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20 Cards in this Set
- Front
- Back
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primary and secondary pathological causes of metabolic encephalopathy
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primary: decreased oxygen/glucosed
secondary: altered electrolytes, increased metabolic byproducts b/c liver/kidney disease |
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What 3 things are clinically seen/not seen in metabolic encephalopathy?
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1. Impaired Renticular Activating system which alters consciousness
2. diffuse and bilateral cortical activity (decreased concentration, slow, delusions/hallucinations, babinkski, myclonic jerks) 3. pupillary light and oculo-vestibular reflexes are intact b/c brainstem is not harmed |
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What is the primary and secondary etiologies of metabolic encephalopathy?
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Primary: hypoxia
Secondary: hypoglycemia, hypernatremia, hypo/hypercalcemia, hypomagnesium, kidney/liver dysfunction |
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What are the gross and microscopic changes seen in hypoic metabolic encephatlopathy?
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Gross: cortical atrophy
Micro: neuronal necrosis in vulnerable aras (hypothalamus, purkinje cells, etc) |
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What are the microscopic changes seen in B1/Thymine deficiency?
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- hemorrhages in thalamus, mamillary, walls of thalamus, perventricular gray, floor of the 4th ventricle
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What is the triad seen in WErnicke's Encephalopathy due to B1 deficiency?
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1. confusion (walls of 3rd)
2. gait instability (floor of the 4th) 3. ocular defects (CN 3,4,6) |
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B1/Thiamine deficiency most often seen in?
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alcoholics
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What is Korsacoff psychosis?
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impaired recent memories and polyneuropathy seen after Wernicke's Encephalopathy (sometimes)
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What is the pathological cause of B12/Cyanocobalamin deficiency?
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- loss of intrinsic factor and inability to absorb B12
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What are the 2 pathological symptoms seen with B12 deficiency
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- MAcrocytic anemia
- neuro symptoms that involve posterior and lateral columns |
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What are the first signs and progressive neuro symptoms seen in B12 deficiency?
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Primary: decrease vibratory/position sense in extremities, stiffness/babinksi, hyperreflexia
Later: encephalopathy and decrease in vision (lose myelin) |
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What is the pathological different of toxic disorders vs metabolic/nutrtion?
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- bilateral findings that may be assymetric
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Describe lead toxicity
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- attacks immature endothelial cells
- metabolic encephalopathy |
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Describe mercury toxicity
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- impaires neuronal ribosomes which causes the granular layer of the cerebellum to be lost
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Describe MPTP toxicity
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- toxic to dopaminergic cells
- parkinson disease |
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Describe what happens with toxic levels of phenytoin
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-impaires cerebellar neurons
- nystagmus and cerebellar dysfunction |
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Describe what happens in Clostritidum tetani toxcity
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- travels up peripheral nerves to anterior horn cells
- blocks inhibitory interneurons causing spasms |
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Describe what happens in Botulinum toxin
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- prevents release of ACh from peripheral nerves
- Descending paralysis |
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Describe what happens in diptheria
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- attacks Schwann cells
- neuropathy of pharynx and can progress to limbs |
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Describe what happens when consume Jimson Weed
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- muscarinic parasympathetic Neumuscular junction block (like atropine)
- mydriatic that does not respond to pilocarpine |
