Genetics of Neurofibromatosis Quiz
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Questions and Answers

What is the primary genetic cause of the disease described?

  • Chromosomal abnormalities on chromosome 22
  • Germline mutations in the TP53 gene
  • Mutations in the NF2 gene
  • Loss-of-function mutations in the NF1 gene (correct)
  • Which of the following tumors is NOT typically associated with the disease?

  • Meningiomas
  • Osteosarcomas (correct)
  • Ependymomas
  • Schwannomas
  • What is a hallmark symptom associated with the disease referenced?

  • Bilateral acoustic neuromas
  • Chronic headaches
  • Peripheral nerve sheath tumors
  • Neurofibromas of all types (correct)
  • How frequently do Malignant Peripheral Nerve Sheath Tumors (MPNST) occur in comparison to NF1?

    <p>1 in 40,000 to 50,000 (D)</p> Signup and view all the answers

    Which genetic defect influences the lack of neurofibromin in neoplastic cells?

    <p>Biallelic defects in the NF1 gene (C)</p> Signup and view all the answers

    What is the primary target of damage in peripheral neuropathies related to demyelination?

    <p>Axons (C)</p> Signup and view all the answers

    Which pattern of nerve damage is characterized by the degeneration of myelin without affecting the axon itself?

    <p>Acute demyelinating disease (C)</p> Signup and view all the answers

    What electrophysiologic hallmark is associated with axonal neuropathies?

    <p>Reduction in signal amplitude (B)</p> Signup and view all the answers

    In the context of demyelination, what typically happens to the longest axons during toxic and metabolic insults?

    <p>They are most susceptible to degeneration (A)</p> Signup and view all the answers

    What is the fate of myofibers that are denervated following acute axonal injury?

    <p>They undergo atrophy (C)</p> Signup and view all the answers

    After axonal injury, what characteristic is true about the regenerated axons?

    <p>They are shorter and myelinated by fewer Schwann cells (C)</p> Signup and view all the answers

    In a biopsy of a patient with chronic demyelinating disease, which finding would you expect?

    <p>Random segmental degeneration of myelin internodes (B)</p> Signup and view all the answers

    What is a critical aspect of Alzheimer's disease pathogenesis that remains partially understood?

    <p>The interaction between plaques and tangles (C)</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with the progression of Alzheimer's disease?

    <p>Improvement in communication skills (B)</p> Signup and view all the answers

    What primary factor contributes to the onset of vascular dementia?

    <p>Disruption of the brain's blood supply (D)</p> Signup and view all the answers

    Which of the following is a common cognitive deficit observed in individuals with vascular dementia?

    <p>Difficulty planning and organizing (D)</p> Signup and view all the answers

    According to the clinical manifestations of Alzheimer's disease, which of the following is a late-stage symptom?

    <p>Loss of the ability to ambulate (A)</p> Signup and view all the answers

    What symptom might develop in the early stages of vascular dementia?

    <p>Short periods of confusion (B)</p> Signup and view all the answers

    What is the typical female-to-male ratio in young adults with myasthenia gravis?

    <p>2:1 (C)</p> Signup and view all the answers

    Which symptom is more likely to be seen in vascular dementia rather than Alzheimer's disease?

    <p>Visual orientation problems (C)</p> Signup and view all the answers

    Which of the following describes how vascular dementia can present in an individual?

    <p>Symptoms that vary based on brain areas affected (C)</p> Signup and view all the answers

    What percentage of patients with myasthenia gravis have autoantibodies against postsynaptic ACh receptors?

    <p>85% (B)</p> Signup and view all the answers

    Which symptom is most commonly associated with the involvement of extraocular muscles in myasthenia gravis?

    <p>Diplopia (B)</p> Signup and view all the answers

    What is the expected trajectory of an individual suffering from Alzheimer's disease over 5 to 10 years?

    <p>Becoming progressively disabled and mute (C)</p> Signup and view all the answers

    How is myasthenia gravis primarily diagnosed?

    <p>Clinical history and physical findings (A)</p> Signup and view all the answers

    What is the predominant effect of anti–ACh receptor antibodies in myasthenia gravis?

    <p>Destruction of postsynaptic membranes (A)</p> Signup and view all the answers

    In myasthenia gravis, what motor response change is observed during electrophysiologic studies?

    <p>Decrement in muscle response with repeated stimulation (C)</p> Signup and view all the answers

    What distinguishes myasthenia gravis from myopathies in terms of muscle involvement?

    <p>Involvement of extraocular muscles (D)</p> Signup and view all the answers

    What type of tumor is commonly found in approximately 10% of patients with myasthenia gravis?

    <p>Thymoma (B)</p> Signup and view all the answers

    What is a characteristic manifestation of dermatomyositis?

    <p>Proximal muscle weakness (A)</p> Signup and view all the answers

    What is the primary action of autoantibodies directed against muscle-specific receptor tyrosine kinase?

    <p>Interfering with receptor clustering (D)</p> Signup and view all the answers

    What is a common initial manifestation of multiple sclerosis (MS)?

    <p>Optic neuritis (C)</p> Signup and view all the answers

    Which of the following is a characteristic feature of Parkinson's disease?

    <p>Dopamine deficiency in the basal ganglia (C)</p> Signup and view all the answers

    What percentage of individuals with an episode of optic neuritis may develop multiple sclerosis?

    <p>10% to 50% (D)</p> Signup and view all the answers

    In the context of MS, what does the term 'secondary axon loss' refer to?

    <p>Progressive accumulation of neurological deficits (A)</p> Signup and view all the answers

    What is the primary treatment approach for Parkinson's disease?

    <p>Restoration of brain dopamine levels (C)</p> Signup and view all the answers

    Which neurological manifestation is commonly associated with spinal cord lesions in MS?

    <p>Loss of bladder control (D)</p> Signup and view all the answers

    What morphological feature is indicative of Parkinson's disease?

    <p>Lewy bodies (B)</p> Signup and view all the answers

    Which of the following statements about the relapsing-remitting course of MS is true?

    <p>It usually results in eventual progressive neurological deterioration. (C)</p> Signup and view all the answers

    What symptom is associated with the involvement of the brainstem in MS?

    <p>Cranial nerve signs (A)</p> Signup and view all the answers

    Parkinson's disease is most directly characterized by a deficit in which neurotransmitter?

    <p>Dopamine (D)</p> Signup and view all the answers

    What primarily distinguishes a coup injury from a contrecoup injury?

    <p>The immobility of the head at the time of impact. (B)</p> Signup and view all the answers

    What condition is classified as a transient ischemic event?

    <p>Neurologic symptoms that resolve within 24 hours. (B)</p> Signup and view all the answers

    Which imaging technique is primarily used to diagnose cerebrovascular accidents (CVA)?

    <p>Computed Tomography (CT) (B)</p> Signup and view all the answers

    What is a significant consequence of a sudden occlusion of a cerebral artery?

    <p>Focal cerebral ischemia leading to localized tissue infarction. (C)</p> Signup and view all the answers

    Which of the following is a common clinical manifestation of a cerebrovascular accident?

    <p>Contralateral hemiplegia and hemisensory loss. (B)</p> Signup and view all the answers

    Which factor significantly increases the risk of thrombotic strokes?

