1 / 13

Neuropathology Review Questions

Neuropathology Review Questions. 11/2/2012. Match the metal with the toxicity or description. Mees ’ transverse white lines on fingernails Psychological dysfunction Parkinson’s symptoms Red blood cell basophilic stippling Brain levels increased by dimercaprol (BAL)

remy
Download Presentation

Neuropathology Review Questions

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Neuropathology Review Questions 11/2/2012

  2. Match the metal with the toxicity or description Mees’ transverse white lines on fingernails Psychological dysfunction Parkinson’s symptoms Red blood cell basophilic stippling Brain levels increased by dimercaprol (BAL) Symptoms improve with L-dopa Increased urine coproporphyrin Penicillamine and BAL are used in treatment • Arsenic • Lead • Mercury • Manganese Arsenic Mercury Manganese Lead Mercury Manganese Lead Lead

  3. Arsenic • Acute intoxication • Encephalopathy • Peripheral neuropathy • Abdominal pain • Nausea/vomiting • Diarrhea • Shock • Chronic intoxication • Malaise • Mees lines • Increased pigment & hyperkeratosis • From insecticides • Detect in hair & urine • Treat with (BAL)

  4. Lead • Kids • Encephalopathy • Adults • Motor demyelinating peripheral neuropathy (wrist drop) • Anemia • Gingival lead line • Diagnosis • Erythrocyte basophilic stippling • Long bone metaphyseal lead lines • Serum lead level • Increased urine proporhyrin & delta-aminolevulinic acid • Treatment • EDTA • BAL • Penicillamine

  5. Mercury • Symptoms • Psychologic dysfunction • Tremor, movement disorder, cerebellar signs • Peripheral neuropathy • GI dysfunction • Rental tubular necrosis • From contaminated fish & felt hat dyes • Treatment • Penicillamine • BAL increases brain levels

  6. Manganese • Miners • Symptoms • Parkinsonianism • Psychologic disorders • Headache • Neuronal loss & gliosis in pallidum & striatum • Treatment • L-Dopa • Chelators do not help

  7. Match the vitamin with is deficiency or toxicity • Wernicke’s encephalopathy • Korsakoff’s psychosis • Pellegra • Beriberi • Seen in rice eaters • Seen in corn eaters • Rickets • Pernicious Anemia • Subacute combined degeneration • Pseudotumor Thiamine • Thiamine • Niacin • Vitamin B12 • Vitamin A • Vitamin D Thiamine Niacin Thiamine Thiamine Niacin Vitamin D Vitamin B12 Vitamin B12 Vitamin A

  8. Thiamine • Deficiencies • Alcoholics • GI tumors • Dialysis • TPN • Gastric Plication • Europeans • Involved in carbohydrate metabolism (transketolase) • High transketolase activity in mamillary bodies

  9. Wernicke Encephalopathy • Signs • Conjugate gaze & lateral rectus palsy • Nystagmus • Gait ataxia • Confusion • Affected areas • Mammilary bodies • Mediodorsal nucleus of thalamus • Periaqueductal gray • Floor of 4th ventricle (dorsal motor nuclei of X, vestibular nuclei) • Superior cerebellarvermis • Path findings • Brown-gray discoloration • Edema • Hemorrhage • Loss of purkinje cells • Reactive astrocytosis • Lab findings • Increased pyruvate & thymidinetriphosphate • Decreased transketolase

  10. Korsakoff Psychosis & Beriberi • Korsakoff • Chronic disorder • Deterioration in memory • Lesions in dorsomedial thalamus • Beriberi • Common in rice eaters (refined) • Peripheral neuropathy • Autonomic dysfunction • Heart disease

  11. Niacin • Common in corn eaters (tryptophan deficiency) • Deficiency causes pellagra • Dermatitis • Dementia • Diarrhea • Similar syndrome caused by carcinoid tumors

  12. Vitamin B12 • Deficiency causes • Pernicious anemia • Tumors • Infection • Parasites • Nitrous Oxide • Signs & Symptoms • Megaloblastic anemia • Glossitis • Anorexia • Diarrhea • Impaired vibration sense, proprioception, paraplegia • Spinal Cord Involvement • Subacute combined degeneration • Lower C-Spine/Upper T-Spine posterior & lateral columns • Spongiform demyelination • Diagnosis • Hypersegmented PMNs • B12 assay • Increased methylmalonic acid & homocysteine

  13. Others • Vitamin A • Deficiency: decreased vision • Toxicity: pseudotumor & increased ICP • Vitamin B6 • Deficiency: lower limb paresthesia, pain & weakness • Vitamin D • Deficiency: Rickets, decreased bone strength • Vitamin E • Deficiency: thick dystrophic axons in posterior columns, polyneuropathy.

More Related