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First Aid STEP 1 - Neurology > Pathology > Flashcards

Flashcards in Pathology Deck (93)
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1

What is the most common cause of dementia in the elderly?

Alzheimer disease

2

Alzheimer is associated with which other genetic disease?

Down Syndrome

3

What are genes associated with Alzheimer's disease?

Early onset: APP (Chr 21), presenilin-1 (Chr 14), presenilin-2 (Chr 1)

Late onset: ApoE4 (Chr 19)

PROTECTIVE: ApoE2 (Chr 19)

4

What are gross findings of Alzheimer's disease?

widespread cortical atrophy

narrowing of gyri and widening of sulci

5

What are histological findings of Alzheimer's disease?

Senile plaques: extracellular beta-amyloid core

Amyloid- Beta synthesized by cleaving amyloid precursor protein (APP)

6

Neurofibrillary tanges (intracellular, hyperphosphorylated tau protein) are associated with what disease?

Alzheimer Disease

7

What are clinical findings of Pick Disease?

dementia
aphasia
parkinsonian aspects
personality changes

8

What area of the brain is spared with Pick Disease?

parietal lobe and posterior ⅔ of superior temporal gyrus

9

What are gross findings of Pick disease?

Pick bodies: spherical tau protein aggregates

10

What are histological findings of Pick disease?

frontotemporal atrophy

11

What are clinical findings of Lewy body dementia?

initially dementia and visual hallucinations followed by parkinsonian features

12

What are histological findings of Lewy body dementia?

alpha-synuclein defect

13

What are clinical findings of Creutzfeldt-Jakob Disease?

rapidly progressive (wks to mos) dementia with myoclonus ("startle myoclonus")

14

What are gross findings of Creutzfeldt-Jakob Disease?

spongiform cortex

15

What are histological findings of Creutzfeldt-Jakob Disease?

prions (PrPc --> PrPsc sheet)

Beta-pleated sheets are resistant to proteases

16

What are other causes of dementia?

Multi-infarct (2nd MCC of dementia in the elderly)
syphilis
HIV
vitamins B1, B3, or B12 deficiency
Wilson disease
NPH

17

What is the pathogenesis of multiple sclerosis?

autoimmune inflammation and demyelination of CNS (brain and spinal cord)

18

What are clinical symptoms of a patient with multiple sclerosis?

optic neuritis (sudden loss of vision resulting in Marcus Gunn pupils)
internuclear ophthalmoplegia
hemiparesis
hemisensory symptoms
bladder/bowel incontinence

19

What age group does multiple sclerosis most often showing clinical symptoms?

20s and 30s

20

What is the Charcot classic triad of MS?

Scanning speech
Intention tremor
Nystagmus

Remember: SIN

21

What type of hypersensitivity is multiple sclerosis?

Type IV Hypersensitivity

22

What are laboratory findings of multiple sclerosis?

increased protein (IgG) in CSF

23

What can be seen on an MRI of a patient with multiple sclerosis?

periventricular plaques with destruction of axons.

multiple white matter lesions separated in space and time

24

What is the treatment for multiple sclerosis?

beta-interferon
immunosuppression
natalizumab

Symptomatic treatment for neurogenic bladder --> catheterization, muscarinic antagonists)

Symptomatic treatment for spasticity --> baclofen, GABA receptor agonist

Symptomatic treatment for pain --> opioids

25

What is the MC variant of Guillain-Barre Syndrome?

acute inflammatory demyelinating polyradiculopathy

26

What type of cells are injured in acute inflammatory demyelinating polyradiculopathy?

Schwann cells --> inflammation and demyelination of peripheral nerves and motor fibers

27

What are physical findings of acute inflammatory demyelinating polyradiculopathy?

symmetric ascending muscle weakness/paralysis beginning in lower extremities

facial paralysis in 50% of cases

autonomic function may be severely affected

28

What are laboratory findings in acute inflammatory demyelinating polyradiculopathy?

increased CSF protein with normal cell count

29

What pathogens are associated with acute inflammatory demyelinating polyradiculopathy?

Campylobacter jejuni and CMV

30

What type of support is critical in acute inflammatory demyelinating polyradiculopathy patients?

respiratory support