    <p>Atrial fibrillation and cardiac dysrhythmias. (A)</p> Signup and view all the answers

    What is the primary pathological mechanism underlying both ischemic and hemorrhagic strokes?

    <p>Alteration in blood flow leading to brain injury. (A)</p> Signup and view all the answers

    What is the primary role of osteoblasts in bone tissue?

    <p>Synthesize and regulate mineralization of the matrix (A)</p> Signup and view all the answers

    Which type of synoviocyte is responsible for synthesizing hyaluronic acid and various proteins?

    <p>Type B synoviocytes (A)</p> Signup and view all the answers

    What component of hyaline cartilage primarily helps resist tensile stresses?

    <p>Type II collagen (C)</p> Signup and view all the answers

    Which cytokines are mentioned as being released by various cells and contributing to the degradative processes in joint diseases?

    <p>IL-1 and TNF (C)</p> Signup and view all the answers

    What is the main function of hyaline articular cartilage in synovial joints?

    <p>Protect the articular surface and provide a lubricated surface for movement (C)</p> Signup and view all the answers

    Which characteristic is NOT typically associated with ankylosing spondylitis?

    <p>Low back pain that worsens with activity (A)</p> Signup and view all the answers

    What common feature of Ehlers-Danlos Syndromes is characterized by abnormal collagen synthesis?

    <p>Skin hyperextensibility (D)</p> Signup and view all the answers

    Which condition typically shows HLA-B27 positivity in approximately 90% of patients?

    <p>Ankylosing spondylitis (A)</p> Signup and view all the answers

    Which symptom is most characteristic of Ehlers-Danlos Syndromes?

    <p>Hypermobile joints (D)</p> Signup and view all the answers

    Which statement about the genetic factors in Ehlers-Danlos Syndromes is true?

    <p>They involve mutations in genes that encode collagen or related proteins. (C)</p> Signup and view all the answers

    What physical manifestation is commonly observed in individuals with Ehlers-Danlos Syndromes?

    <p>Joint dislocations (C)</p> Signup and view all the answers

    In which age group is ankylosing spondylitis most frequently diagnosed?

    <p>20s to 30s (A)</p> Signup and view all the answers

    Which of the following joints is least likely to be involved in ankylosing spondylitis?

    <p>Fingers (A)</p> Signup and view all the answers

    What is a common characteristic of both ankylosing spondylitis and Ehlers-Danlos Syndromes?

    <p>Involvement of the hip joints (C)</p> Signup and view all the answers

    What is the primary mechanism that causes seizures in epilepsy?

    <p>Alteration in membrane potential leading to neuronal hyperactivity (A)</p> Signup and view all the answers

    Which seizure type is characterized by a loss of body tone and might lead to falls?

    <p>Atonic seizure (A)</p> Signup and view all the answers

    What distinguishes complex partial seizures from simple partial seizures?

    <p>Change in consciousness (A)</p> Signup and view all the answers

    What are the hallmark pathologic findings in Alzheimer's disease?

    <p>Amyloid plaques and neurofibrillary tangles (B)</p> Signup and view all the answers

    What condition describes a prolonged series of seizures without recovery?

    <p>Status epilepticus (B)</p> Signup and view all the answers

    What is a common trigger for seizures in individuals with epilepsy?

    <p>Flashing lights or loud noises (D)</p> Signup and view all the answers

    Which statement accurately describes absence seizures?

    <p>They usually manifest as staring spells lasting only seconds. (B)</p> Signup and view all the answers

    Which risk factor is NOT associated with the development of epilepsy?

    <p>Exposure to sunlight (A)</p> Signup and view all the answers

    What describes the characteristics of myoclonic seizures?

    <p>Multiple jerking movements, either single or several (C)</p> Signup and view all the answers

    What percentage of Ewing sarcoma patients are typically younger than 20 years of age?

    <p>80% (B)</p> Signup and view all the answers

    What is a characteristic feature of Ewing sarcoma as seen in radiographs?

    <p>Destructive lytic tumor with moth-eaten margins (C)</p> Signup and view all the answers

    Which gene is predominantly involved in Ewing sarcoma tumors?

    <p>EWSR1 (D)</p> Signup and view all the answers

    What type of cells characterizes the malignant bone tumor known as Ewing sarcoma?

    <p>Primitive round cells without obvious differentiation (A)</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with Ewing sarcoma?

    <p>Rapid bone growth (D)</p> Signup and view all the answers

    Which demographic is affected more often by Ewing sarcoma?

    <p>Caucasian descent (D)</p> Signup and view all the answers

    What pattern is characteristic of the periosteal reaction in Ewing sarcoma?

    <p>Laminated or onion-skin fashion (A)</p> Signup and view all the answers

    In which bones is Ewing sarcoma most commonly found?

    <p>Diaphysis of long tubular bones (A)</p> Signup and view all the answers

    What is the age range for the typical presentation of Ewing sarcoma?

    <p>5 - 25 years (B)</p> Signup and view all the answers

    Which of the following is a common presenting symptom of Ewing sarcoma?

    <p>Localized tenderness and swelling (B)</p> Signup and view all the answers

    What effect does Paget disease have on bone matrices?

    <p>Thickens but disorganizes and softens (C)</p> Signup and view all the answers

    Which condition is the most serious complication associated with Paget disease?

    <p>Sarcoma development (D)</p> Signup and view all the answers

    What initial phase characterizes the progression of Paget disease?

    <p>Excessive bone resorption by osteoclasts (D)</p> Signup and view all the answers

    What diagnostic feature is commonly associated with Paget disease seen on radiographs?

    <p>Enlarged bones with thick, coarsened cortices (C)</p> Signup and view all the answers

    What is the expected serum level profile in individuals affected by Paget disease?

    <p>Normal serum calcium and phosphate with elevated alkaline phosphatase (C)</p> Signup and view all the answers

    What is the most sensitive indicator of altered brain function after an injury?

    <p>Loss of consciousness (D)</p> Signup and view all the answers

    What distinguishes a coup injury from a contrecoup injury?

    <p>Location of impact on the brain (C)</p> Signup and view all the answers

    Which of the following factors is crucial for diagnosing a traumatic brain injury (TBI)?

    <p>Time of injury (D)</p> Signup and view all the answers

    Which pupil reflex change early after a brain injury might indicate increased intracranial pressure (ICP)?

    <p>Dilation of one pupil (B)</p> Signup and view all the answers

    What does the absence of a corneal reflex indicate in a brain-injured person?

    <p>Severely impaired brain function (B)</p> Signup and view all the answers

    What is indicated by a Glasgow Coma Scale (GCS) score of 9 to 12?

    <p>Moderate brain injury (B)</p> Signup and view all the answers

    Which type of intracranial injury is characterized by a localized collection of blood within the cranium?

    <p>Intracranial hematoma (A)</p> Signup and view all the answers

    What is the primary role of active vitamin D in the body?

    <p>Raising serum calcium and phosphate levels (C)</p> Signup and view all the answers

    Which condition develops specifically in growing children due to defective bone mineralization?

    <p>Rickets (A)</p> Signup and view all the answers

    Which of the following symptoms is not typically associated with osteomalacia in adults?

