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Flashcards in PNS Pathology Deck (51)
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1

What organism causes leprosy?

Mycobacterium leprae

2

MC cranial neuropathy in Lyme. What is this commonly misDx'd as?

Facial neuropathy. Bell's palsy

3

MC viral pathogen affecting PNS

Varicella zoster virus

4

Nerve cut or crushed. Part of the axon is separate from neuron cell body. Bead-like degeneration distal to injury.

Wallerian degeneration

5

Wallerian degeneration begins _____ hours after a lesion.

24-36

6

Axonal degeneration is followed by degradation of _____ and infiltration by _____

myelin sheath
MO

7

____ and ____ clear cellular debris from axonal degeneration

MO and schwann cells

8

What three CNs account for majority of CN mononeuropathies MC in clinical practice?

CN III, CN V, CN VII

9

MC cranial nerve neuropathy

Bell's palsy

10

Pts with Bell's Palsy may have Hx of ____

URI preceeding 1-3 weeks

11

Organism that is possible cause of Bell's palsy

HSV I

12

Artery most often responsible for compression of trigeminal nerve root?

Superior cerebellar

13

Damage to CN III results in this type of gaze

down and out

14

Mononeuropathies are most often related to _____

compression of the nerve

15

MC sites of ulnar nerve entrapment

elbow, then wrist

16

Ulnar nerve injuries affect what digits?

4 and 5

17

Carpal tunnel injury affects what digits?

1-3 and half of 4

18

What area of the body is affected by Meralgia paresthetica?

anterolateral thigh

19

What nerve is affected in Meralgia paresthetica? What is the injury to the nerve?

lateral cutaneous nerve of thigh
compression by inguinal ligament

20

Of the types of neuropathies related to diabetes, what type is MC?

Distal symmetrical and sensorimotor neuropathy

21

What is thought to be the most important underlying cause of diabetic neuropathy?

Ischemia and hypoxia caused by microvascular disease from endothelial inflammation and atherosclerosis

22

What is another proposed mechanism for diabetic neuropathy?

Accumulation of sorbitol and depletion of inositol results in reduced NaKATPase

23

Some pts with diabetic polyneuropathy also have ___

diabetic autonomic neuropathy

24

polyneuropathy develops in ___% of pts with chronic renal failure

60%

25

Chief pathological finding in uremic neuropathy

axonal degeneration

26

MC cause of acute generalized paralysis in the US

Guillain-Barre syndrome

27

Condition involving stripping of myelin from axons by macrophages which slows or blocks nerve conduction

Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)

28

CIPD or GBS?
A) Insidous onset
B) Major autonomic or respiratory involvement
C)Relapsing and remitting

A) CIPD
B) GBS
C) CIPD

29

T or F: The neurologic deficits that may be seen as a consequence of paraneoplastic syndromes are a result of metastasis to an involved nerve or nerves

F, are not

30

Most toxic neuropathies begin distally or proximally? Slow or rapid progression?

distally
slow

31

Metal exposure neuropathy
A) Predominantly motor
B) CNS effects predominate
C) Abd pain, vomiting, diarrhea, skin and nail
D) Predilection for upper limbs

A. Lead
B. Mercury
C. Arsenic
D. Lead

32

Blockage of voluntary motor and autonomic cholinergic neuromuscular junctions by neurotoxin prevents motor fiber stimulation in what illness? Caused by what organism?

Botulism
Clostridium botulinum

33

Examples of common infectious diseases associated with secondary neuropathies include?

Leprosy
HIV/AIDS
Lyme
Varicella zoster

34

Mycobacterial disease that is one of the most common causes of polyneuropathy worldwide

Leprosy

35

Main symptom of neuropathy in HIV/AIDS pts

continuous burning discomfort mostly in feet, sensory loss

36

Areas of body MC affected by shingles

Thoracic and trigeminal (especially ophthalmic branch) dermatomes

37

Characteristic histo of herpes zoster

multinucleated giant cell with most nuclear material at periphery of nuclei

38

What type of histological preparation is used to see herpes zoster?

Tzank smear

39

Hutchinson's sign

skin lesion on tip of nose. may precede ophthalmic herpes zoster

40

Ramsay-Hunt syndrome

Herpes zoster oticus with facial paralysis

41

Condition of pain persisting more than 4 to 8 weeks after healing of herpes zoster skin lesions

Postherpetic neuralgia

42

Schwannoma

Schwann cells proliferate out of control resulting in a benign bundle of cells that can compress the nerve

43

Benign primary intracranial tumor of myelin forming cells of CN VIII)

Vestibular schwannoma or acoustic neuroma

44

Common benign spindle cell tumor of peripheral nerves

Neurofibroma

45

T or F: Neurofibroma is associated with solitary tumors

F

46

In neurofibromatosis type 1, what CN is often involved?

CN VIII
but any can be affected

47

Skin lesion characteristic of cutaneous neurofibromas

café au lait spots

48

Neurofibromatosis Type I or 2?
A) mutation of neurofibromin, a tumor suppressor gene
B) Usually unilateral
C) mutation of protein merlin
D) Bilateral hearing loss

A) Type 1
B) Type 1
C) Type 2
D) Type 2

49

Characterized by elongated cells in parallel bundles. May resemble of neurofibroma. Benign with no atypia, rare mitotic figures

Perineuroma

50

Tumor usually arises from major nerves in neck, forearm, lower leg, or buttocks. 50% associated with underlying neurofibromatosis

Malignant peripheral nerve sheath tumor (MPNST) aka malignant schwannoma

51

Histo of MPNST

increased cellularity and disordered arrangement of Schwann cells. palisading, serpentine. large gaping vascular spaces