Misc. Neuro disorders

Question 1

what is the purpose of astrocytes

Answer 1

form contacts between neuronal surfaces and and blood cells. transports nutrients and metabolites
IMPORTANT PART OF BLOOD BRAIN BARRIER

Question 2

what is the function of microglia

Answer 2

clear cellular debris

Question 3

what is the function of non-myelinating Schwann cells

Answer 3

neuronal metabolic support and regrowth within PNS

Question 4

what is the function of satellite glial cells

Answer 4

surround the sensory, sympathetic, parasympathetic nerves to help protect and promote cellular communication

Question 5

what is the function of myelin

Answer 5

segments of lipid wrap that insulates the axon - allows for saltatory conduction

Question 6

oligodendrocyte location

Answer 6

CNS

Question 7

Schwann cell location

Answer 7

PNS

Question 8

what is a deymelination of oligodendrocytes

Answer 8

Multiple sclerosis

Question 9

what is demylination of schwann cells

Answer 9

Guillain-Barre

Question 10

what is MS

Answer 10

degenerative, chronic disease
autoimmune inflammatory state leading to demyelination - will occur over hours to days
affects to myelin of the CNS (oligodendrocytes)

Question 11

what is the pathophysiology of MS

Answer 11

genetic predisposition with environmental triggers
HLA-DRB mutation - causes abnormal response to MHC proteins

Question 12

what is the etiology of MS

Answer 12

F>M
low vitamin D
viral infections

Question 13

what is EBV

Answer 13

Epstein Barr virus
type of herpes virus - asymptomatic or may cause mono

Question 14

what is necessary for MS to develop

Answer 14

EBV - since EBC antigen looks very similar to myelin and demyelination during the inflammatory response to autoimmune reaction

Question 15

what type of cell mediated disease is MS

Answer 15

B-cell mediated disease

Question 16

how does MS start

Answer 16

starts with clinically isolated syndrome
must occur for > 24 hours
typically recover (remyelination)

Question 17

what is gliosis

Answer 17

scar tissue of glial cells

Question 18

what is the most common symptom of MS

Answer 18

optic neuritic - can also be spinal cord syndrome, brain stem syndrome, cerebellar syndrome

Question 19

what is possible presentation of MS

Answer 19

may present with spasticity, muscular weakness, sensory changes, incontinence (if autonomic system involved, ataxia(cerebrellum))

Question 20

as MS progressed what is most likely to be affected

Answer 20

cognitive deficits (memory, attention, psychiatric, depression, dementia)

Question 21

what are the MS classifications

Answer 21

relapsing remitting
primary progressive
secondary progressive
progressive relapsing

Question 22

what is relapsing remitting MS

Answer 22

most common
will have recurrent relapses during inflammatory activation
may or may not have symptoms
typically worsens clinically over time - progressive disability

Question 23

what environmental factor affects MS

Answer 23

heat

Question 24

what is primary progressive MS

Answer 24

more consistent worsening of symptoms without relief

Question 25

what is secondary progressive MS

Answer 25

relapsing turned progressive

Question 26

what is progressive relapsing MS

Answer 26

will have consistent worsening with flairs

Question 27

what can be repaired, axons or myelin

Answer 27

myelin can be repaired

Question 28

what Cranial nerves have oligodendrocytes

Answer 28

CN1 and CN2

Question 29

what is Marcus Gun pupil

Answer 29

vasodilation with light sign of optic neuritis

Question 30

what part of your brain makes you emotional

Answer 30

limbic system

Question 31

what is function of the limbic system

Answer 31

mediates emotional response with memory/learning visceral reaction

Question 32

what makes up the limbic system

Answer 32

Basal Ganglia, hypothalamus, thalamus, amygdala and hippocampus

Question 33

what is the function of the basal ganglia

Answer 33

part of the limbic system includes caudate and putamen (together = striatum) these pathways help with motor, emotional and learning reward

Question 34

what is the cause of tourettes disorder

Answer 34

lack of inhibiting factors of the limbic and motor syndrome lead to motor and phonic tics - specifically the cortico-striatal-thalamic-cortical (mesolimbic) circuit which is important in decision making, regulation of affect, goal-directed behaviors

Question 35

what is used to ID changes in the structural as well as metabolic processes in pts with tourettes

Answer 35

functional imaging

Question 36

what portion of the brain is triggered just prior to a tourettes tic

Answer 36

insula implicated which typically helps to monitor sensation/urges changes in basal ganglio functionally

Question 37

what is structurally smaller in patients with tourettes

Answer 37

decrease in size of the caudate which is part of the basal ganglion and helps to organize our motor movements

Question 38

what is decreased wtihin the basal ganglio

Answer 38

GABA - creates stimulating effect without GABA receptor

Question 39

when is the peak symptom of tourettes

Answer 39

around puberty with many patients and resolving their ticks after puberty

Question 40

how is ICP assessed

Answer 40

lumbar puncture

Question 41

what is NPH

Answer 41

Normal pressure hydrocephalus normal flow of CSF, no constriction or blockage of flow of the CSF

Question 42

what is the presentation of NPH

Answer 42

dementia, gait alteration, incontinence gait is the first thing affected

Question 43

how can NPH be treated/reversed

Answer 43

VP shunt

Question 44

what is the cause of NPH

Answer 44

Idiopathic or secondary to hemorrhage or infection

Question 45

what are the cause of Idiopathic NPH

Answer 45

HTN, CAD, PAD increase risk decreased absorption increased venous pressure

Question 46

what is the triad of NPH

Answer 46

wacky, wobbly, wet dementia, wide gait, urinary incontinence

Question 47

what is the most common NMJ disorder

Answer 47

Myasthenia gravis

Question 48

what is M. gravis

Answer 48

autoimmune response to the Ach receptors of NMJ antibodies attack ocular, respiratory, head/neck and limb muscles

Question 49

what do antibodies target in M. gravis

Answer 49

AChR antigen

Question 50

what type of hypersensitivity reaction is M. gravis

Answer 50

type 2 tissue specific hypersensitivities

Question 51

what is ALS

Answer 51

amytrophic lateral sclerosis progressive neurodegenerative disease - ultimately fatal

Question 52

what is degenerated in ALS

Answer 52

the upper and lower motor neurons - causes thinning of spinal cord and causes muscle atrophy

Question 53

where does ALS begin

Answer 53

neck/head muscles, limbs and then respiratory muscles

Question 54

what causes fatality in ALS patients

Answer 54

respiratory compromise

Question 55

what is decreased in uptake in ALS

Answer 55

decreased glutamate uptake which causes excitotoxicity and calcium goes crazy and triggers microglia to cause inflammation and damage axons