    <p>Knock knee deformity (D)</p> Signup and view all the answers

    What common dietary deficiency can lead to vitamin D deficiency, potentially resulting in osteomalacia?

    <p>Deficient calcium and vitamin D intake (C)</p> Signup and view all the answers

    What is a physiological response triggered by low serum calcium levels due to vitamin D deficiency?

    <p>Increased secretion of parathyroid hormone (B)</p> Signup and view all the answers

    Which statement best describes the difference between myelomeningocele and meningocele?

    <p>Myelomeningocele involves CNS tissue extension through vertebral defects, while meningocele involves only meningeal extrusion. (B)</p> Signup and view all the answers

    In which anatomical areas might significant deformation occur as a result of rickets?

    <p>Occipital and parietal bones (C)</p> Signup and view all the answers

    What is the primary pathogenic mechanism involved in spina bifida?

    <p>Primary bony defects caused by abnormal axial mesoderm development. (B)</p> Signup and view all the answers

    Which condition is characterized by a decrease in serum calcium, phosphate, and an increase in alkaline phosphatase?

    <p>Osteomalacia (B)</p> Signup and view all the answers

    In which region of the body do myelomeningoceles most frequently occur?

    <p>Lumbosacral region (A)</p> Signup and view all the answers

    Which of the following best characterizes the clinical features associated with spina bifida?

    <p>Motor and sensory deficits occur primarily in the lower extremities. (C)</p> Signup and view all the answers

    What is the consequence of prolonged vitamin D deficiency in adults?

    <p>Bone softening (D)</p> Signup and view all the answers

    Which of the following statements correctly describes the differences in bone conditions between osteomalacia and rickets?

    <p>Rickets affects growing bones while osteomalacia affects already developed bones (D)</p> Signup and view all the answers

    Which of the following is true regarding the ethnic prevalence of neural tube defects?

    <p>The frequency varies widely among different ethnic groups. (B)</p> Signup and view all the answers

    What non-dietary factor commonly contributes to vitamin D deficiency?

    <p>Limited exposure to sunlight (B)</p> Signup and view all the answers

    Which of the following accurately describes anencephaly?

    <p>It leads to the absence of most of the brain and calvarium. (C)</p> Signup and view all the answers

    Which aspect of Amyotrophic Lateral Sclerosis (ALS) is primarily affected?

    <p>Both upper and lower motor neurons are affected. (B)</p> Signup and view all the answers

    What is a common complication associated with myelomeningocele due to infection risk?

    <p>Superimposed infection of the spinal cord. (D)</p> Signup and view all the answers

    Which factor contributes to the recurrence rate of neural tube defects in subsequent pregnancies?

    <p>A previous pregnancy with a neural tube defect increases risk. (B)</p> Signup and view all the answers

    Which of the following accurately describes the typical progression of joint involvement in hematogenous osteomyelitis?

    <p>Usually progresses from small joints to larger joints (A)</p> Signup and view all the answers

    What is a key characteristic of pannus formation in rheumatoid arthritis?

    <p>It leads to erosion of articular cartilage and bone erosion (B)</p> Signup and view all the answers

    In the context of osteoporosis, what differentiates it from osteopenia?

    <p>Osteoporosis significantly increases fracture risk due to severe osteopenia (C)</p> Signup and view all the answers

    Which of the following is a common radiographic finding in rheumatoid arthritis?

    <p>Joint effusions and juxta-articular osteopenia (C)</p> Signup and view all the answers

    What is a consequence of recurrent vertebral fractures in osteoporosis?

    <p>Loss of height and spinal deformities (C)</p> Signup and view all the answers

    Which statement is true about the initial symptoms of hematogenous osteomyelitis in children?

    <p>Malaise, fatigue, and generalized musculoskeletal pain are common (B)</p> Signup and view all the answers

    In osteoporotic patients, which regions are most commonly affected by fractures?

    <p>Thoracic and lumbar regions (B)</p> Signup and view all the answers

    What is a typical manifestation of chronic rheumatoid arthritis affecting the hand?

    <p>Flexion-hyperextension deformities like swan-neck and boutonnière (D)</p> Signup and view all the answers

    Which clinical feature is typically seen in patients with chronic arthritis?

    <p>Progressive joint enlargement and decreased range of motion (A)</p> Signup and view all the answers

    Which condition is characterized by a decrease in bone mass without yet being severe enough to increase fracture risk?

    <p>Osteopenia (A)</p> Signup and view all the answers

    What is the best timing for making a TBI diagnosis to ensure accuracy?

    <p>Within the first 24 hours (A)</p> Signup and view all the answers

    Which condition reflects a significant indicator of altered brain function?

    <p>Change in level of consciousness (B)</p> Signup and view all the answers

    What characterizes a contrecoup injury compared to a coup injury?

    <p>Injury occurs on the opposite side of impact (A)</p> Signup and view all the answers

    What does an absence of the corneal reflex indicate?

    <p>Severely impaired brain function (D)</p> Signup and view all the answers

    What condition is characterized by a localized collection of blood within the cranium?

    <p>Intracranial hematoma (A)</p> Signup and view all the answers

    Which pupil reflex abnormality could indicate potential brain herniation?

    <p>Unequal pupil size or shape (C)</p> Signup and view all the answers

    What type of injury results from a loss of consciousness during a fall?

    <p>Frontal or occipital impact (C)</p> Signup and view all the answers

    What is a significant complication associated with Paget disease that affects the prognosis?

    <p>Sarcoma transformation (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the bone characteristics in Paget disease?

    <p>Pagetic bone is enlarged with thick, coarsened cortices (B)</p> Signup and view all the answers

    Elevated serum alkaline phosphatase levels in Paget disease indicate what about the bone activity?

    <p>Increased osteoblast activity (D)</p> Signup and view all the answers

    How does Paget disease typically progress over time?

    <p>Slowly progressive with alternating phases of bone resorption and formation (B)</p> Signup and view all the answers

    Which geographic and demographic trend is associated with Paget disease?

    <p>Relatively common among Caucasians in Western countries (C)</p> Signup and view all the answers

    What condition develops after repeated head trauma and is characterized by tau-containing neurofibrillary tangles?

    <p>Chronic traumatic encephalopathy (C)</p> Signup and view all the answers

    Which of the following describes the loss of visual field on the paralyzed side following a cerebrovascular accident?

    <p>Homonymous hemianopsia (D)</p> Signup and view all the answers

    Which intervention should be initiated during the acute phase of recovery from motor deficits?

    <p>Active/passive range of motion exercises (B)</p> Signup and view all the answers

    What is the primary cause of posttraumatic hydrocephalus?

    <p>Obstruction of CSF resorption (D)</p> Signup and view all the answers

    What common sensory disturbance may occur in conjunction with motor paralysis after a stroke?

    <p>Visual impairment (A)</p> Signup and view all the answers

    What term is used to describe the phenomenon of elevated intracranial pressure resulting from brain injury?

    <p>Cerebral edema (D)</p> Signup and view all the answers

    What neurological event is characterized by paroxysmal abnormal or excessive electrical discharges?

    <p>Seizure disorder (C)</p> Signup and view all the answers

    What is the typical manifestation of chronic traumatic encephalopathy observed in brain imaging?

