brain Abscess sources:

local or distant infection
o Endocarditis, tooth extraction
• Endocarditis: emboli on valves travel to brain

5

Etiology of brain abscess:

usually bacterial, not a single species, but mixed flora

6

Signs of brain abscess:

signs of mass lesion w fever, headache, sizures, elevated WBC

7

Mortality, morbidity of brain abscesses:

10%, 50%

8

Abscess:

necrosis of tissue + inflammation, PMNs

9

What forms the capsule around an abscess?

collagen

10

Why does a capsule form around an abscess?

Attempt to wall-off infection and prevent spread

11

Myotonic Dystrophy:

Hatchet face with ptosis (droopy eyelids), dysphagia (be aware, may choke on saliva), muscle disease, dominant inheritance, progressive muscle weakness

12

Mito Disorders esp effect:

cells in organs that don’t turn over quickly (heart, skeletal muscle, brain)

13

Mito Myopathies:

Ptosis, dysphagia, too many mito, abnormal mitochondria

14

Abnormal mitochondria:

Differing sizes & shapes, whorled appearance (whirling cristae), crystal-like inclusions

15

Degenerative Diseases:

Selective vulnerability: distinct topography, often Idiopathic, hereditary/genetic/molecular basis, neurons primarily affected, atrophy + gliosis (astrocytes proliferate → scarring of the brain) + a unique change

16

Dementia:

Loss of cognitive function, decline from a previous level of function, slowly progressive, modalities affected: memory, judgment, reasoning, calculation, language, lesions in cerebrum

17

Causes of dementia:

Alzheimer’s & similar diseases, Huntington’s, Parkinson’s (movement disorders), vascular disease, infections, alcohol abuse, Vit deficiency

18

Alzheimer’s:

- 50-75% of all dementia cases
- Incidence increases w age
o 50% people > 85yo
- 5-10yr survival after dx
- Disease of cerebral cortex- cerebral cortical atrophy, diffuse
- Senile plaques in Alzheimer’s

19

Alzheimers effects on cerebral cortex:

diffuse, sulci bw gyri are very wide, representing atrophy, ventricles dilated, loss of cortical neurons- almost 50%, neural connections to create memory, calculation and reasoning are lost, leads to dementia, senile plaques:

20

What are senile plaques in Alzheimer’s made of?

Core: amyloid, surrounded by degenerating neurites (damaged neurons)

21

Pathogenesis of Alzheimer's – Amyloid

Several pws, all begin with Beta-amyloid deposits (plaques in brain), neurotoxic w loss of neurons (activates macs inducing inflammation, accelerates apoptosis of neurons)

22

Amyloid Formation and Breakdown:

APP (Amyloid Precursor Protein) formation, may be increased (Ex. Down’s Syndrome), cleavage/degradation may be reduced

23

APP:

normal membrane protein, 563-770 AAs

24

May lead to the reduction of amyloid breakdown:

Secretase enzymes break down APP, failure of breakdown → amyloid deposits

25

process of amyloid breakdown failure:

Alpha secretase cuts amyloid in half so that it becomes soluble and goes away, if alpha secretase doesn’t cleave, the amyloid is intact and insoluble, Beta and Gamma secretases then liberate the amyloid so that it floats free and deposits in the brain, may also have a mutation in alpha secretase that causes it to cleave the wrong area or not at all.

26

Parkinsonism:

Syndrome, not a single disease, 50-70yo, tremor at rest, rigidity, bradykinesia (slow movements), disorder of involuntary nervous system (normally modulates motor activity), gradually results in disability

27

Causes of parkinsonism:

Idiopathic: classical Parkinson’s disease, hereditary: alpha-synuclein gene, post-encephalitic: viral encephalitis, toxic: MPTP, cycad beans, pesticides?, head trauma

28

Loss of neuromelanin =

loss of neurons containing melanin

29

Parkinson’s Disease:

Cytoplasmic Lewy Bodies (dense center, lighter halo around), composed of filaments, contain alpha-synuclein, neurons with Lewy bodies are damaged and will die

30

Trigeminal Neuralgia is aka:

Tic douloureux

31

Trigeminal Neuralgia:

Sudden, severe, stabbing pain, many small attacks, lasting < 2m each (episodic), triggered by: touching face, brushing teeth, but mostly nothing

32

Causes of Trigeminal Neuralgia:

Usually idiopathic, vascular compression?, MS, tumors

33

Trigeminal Neuralgia presents similarly to:

neuralgia inducing osteonecrosis of jaw

34

pain is least common in the branch of CNV in Trigeminal neuralgia:

Division 1

35

Pathogenesis of Trigeminal neuralgia:

Nerve root compressed by vascular structure, irritation of nerve → hyperactive nerve nucleus, myelin begins to break down on CN V

36

Causes of Bell’s Palsy:

Idiopathic, trauma: surgery of parotid gland, infections: herpes simplex, zoster, Lyme disease, tumors, demyelinating diseases (MS, Guillain-Barré)

37

Bell's Palsy:

Often subacute onset and course (Self-limited, 85% improve in 3wks), facial paralysis- usually unilateral (Eyelid can’t close, mouth droops), slurred speech, drooling, decreased lacrimation, taste