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23 Cards in this Set

  • Front
  • Back
Key points of MS
- autoimmune demyelinating disorder
- white matter lesions separated in TIME and SPACE
Immune causality of MS
-CD4 Th1 cells that react against self myelin antigens and secrete cytokines (i-gamma) that activate macrophages = eat the myelin
Localizations of MS plaques
near lateral ventricles, optic nerves/chiasm, brainstem tracts, cerebellum, spinal cord
Active plaques
Plenty of debris, macrophages, inflammatory infiltrate, perivascular cuff
Inactive plaques
No myelin, almost no oligodendrocytes, prominent gliosis
Shadow plaques
No sharp demarcation, either no progression or some recovery and remyelination of thin sheaths.
Optic (retrobulbar) neuritis
Sequelae of MS, unilateral vision loss early in disease
CSF finding in MS (common, not diagnostic)
Oligoclonal bands (and therefore elevated gamma globulin)
Neuromyelitis Optica (Devic)
MS variant involving bilateral optic tract and extreme spinal cord degen (even grey matter)
Marburg MS
Attacks the young, fulminant, swiftly fatal with prominent plaques
(Acute Disseminating Encephalomyelitis) Monophasic, follows a viral infxn or immunization. Kills approximately 20% with widespread brain involvement. The rest recover fully
(Acute Necrotizing Hemorrhagic Encephalomyelitis) Preceded by URI from mycoplasma pneumoniae. Considerably fatal.
Loss of myelin in basis pontis
Central pontine myelinolysis. Caused by rapid correction of hyponatremia. Rapid quadriplegia in setting of alcoholism, electrolyte imbalance, orthotopic liver transplantation
What is a leukodystrophy, by definition?
A genetically caused myelin disorder: abnormal synthesis or turnover
Krabbe Disease
Deficiency in galactocerebroside catabolism. Not toxic, the alternate pathway is deadly. Hits children after 3rd month, motor deficits followed by oligodendrocyte degeneration. Dead in 2 yrs.
Morphology of Krabbe disease?
Globoid cells around blood vessels.
Metachromatic Leukodystrophy
Accumulate sulfatides: infantile onset with death in 5-10 years. Adult disease is slower. Demyelination with gliosis, one color in most dye preps (hence, metachrome)
Myelin loss and adrenal atrophy
Adrenoleukodystrophy. In children it is rapidly fatal, in adults it is peripheral and takes decades. X-linked. VLCFA accumulation.
Hepatic encephalopathy
Liver disease leads to liver failure, astrocytes take on Alzheimer's 2 characteristics in basal ganglia and cortex
Encephalopathies caused by alcoholism
Cerebellar atrophy, cerebral atrophy, Wernick's encephalopathy, fetal alcohol syndrome
Thiamine deficiency (due to alcoholism, starvation, IV feeding, etc) causes . . .?
Wernicke's encephalopathy: degradation of hypothalamus/mamillary bodies: active psychosis
Wernicke-Korsakoff syndrome
Long-term sequelae of Wernicke's encephalopathy: opthamaloplegia, nystagmus, ataxia, confusion, coma, psychotic behavior, antegrade episodic memory loss, confabulation, amnesia
Carbon monoxide poisoning breaks down what part of the brain?
Globus Pallidus