    <p>Atrophy with enlarged ventricles (D)</p> Signup and view all the answers

    What facilitates the rehabilitation process for patients recovering from motor deficits?

    <p>Maintaining body alignment (A)</p> Signup and view all the answers

    Which type of seizure is characterized by a series of seizures with no recovery period?

    <p>Status epilepticus (C)</p> Signup and view all the answers

    What is a common manifestation of generalized seizures that involves loss of consciousness?

    <p>Tonic-clonic seizures (A)</p> Signup and view all the answers

    Which factor is NOT recognized as a risk factor for developing seizures?

    <p>Age at onset (A)</p> Signup and view all the answers

    What is the primary pathological feature of Alzheimer's disease?

    <p>Accumulation of amyloid plaques and neurofibrillary tangles (C)</p> Signup and view all the answers

    In the context of seizures, what is the term for the subjective sense of an impending seizure?

    <p>Aura (C)</p> Signup and view all the answers

    Which type of seizure involves no alteration in consciousness and can have motor or sensory symptoms?

    <p>Simple partial seizures (C)</p> Signup and view all the answers

    Which of the following accurately describes atypical absence seizures?

    <p>Accompanied by myoclonic jerks and automatism (A)</p> Signup and view all the answers

    Which statement accurately describes the role of tau protein in Alzheimer's disease?

    <p>It aggregates to form neurofibrillary tangles intracellularly. (C)</p> Signup and view all the answers

    What is the altered state of consciousness following an epileptic seizure called?

    <p>Postictal state (A)</p> Signup and view all the answers

    Which seizure type is characterized by muscle jerking without a loss of consciousness?

    <p>Myoclonic seizures (B)</p> Signup and view all the answers

    What primary dysfunction results from the presence of anti-ACh receptor antibodies in myasthenia gravis?

    <p>Degradation and aggregation of ACh receptors (C)</p> Signup and view all the answers

    Which clinical manifestation is most indicative of myasthenia gravis as compared to other myopathies?

    <p>Ptosis and diplopia (D)</p> Signup and view all the answers

    In which age group is the female-to-male ratio for myasthenia gravis predominantly 2:1?

    <p>Young adults (C)</p> Signup and view all the answers

    What is a characteristic finding on electrophysiologic studies for diagnosing myasthenia gravis?

    <p>Decrement in muscle response with repeated stimulation (C)</p> Signup and view all the answers

    What abnormality is approximately found in 10% of patients with myasthenia gravis?

    <p>Thymoma (A)</p> Signup and view all the answers

    Which mechanism is primarily attributed to autoantibodies against muscle-specific receptor tyrosine kinase?

    <p>Disruption of ACh receptor trafficking (B)</p> Signup and view all the answers

    What is the primary impact of postsynaptic membrane alterations due to anti-ACh receptor antibodies?

    <p>Decreased response of myofibers to ACh (B)</p> Signup and view all the answers

    What symptom commonly occurs in patients with antibodies against muscle-specific receptor tyrosine kinase?

    <p>Focal muscle weakness in specific muscle groups (C)</p> Signup and view all the answers

    What type of muscle weakness is typically observed in dermatomyositis?

    <p>Proximal muscle weakness (A)</p> Signup and view all the answers

    What fundamental difference distinguishes myasthenia gravis from typical myopathies regarding muscle involvement?

    <p>Myasthenia gravis involves extraocular muscles more commonly. (B)</p> Signup and view all the answers

    Flashcards

    Demyelination Definition

    Loss of myelin sheath around nerve fibers. This affects the nerve's ability to transmit signals.

    Axonal Neuropathies

    Damage to the axons of nerve cells. This often leads to progressive loss of axons.

    Electrophysiologic Hallmark of Axonal Neuropathies

    Reduced signal amplitude (lower signal strength) due to lost axons in peripheral nerves, despite relatively normal conduction speed.

    Acute Demyelinating Disease

    Sudden damage to the myelin sheaths surrounding nerve fibers. Usually affecting isolated segments of the nerve internodes.

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    Peripheral Nerve Damage Patterns

    Patterns of injury in peripheral nerve fibers: normal axons in motor units are arranged checkerboard style, acute axons lose distal parts and myelin, and acute demyelinating disease targets myelin segments, sparing axons

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    Axon Regeneration

    Regrowth of damaged axons; myelination occurs with Schwann cells but the new myelin, while functioning, may be shorter and thinner, compared to original.

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    Dying-Back Pattern

    Degeneration of longer axons first, in cases of toxic or metabolic insults; like a chain reaction, starting from the long ends and progressively deteriorating towards the core.

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    Alzheimer's Disease

    A progressive brain disorder characterized by plaque and tangle accumulation, leading to cognitive decline and dysfunction.

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    Plaques and Tangles

    Abnormal protein aggregates in the brain associated with Alzheimer's Disease.

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    AD Pathogenesis

    The process of development of Alzheimer's disease.

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    Symptoms of AD (Progressing)

    Increasing difficulties with judgment, thinking, problem-solving, communication, daily living, swallowing, and weight loss. Personality and behavioral changes also occur.

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    Vascular Dementia

    Dementia caused by disrupted blood flow to the brain.

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    Vascular Dementia Symptoms

    Include difficulties with memory, thinking, behavior, reading, writing, interest, personality, planning, attention, calculations, problem-solving, and possibly visual issues and motor skill impairments.

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    Dementia

    A group of brain disorders causing progressive decline in memory and other cognitive abilities.

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    Vascular Dementia vs. Other Dementias

    Vascular dementia can occur alone or with other types of dementia, such as Alzheimer's.

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    Clinical Manifestations (AD)

    Gradual emergence of memory, visuospatial, judgment, personality and language deficits, leading to severe disability, muteness, and immobility over a 5-10 year period.

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    MS relapses

    Episodes of worsening neurological symptoms in Multiple Sclerosis (MS).

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    MS neurologic deterioration

    A gradual worsening of neurological function in MS patients.

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    Optic neuritis

    Inflammation of the optic nerve, causing visual problems.

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    Parkinson's Disease (PD)

    Neurodegenerative disorder impacting movement and often leading to dementia.

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    Dopamine deficiency

    Lower than normal levels of dopamine in the brain.

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    Lewy bodies

    Abnormal protein deposits found in the brain.

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    Basal Ganglia

    Group of structures within the brain controlling movement.

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    Multiple Sclerosis

    Autoimmune disease that damages myelin in the CNS.

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    CNS demyelination

    Damage to the insulating layer (myelin) of nerve cells in the central nervous system.

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    PD motor impairments

    Symptoms in Parkinson's Disease affecting movement.

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    Myasthenia Gravis (MG)

    An autoimmune disease where antibodies attack acetylcholine (ACh) receptors at the neuromuscular junction, leading to muscle weakness.

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    ACh Receptor Antibodies

    Antibodies that target and damage acetylcholine receptors, interfering with nerve signal transmission at the neuromuscular junction.

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    Muscle-Specific Receptor Tyrosine Kinase (MuSK)

    A protein found on the muscle surface that helps regulate ACh receptor function.

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    Complement Fixation

    Immune system response where antibodies trigger the destruction of cells or tissues by complement proteins.

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    Thymoma

    A tumor of the thymus gland, often associated with myasthenia gravis.

