Path 28: Demyelination Diseases

Question 1

Characteristics of multiple sclerosis

Answer 1

Distinct episodes of neurologic defecits separated in time

attributable to patchy white matter lesions separated in space

Question 2

Multiple sclerosis cause

Answer 2

Autoimmune response agaisnt myelin sheath

Question 3

Multiple sclerosis intiated by _____ and ______ T cells that ________

Answer 3

Multiple sclerosis intiated by TH1 and TH17 T cells that react against myelin agents

Question 4

Th1 T cell function

Answer 4

secrete IFN-gamma which activates macrophages

Question 5

Th17 cell function

Answer 5

Promote leukocyte recruitment

Question 6

Neuromyelitis Optica:

S/S

Characterized by _____ antibodies

Answer 6

Synchronous bilateral optic neuritis and spinal cord demyelination.

Aquaphorin-4 antibodies (major astrocyte water channel)

Question 7

Neuromyelitis optica attacks treated with:

Answer 7

glucocorticoids in short term

Long term treatments decrease B-cell and block complement

Question 8

Acute disseminated encaphalomyelitis

Answer 8

Diffuse, monophasic demyelinating disease following viral infection

Symptoms are central rather than peripheral.

Coma, lethargy, death.

Question 9

Acute necrotizing hemmorhagic encephalomyelitis

Answer 9

AKA Weston Hurst disease.
Preceded by URI in young adults.
similar to acute disseminated encephalomyeltis but with worse outcomes and very poor recovery.

Question 10

Central Pontine Myelinolysis

Answer 10

Loss of myelin in pons, usually symmetrically.

2-6 days after rapid hyponatremia correction.

AKA osmotic demyelination syndrome.

Rapid onset quadraplegia, locked in syndrome.

Often fatal