PNS Pathology Flashcards

1
Q

What organism causes leprosy?

A

Mycobacterium leprae

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2
Q

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

A

Facial neuropathy. Bell’s palsy

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3
Q

MC viral pathogen affecting PNS

A

Varicella zoster virus

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4
Q

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

A

Wallerian degeneration

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5
Q

Wallerian degeneration begins _____ hours after a lesion.

A

24-36

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6
Q

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

A

myelin sheath

MO

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7
Q

____ and ____ clear cellular debris from axonal degeneration

A

MO and schwann cells

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8
Q

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

A

CN III, CN V, CN VII

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9
Q

MC cranial nerve neuropathy

A

Bell’s palsy

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10
Q

Pts with Bell’s Palsy may have Hx of ____

A

URI preceeding 1-3 weeks

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11
Q

Organism that is possible cause of Bell’s palsy

A

HSV I

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12
Q

Artery most often responsible for compression of trigeminal nerve root?

A

Superior cerebellar

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13
Q

Damage to CN III results in this type of gaze

A

down and out

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14
Q

Mononeuropathies are most often related to _____

A

compression of the nerve

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15
Q

MC sites of ulnar nerve entrapment

A

elbow, then wrist

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16
Q

Ulnar nerve injuries affect what digits?

A

4 and 5

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17
Q

Carpal tunnel injury affects what digits?

A

1-3 and half of 4

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18
Q

What area of the body is affected by Meralgia paresthetica?

A

anterolateral thigh

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19
Q

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

A

lateral cutaneous nerve of thigh

compression by inguinal ligament

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20
Q

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

A

Distal symmetrical and sensorimotor neuropathy

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21
Q

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

A

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

22
Q

What is another proposed mechanism for diabetic neuropathy?

A

Accumulation of sorbitol and depletion of inositol results in reduced NaKATPase

23
Q

Some pts with diabetic polyneuropathy also have ___

A

diabetic autonomic neuropathy

24
Q

polyneuropathy develops in ___% of pts with chronic renal failure

A

60%

25
Q

Chief pathological finding in uremic neuropathy

A

axonal degeneration

26
Q

MC cause of acute generalized paralysis in the US

A

Guillain-Barre syndrome

27
Q

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

A

Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)

28
Q

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

A

A) CIPD
B) GBS
C) CIPD

29
Q

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

A

F, are not

30
Q

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

A

distally

slow

31
Q
Metal exposure neuropathy
A) Predominantly motor
B) CNS effects predominate
C) Abd pain, vomiting, diarrhea, skin and nail
D) Predilection for upper limbs
A

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

32
Q

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

A

Botulism

Clostridium botulinum

33
Q

Examples of common infectious diseases associated with secondary neuropathies include?

A

Leprosy
HIV/AIDS
Lyme
Varicella zoster

34
Q

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

A

Leprosy

35
Q

Main symptom of neuropathy in HIV/AIDS pts

A

continuous burning discomfort mostly in feet, sensory loss

36
Q

Areas of body MC affected by shingles

A

Thoracic and trigeminal (especially ophthalmic branch) dermatomes

37
Q

Characteristic histo of herpes zoster

A

multinucleated giant cell with most nuclear material at periphery of nuclei

38
Q

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

A

Tzank smear

39
Q

Hutchinson’s sign

A

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

40
Q

Ramsay-Hunt syndrome

A

Herpes zoster oticus with facial paralysis

41
Q

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

A

Postherpetic neuralgia

42
Q

Schwannoma

A

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

43
Q

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

A

Vestibular schwannoma or acoustic neuroma

44
Q

Common benign spindle cell tumor of peripheral nerves

A

Neurofibroma

45
Q

T or F: Neurofibroma is associated with solitary tumors

A

F

46
Q

In neurofibromatosis type 1, what CN is often involved?

A

CN VIII

but any can be affected

47
Q

Skin lesion characteristic of cutaneous neurofibromas

A

café au lait spots

48
Q
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

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

49
Q

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

A

Perineuroma

50
Q

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

A

Malignant peripheral nerve sheath tumor (MPNST) aka malignant schwannoma

51
Q

Histo of MPNST

A

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