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    Clinical Manifestations of MG

    Symptoms of myasthenia gravis include fluctuating weakness, worsening with exertion, diplopia (double vision), ptosis (drooping eyelids), and generalized weakness.

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    Electrophysiologic Studies

    Tests that assess the electrical activity of nerves and muscles to help diagnose myasthenia gravis.

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    Decremental Response

    A characteristic finding in electrophysiologic studies of myasthenia gravis where muscle response weakens with repeated nerve stimulation.

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    Dermatomyositis

    A systemic autoimmune disease that affects muscles and skin, causing weakness, inflammation, and skin rashes.

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    Proximal Muscle Weakness

    Weakness in the muscles closer to the center of the body, such as the shoulders and hips.

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    NF1 Gene Mutation

    A change in the NF1 gene causes Neurofibromatosis type 1. It's a loss-of-function mutation, meaning the gene doesn't work properly.

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    Neurofibromin

    A protein encoded by the NF1 gene. It acts as a tumor suppressor, helping to control cell growth and development.

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    NF1-Related Tumors

    Tumors caused by the NF1 gene mutation. These tumors lack neurofibromin, leading to uncontrolled cell growth.

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    NF2 Gene Location

    The NF2 gene is located on chromosome 22q12. It's also commonly mutated in sporadic meningiomas and schwannomas.

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    Neurofibromatosis Type 2 (NF2)

    A genetic disorder caused by mutations in the NF2 gene. It is less common than NF1, affecting about 1 in 40,000 to 50,000 people.

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    Coup Injury

    A brain injury that occurs on the same side of the impact, usually when the head is immobile at the time of trauma.

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    Contrecoup Injury

    A brain injury that occurs on the opposite side of the impact, typically when the head is mobile and recoils after the initial impact.

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    Cerebrovascular Disease

    Conditions affecting the brain due to impaired blood flow, leading to tissue damage and potentially stroke.

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    Stroke

    A clinical term for a cerebrovascular event causing neurologic symptoms that persist beyond 24 hours.

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    Ischemic Stroke

    A stroke caused by blockage of a cerebral artery, depriving brain tissue of blood.

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    Hemorrhagic Stroke

    A stroke caused by bleeding into the brain tissue due to a ruptured blood vessel.

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    Transient Ischemic Attack (TIA)

    A temporary neurological deficit caused by a temporary disruption of blood flow to the brain, usually lasting less than 24 hours.

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    Collagen's Role

    Collagen acts as a 'glue' in the body, providing strength and elasticity to connective tissue.

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    Ehlers-Danlos Syndrome (EDS)

    A group of genetic disorders affecting collagen production, leading to weakened connective tissues.

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    What are the symptoms of EDS?

    Symptoms vary depending on the type of EDS, but commonly involve joint hypermobility, stretchy skin, and fragile blood vessels.

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    Ewing Sarcoma

    A type of malignant bone tumor characterized by primitive round cells.

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    Where does Ewing sarcoma occur?

    Most commonly found in the long bones, particularly the thighbone (femur) and pelvis.

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    Ewing Sarcoma Symptoms

    Painful swelling in the affected area, fever, weight loss, and elevated blood cell counts.

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    Ewing Sarcoma Radiographic Appearance

    X-rays show a destructive tumor with 'moth-eaten' edges that spread into surrounding tissues.

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    EWSR1 Gene

    The gene associated with Ewing sarcoma, encoding a protein that controls growth and differentiation.

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    Ewing Sarcoma Epidemiology

    Most often diagnosed between the ages of 5 and 25, and it's the second most common malignant bone tumor in children.

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    Common Sites of Ewing Sarcoma

    Frequently found in the spine, pelvis, chest, and limbs, with long bone diaphyses being the most common.

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    Ankylosing Spondylitis

    A chronic inflammatory disease that primarily affects the spine, causing inflammation and fusion of the joints, leading to stiffness and limited mobility.

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    Ankylosing Spondylitis Symptoms

    Low back pain that improves with exercise but not rest, severe morning stiffness lasting over 3 months, back pain at night, limited spinal movement, loss of lumbar curve, and possible inflammation in other joints like hips, knees, and shoulders.

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    HLA-B27 Connection?

    About 90% of people with Ankylosing Spondylitis are positive for the HLA-B27 gene. The exact role of this gene in causing the disease is unknown, but it seems linked to presenting specific antigens that may trigger the immune response.

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    EDS Impact on Body

    EDS affects tissues rich in collagen, like skin, ligaments, and joints. This leads to hypermobility (joints bending beyond normal range) and hyperextensibility (skin stretching excessively).

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    Classic EDS

    A type of EDS characterized by stretchy skin, hypermobile joints, and often accompanied by other issues like kyphoscoliosis (curvature of the spine) and digestive problems.

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    Kyphoscoliosis

    A spinal deformity involving both kyphosis (hunchback) and scoliosis (sideways curvature) often seen in individuals with Classic EDS.

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    Arthrochalasia

    A specific type of EDS with extremely loose joints and stretchy skin, often leading to dislocations and joint instability.

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    EDS: Defective Tissues

    The fragile tissues in EDS are a result of faulty collagen, which lacks proper tensile strength. The body cannot properly build and maintain strong, supportive tissues.

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    EDS: Fragile Tissues

    Individuals with EDS have a defect in their connective tissue, which supports many body parts like skin, muscles, and ligaments. This leads to fragile skin and unstable joints.

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    Epilepsy

    A brain disorder characterized by recurrent seizures caused by abnormal neuron activity.

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    Seizure Triggers

    Certain stimuli that can initiate a seizure. Common examples include flashing lights, fever, and loud noises.

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    Generalized Seizure

    A type of seizure where abnormal electrical activity affects the entire brain surface.

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    Simple Partial Seizure

    A type of seizure confined to one hemisphere where consciousness remains intact.

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    Osteoclasts

    Cells responsible for breaking down bone tissue. They attach to the matrix, create a sealed pit, and secrete acids and enzymes to dissolve bone components.

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    Osteoblasts

    Cells responsible for building bone tissue. They synthesize, transport, and assemble matrix components, regulating bone mineralization.

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    Complex Partial Seizure

    A type of seizure confined to one hemisphere where consciousness is altered.

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    Synovial Joints

    Joints that allow for a wide range of motion. They are found between bones formed by endochondral ossification, contain a joint space, and are strengthened by ligaments and muscles.

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    Status Epilepticus

    A life-threatening condition characterized by a series of seizures without recovery between episodes.

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    Hyaline Cartilage

    The most important structure in a synovial joint, composed of water, collagen, proteoglycans, and chondrocytes. Its primary function is to protect bone surfaces and provide a smooth, lubricated surface for joint movement.

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    Cytokines (IL-1 and TNF)

    These molecules, released by various cells, initiate degradative processes in articular cartilage. This can lead to damage and contribute to joint diseases.

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    Amyloid Plaques

    Deposits of aggregated Aβ peptides in the brain that contribute to Alzheimer's disease.

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    Neurofibrillary Tangles

    Aggregated microtubule binding protein tau that develop intracellularly and extracellularly after neuronal death, contributing to Alzheimer's disease.

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    TBI Diagnosis

    A traumatic brain injury (TBI) diagnosis is best made at the time of injury or within the first 24 hours.

