Flashcards in Pathology Deck (93)
What is the most common cause of dementia in the elderly?
Alzheimer is associated with which other genetic disease?
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)
What are gross findings of Alzheimer's disease?
widespread cortical atrophy
narrowing of gyri and widening of sulci
What are histological findings of Alzheimer's disease?
Senile plaques: extracellular beta-amyloid core
Amyloid- Beta synthesized by cleaving amyloid precursor protein (APP)
Neurofibrillary tanges (intracellular, hyperphosphorylated tau protein) are associated with what disease?
What are clinical findings of Pick Disease?
What area of the brain is spared with Pick Disease?
parietal lobe and posterior ⅔ of superior temporal gyrus
What are gross findings of Pick disease?
Pick bodies: spherical tau protein aggregates
What are histological findings of Pick disease?
What are clinical findings of Lewy body dementia?
initially dementia and visual hallucinations followed by parkinsonian features
What are histological findings of Lewy body dementia?
What are clinical findings of Creutzfeldt-Jakob Disease?
rapidly progressive (wks to mos) dementia with myoclonus ("startle myoclonus")
What are gross findings of Creutzfeldt-Jakob Disease?
What are histological findings of Creutzfeldt-Jakob Disease?
prions (PrPc --> PrPsc sheet)
Beta-pleated sheets are resistant to proteases
What are other causes of dementia?
Multi-infarct (2nd MCC of dementia in the elderly)
vitamins B1, B3, or B12 deficiency
What is the pathogenesis of multiple sclerosis?
autoimmune inflammation and demyelination of CNS (brain and spinal cord)
What are clinical symptoms of a patient with multiple sclerosis?
optic neuritis (sudden loss of vision resulting in Marcus Gunn pupils)
What age group does multiple sclerosis most often showing clinical symptoms?
20s and 30s
What is the Charcot classic triad of MS?
What type of hypersensitivity is multiple sclerosis?
Type IV Hypersensitivity
What are laboratory findings of multiple sclerosis?
increased protein (IgG) in CSF
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
What is the treatment for multiple sclerosis?
Symptomatic treatment for neurogenic bladder --> catheterization, muscarinic antagonists)
Symptomatic treatment for spasticity --> baclofen, GABA receptor agonist
Symptomatic treatment for pain --> opioids
What is the MC variant of Guillain-Barre Syndrome?
acute inflammatory demyelinating polyradiculopathy
What type of cells are injured in acute inflammatory demyelinating polyradiculopathy?
Schwann cells --> inflammation and demyelination of peripheral nerves and motor fibers
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
What are laboratory findings in acute inflammatory demyelinating polyradiculopathy?
increased CSF protein with normal cell count
What pathogens are associated with acute inflammatory demyelinating polyradiculopathy?
Campylobacter jejuni and CMV