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    LOC

    Level of consciousness (LOC) is a sensitive indicator of altered brain function. Changes in alertness and attentiveness to one's environment are key signs.

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    Pupil Reflex

    Pupil reflexes indicate the function of the brainstem and cranial nerves (CN) II and III. Changes in size, shape, and reactivity are early indicators of increased intracranial pressure (ICP) and possible brain herniation.

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    GCS

    The Glasgow Coma Scale (GCS) is a standardized tool for assessing LOC in acutely brain-injured persons. It assigns numeric scores based on eye opening, verbal responses, and motor reactions.

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    Corneal Reflex

    The corneal reflex is elicited by touching the cornea with a wisp of cotton. A blink response indicates normal function, while an absence of a blink suggests severely impaired brain function.

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    Vitamin D Synthesis

    The body creates vitamin D from a precursor (7-dehydrocholesterol) through a photochemical reaction triggered by UVB radiation from sunlight or specific artificial light.

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    Cholecalciferol

    The form of vitamin D synthesized in the skin, also known as vitamin D3.

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    Osteomalacia

    A bone disease in adults characterized by inadequate bone mineralization, leading to soft, weak bones.

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    Osteomalacia Causes

    Insufficient vitamin D, calcium, or phosphorus, poor vitamin D metabolism, or kidney disease can cause osteomalacia.

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    Rickets

    A bone disease affecting children, characterized by soft, weak bones due to failure of bone mineralization.

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    Rickets: Genetic Causes

    Some forms of rickets are linked to genetic defects in vitamin D synthesis or its receptor (VDR).

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    Symptoms of Osteomalacia

    Osteomalacia symptoms include: back pain, bowing legs, and increased fracture risk.

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    Symptoms of Rickets

    Rickets symptoms include: deformities like bowing legs, skull deformities, and delayed bone development.

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    Vitamin D's Role

    Vitamin D acts on the kidneys, intestines, and bones to increase calcium and phosphate levels in the blood.

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    PTH and Low Calcium

    When vitamin D is low, calcium levels decrease, triggering an increase in PTH (parathyroid hormone) to compensate for the low calcium.

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    Hematogenous Osteomyelitis

    A type of bone infection caused by bacteria entering the bloodstream from another infection.

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    Osteomyelitis in Children

    Hematogenous osteomyelitis commonly affects children due to their developing immune system and bone structure.

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    Early Signs of Hematogenous Osteomyelitis

    Initial symptoms often include general fatigue, body aches, and malaise.

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    Joint Involvement in Hematogenous Osteomyelitis

    Joint swelling, warmth, and pain develop weeks to months after initial symptoms.

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    Symmetrical Joint Involvement

    Hematogeous osteomyelitis often affects joints on both sides of the body in a mirror-like pattern.

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    Progressive Joint Damage

    Over time, the affected joints can become enlarged, lose range of motion, and experience chronic inflammation.

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    Rheumatoid Arthritis

    An autoimmune disease causing chronic inflammation of the joints, leading to pain, swelling, and joint damage.

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    Pannus Formation

    A destructive layer of inflamed tissue forming in rheumatoid arthritis, eroding articular cartilage and causing bone damage.

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    Osteopenia

    Reduced bone density, making bones weaker and more susceptible to fractures.

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    Osteoporosis

    Severe osteopenia, significantly increasing the risk of fractures.

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    What is Paget's disease?

    A chronic bone disease resulting in abnormal bone growth: faster breakdown then formation, leading to thicker, softer bones.

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    Paget's Disease: Geographic Variation

    Paget's disease prevalence varies drastically across different regions. It's common in England, France, etc. but rare in Scandinavia, China, and Africa.

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    Paget's: Primary Symptom

    Localized pain in the bones due to bone overgrowth or microfractures and compression of spinal and cranial nerves.

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    Most Dreaded Paget's Complication

    Sarcoma, a type of cancer, develops in the bones affected by Paget's disease.

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    Paget's Diagnosis

    X-rays reveal thick, coarsened bone cortices and medulla. Elevated alkaline phosphatase levels in the blood are typical.

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    Spina Bifida

    A birth defect where the spinal cord doesn't close completely during pregnancy, ranging from a mild bony defect to a severe malformation with exposed spinal cord.

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    Neural Tube Defects

    A group of birth defects that occur when the neural tube, the structure that develops into the brain and spinal cord, doesn't close completely during pregnancy.

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    Anencephaly

    A severe birth defect where a major portion of the brain and skull are missing.

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    Myelomeningocele

    A type of neural tube defect where spinal cord tissue protrudes through a gap in the spine.

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    Encephalocele

    A birth defect where brain tissue protrudes through a gap in the skull.

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    ALS (Amyotrophic Lateral Sclerosis)

    A progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness, difficulty speaking, and eventually paralysis.

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    What is the core pathology of ALS?

    ALS involves the loss of upper and lower motor neurons in the brain and spinal cord, often accompanied by the buildup of toxic proteins.

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    What are the clinical features of Spina Bifida?

    Individuals with Spina Bifida may have motor and sensory deficits in the lower extremities, bowel and bladder control problems, and are vulnerable to infections due to weakened skin barriers.

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    How common are neural tube defects?

    The frequency of neural tube defects varies between ethnic groups. The overall recurrence rate for a neural tube defect in subsequent pregnancies is estimated at 4% to 5%.

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    TBI Diagnosis Timeframe

    A traumatic brain injury (TBI) diagnosis is most accurately made at the time of injury or within the first 24 hours.

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    What is LOC?

    Level of consciousness (LOC) refers to a person's alertness and attentiveness to their environment. Changes in LOC are a sensitive indicator of altered brain function.

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    Pupil Reflex Significance

    Pupil reflexes reflect the function of the brainstem and cranial nerves II and III. Changes in pupil size, shape, and reactivity can be early indicators of increased intracranial pressure (ICP) or a brain herniation.

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    What is the GCS?

    The Glasgow Coma Scale (GCS) is a standardized tool used to assess the level of consciousness in acutely brain-injured patients. It assigns numeric scores based on eye opening, verbal responses, and motor reactions.

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    Corneal Reflex Test

    The corneal reflex is tested by lightly touching a wisp of cotton to the cornea. A normal response is a blink, while an absence of a blink can indicate severely impaired brain function.

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    Post-Stroke Motor Function

    Initially, a stroke causes flaccidity or paralysis. As recovery progresses, spasticity develops.

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    Stroke Impact: Location

    Stroke symptoms affect the opposite side of the body from the brain region affected.

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    Early Stroke Rehabilitation

    Active and passive range of motion exercises are crucial even in the acute phase of stroke recovery.

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    Managing Stroke Edema

    To reduce swelling after a stroke, elevate the affected limb, use compression stockings, and ensure proper body alignment.

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    Stroke: Sensory Impact

    Sensory disturbances mirror the motor paralysis, potentially including neglect and visual impairments.

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    Contralateral Hemianopsia

    A stroke can cause blindness in the same side of the visual field in both eyes, called contralateral hemianopsia.

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    Brain Trauma: Long-Term Effects

    Years after brain injury, various neurological syndromes can arise, including posttraumatic hydrocephalus, chronic traumatic encephalopathy (CTE), epilepsy, and psychiatric disorders.

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    CTE: Brain Changes

    CTE, a dementing illness from repeated head trauma, leads to brain atrophy, enlarged ventricles, and tau protein buildup.

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    Seizure Disorder: Basics

    Seizures are caused by sudden, abnormal excessive electrical discharges in the brain.

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    What are the clinical manifestations of MG?

    Symptoms include fluctuating weakness, worsening with exertion, diplopia (double vision), ptosis (drooping eyelids), and generalized weakness. The disease can affect the muscles that control eye movement, facial expressions, swallowing, and breathing.

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    How are electrophysiologic studies used in diagnosing Myasthenia Gravis?

    These tests assess the electrical activity of nerves and muscles. They reveal a decrement in muscle response with repeated nerve stimulation, a characteristic feature of MG.

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    What are thymic abnormalities in MG?

    A significant association exists between pathogenic anti-ACh receptor autoantibodies and thymic abnormalities. About 10% of patients with MG have a thymoma, a tumor of thymic epithelial cells.

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    What are the typical presentations of Dermatomyositis?

    Dermatomyositis often presents with proximal muscle weakness (weakness in the shoulders, hips, and thighs), skin changes like Gottron's papules and heliotrope rash, and possible internal organ involvement.

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    What is the difference between typical cases of MG and cases with antibodies against muscle-specific receptor tyrosine kinase?

    Cases with antibodies against muscle-specific receptor tyrosine kinase tend to have more focal muscle involvement (neck, shoulder, facial, respiratory, and bulbar muscles) in comparison to typical MG cases.

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    How are the antibodies against muscle-specific receptor tyrosine kinase different from anti-ACh receptor antibodies?

    Antibodies against muscle-specific receptor tyrosine kinase do not fix complement. Instead, they interfere with the trafficking and clustering of ACh receptors within the muscle cell membrane, reducing ACh receptor function.

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    What is epilepsy?

    Epilepsy is a brain disorder characterized by recurrent seizures caused by abnormal neuron activity.

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    What are the two hallmark signs of Alzheimer's?

    The two hallmark signs of Alzheimer's disease are amyloid plaques and neurofibrillary tangles.

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    The postictal state

    The altered state of consciousness after an epileptic seizure.

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    Paget's Disease Prevalence

    Paget's disease is more common in certain geographic regions, particularly in Caucasians of England, France, Austria, and parts of Germany, Australia, New Zealand, and the United States. It is less prevalent in native populations of Scandinavia, China, Japan, and Africa.

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    Paget's Disease: What happens to bones?

    In Paget's disease, bone matrices become thicker but disorganized and softer. This occurs due to an initial phase of excessive bone resorption by osteoclasts, followed by excessive bone formation by osteoblasts.

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    Paget's Disease: Signs and symptoms

    Paget's disease often presents with localized bone pain, due to microfractures or bone overgrowth. It can also lead to bone deformities, such as bowing of the femurs and tibiae, and cranial enlargement known as leontiasis ossea.

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    Paget's Disease: The most serious complication?

    The most serious complication of Paget's disease is the development of sarcoma, usually osteosarcoma or fibrosarcoma, which can arise in Paget lesions in the long bones, pelvis, skull, and spine.

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    Paget's Disease: Diagnosis

    Paget's disease is diagnosed by radiographic examination, which typically reveals enlarged bones with thickened, coarsened cortices and medulla. Serum alkaline phosphatase levels are often elevated, while calcium and phosphate levels usually remain normal.

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    Study Notes

    Disease of the Peripheral and Central Nervous System

    • Missing slides cover cellular structure, diffuse axonal injury, spinal cord injury, and vascular malformations
    • Key topics emphasized include Guillain-Barre Syndrome, Trigeminal Neuralgia, Bell's palsy, Carpal tunnel/compression neuropathies, Myasthenia Gravis, Muscular Dystrophies, and Neurofibromatosis type 1 and type 2.
    • Topics also covered include Cerebral Edema, Increased ICP, Neural tube defects and folate, assessing brain injury

    Cranial Nerve Function

    • Axons are the primary target of damage in peripheral neuropathies over time
    • Damage may outpace repair, leading to progressive loss of axons
    • Toxic and metabolic insults often cause "dying-back" damage
    • Electrophysiologic hallmark of these neuropathies is reduced signal amplitude.

    Demyelination

    • Schwann cells and their myelin sheaths are the targets in demyelinating disorders
    • Myelin degrades in a random pattern, causing discontinuous damage
    • Regeneration forms shorter, thinner myelin sheaths

    Traumatic Brain Injury (TBI)

    • Can result in skull fractures, parenchymal injury, and vascular injury
    • Magnitude and location of damage depends on force, object shape, head motion during impact, and whether the injury is blunt or penetrating
    • TBI diagnosis is usually made within 24 hrs of injury
    • Glasgow Coma Scale is used to assess level of consciousness via eye opening, verbal response, and motor response, with higher scores indicating better consciousness

    Skull Fractures

    • A displaced skull fracture occurs when fractured bone displaces into the cranial cavity further than the thickness of the bone
    • Resistance varies depending on the thickness of the cranial bones
    • Symptoms can be in lower cranial nerves and cervical spinal cord, including orbital and mastoid hematoma or CSF leakage and infection
    • Usually caused by impact to the skull's occiput or sides of the head

    Concussion

    • Mild TBI common in military personnel and athletes with no evidence of structural injury
    • Symptoms include altered consciousness, loss of consciousness for under 30 minutes, and no brain damage on CT scan
    • Symptoms: headache, nausea, dizziness, fatigue, blurred vision, cognitive and emotional disturbances
    • Can lead to postconcussive symptoms with cognitive impairment due to repetitive injuries or chronic traumatic encephalopathy.

    Contusion

    • Damage from transmitted kinetic energy resulting in brain bruising and laceration (tearing)
    • Trauma to the brain surface by a blow typically produces a coup injury on the point of contact and a contrecoup injury on the opposite side of the brain
    • Hemorrhage may extend into the subarachnoid space resulting in a coup injury, on the side of impact, or a contrecoup injury, on the opposite side of impact

    Cerebrovascular Disease and Stroke

    • Stroke is acute neurologic signs from vascular cause lasting more than 24 hours
    • Ischemic strokes, caused by reduced blood flow, are most common
    • Hemorrhagic strokes, result from ruptured blood vessels
    • Risk factors include hypertension, diabetes, hyperlipidemia, smoking, and advancing age
    • Symptoms vary by location of the stroke and can include hemiplegia, hemisensory loss, or visual field blindness

    Intracranial Hemorrhage

    • Common cause is usually a ruptured saccular aneurysm, with bleeding into the subarachnoid space
    • Hypertension, recreational drug use and acute alcohol intoxication can also be factors
    • Subarachnoid hemorrhages typically occur in the 5th decade of life and are slightly more common in females.
    • Characterized by severe headache and loss of consciousness
    • Subsequent ischemic damage from vasospasm is possible

    Vascular Malformations

    • Can be in the form of arteriovenous malformations(AVMs) or cavernous malformations (CM)
    • AVMs are tangled networks of vascular channels with high blood flow due to arteriovenous shunting and CMs are distended, loosely organized channels.
    • CM lesions are more common bilaterally and are most commonly found in the cerebellum, pons and subcortical areas

    Stroke Sequence

    • Motor deficits include flaccidity or paralysis and usually occur contralateral to the side of the stroke
    • Sensory disturbances occur in the same locations as motor paralysis which may involve neglect or visual impairment.
    • Sensory loss involves the same side of each eye causing homonymous hemianopsia

    Epilepsy

    • Characterized by recurrent, paroxysmal, excessive cortical electrical discharges.
    • Seizures can involve a portion of the brain, leading to localized symptoms, or encompass the whole brain (generalized).
    • Types of seizures include absence (especially in children), myoclonic (brief jerks), atonic (sudden loss of muscle tone), and tonic-clonic (grand mal)

    Dementia

    • Alzheimer's disease is the most common type of dementia, increasing with age.
    • Characterized by amyloid plaques and neurofibrillary tangles of abnormal proteins accumulating in specific brain regions, leading to progressive memory loss, impairment of judgment and behavior changes
    • Vascular dementia results from damaged brain blood vessels and reduced oxygen.
    • Symptoms include difficulty with memory, thinking, and behavior, reading, and writing, loss of interest, and personality changes

    Edema

    • Vasogenic edema is a result of blood-brain barrier disruption
    • Cytoxic edema is a result of neuronal injury, glial cells or endothelial cells damaging their cell membranes
    • Both affect the ventricles which could lead to herniation

    Hydrocephalus

    • Results from excessive cerebrospinal fluid within the ventricular system
    • Impaired CSF flow or resorption which eventually expands the ventricles, increasing intracranial pressure
    • In infants, head enlargement occurs prior to suture closure.

    Multiple Sclerosis

    • Autoimmune disorder causing demyelination of brain and spinal cord white matter.
    • Characterized by periods of neurologic deficits which can include visual loss, pain, fatigue, coordination difficulty, muscle weakness, numbness and memory problems.

    Parkinson's Disease

    • Associated with a loss of dopamine-producing cells in the substantia nigra, affecting the basal ganglia
    • Causes motor impairment, such as tremors, muscle rigidity, and slow movement
    • Often presents with a characteristic shuffling gait (but not always)
    • About 10-15% of individuals with the disease eventually develop dementia

    Spinal Bifid

    • Midline malformations that involve the neural tissue, meninges and sometimes overlying bones or soft tissue.
    • Defects can be a flat, disorganize segment or sometimes an asymptomatic bony defect (spina bifida occulta).
    • Can be myelomeningocele (extension from the neural tube), encephalocele (part of the brain extending through the skull) and sometimes meningocele

    Amyotrophic Lateral Sclerosis (ALS)

    • Progressive neuromuscular disorder characterized by damage to upper and lower motor neurons, often caused by a toxic protein accumulation.
    • The disease causes damage resulting in muscle weakness and denervation, symptoms can vary but usually start with muscle weakness of the hands which worsens over time including issues with swallowing, speaking, and breathing

    Bell's Palsy

    • Idiopathic facial nerve paralysis
    • Rapid onset of unilateral facial weakness
    • Symptoms typically resolve on their own in a few weeks

    Trigeminal Neuralgia

    • Characterized by sudden, brief, and excruciating facial pain, in one or more branches of the trigeminal nerve.

    Inflammatory Neuropathies

    • Conditions broadly categorized as immune-mediated diseases causing peripheral nerve inflammation
    • Guillain-Barré syndrome, chronic inflammatory demmyelating neuropathy, and Herpes Zoster are some examples of this category.

    Compression Neuropathies

    • Result from chronic pressure on a peripheral nerve.
    • Examples include carpal tunnel syndrome (median nerve compression at the wrist), ulnar nerve entrapment (at the elbow), and peroneal nerve entrapment (at the knee).

    Myasthenia Gravis

    • Autoimmune neuromuscular junction disorder resulting in muscle weakness.
    • Characterized by fluctuating weakness that worsens with use, affecting extraocular muscles frequently, and often accompanied by thymic abnormalities.

    Muscular Dystrophy

    • Group of inherited muscle disorders causing progressive muscle damage
    • Symptoms include muscle weakness and often times muscle enlargement (pseudohypertrophy)
    • Various forms including Duchenne muscular dystrophy, Becker muscular dystrophy, and limb-girdle muscular dystrophy

    Schwannomas

    • Benign nerve sheath tumors involving Schwann cell differentiation.
    • May be located in the cerebellopontine angle (affecting hearing and balance) and elsewhere; affecting the spine or cranial nerves
    • Tumors primarily cause symptoms from compression
    • Common genetic association with neurofibromatosis.

    Neurofibromatosis Type 1 and Type 2

    • Are inherited disorders that lead to tumors growing along the nerves or in other parts of the body
    • Neurofibromatosis type 1 characterized by a number of cutaneous lesions and an increased risk of several types of tumors, while NF2 is characterized by acoustic neuromas and other intracranial tumors

    Huntington's Disease (HD)

    • Inherited disorder characterized by a progressive movement disorder and dementia.
    • Results from repeated repeats in the huntingtin gene leading to an accumulation of abnormal proteins that affect the brain cells.
    • Symptoms appear typically in the fourth or fifth decades and are characterized by progressive, involuntary movements and cognitive decline.

    Osteomyelitis

    • Bone infection
    • Occurs when bacteria enter the bone tissue, either through the bloodstream, open fractures or penetrating injuries
    • May also present with fever, malaise, and pain

    Osteoarthritis

    • Degenerative joint disease
    • Gradual breakdown and damage of articular cartilage
    • Symptoms: pain, stiffness, and reduced range of motion, commonly affecting weight-bearing joints like the knees and hips

    Rheumatoid Arthritis

    • Autoimmune disorder that primarily targets joints
    • Results in chronic inflammation and destruction of cartilage and bone.
    • Often presents with fatigue, stiffness, and joint pain, typically affecting joints symmetrically.

    Osteoporosis

    • Bone disease characterized by decreased bone density and increased risk of fractures
    • Associated with age and hormonal changes, particularly in postmenopausal women.
    • Symptoms often do not appear until later in life and may include back pain, fractures, loss of height etc.

    Gout

    • Arthropathy characterized by acute attacks of painful inflammation, frequently localized to a single joint
    • Caused by excess uric acid, forming needle-shaped urate crystals in the joints and surrounding tissues.

    Paget's Disease

    • Progressive bone remodeling disorder
    • Characterized by excessive bone turnover
    • Results in abnormally thick, but weakened, bones

    Ehlers-Danlos Syndrome (EDS)

    • Hereditary connective tissue disorders characterized by stretchy skin, hypermobile joints and possible fragile blood vessels
    • May involve ligaments, tendons, or blood vessels

    Ewing Sarcoma

    • Malignant bone tumor, particularly affecting children and young adults
    • Characterized by a lytic bone lesion often located in the shaft of long bones and by a periosteal reaction creating "onionskin" layers around the tumor

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    Test your knowledge on the genetic causes and tumor associations of Neurofibromatosis. This quiz will cover hallmark symptoms, the frequency of tumors related to the disease, and the genetic defects involved. Ideal for students studying genetics or related fields.

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