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Advanced Pathophysiology Exam 3 with correct answers

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Advanced Pathophysiology Exam 3 with correct answers

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Advanced Pathophysiology Exam 3 |||\\\ |||\\\ |||\\\ |||\\\




with correct answers |||\\\ |||\\\




Do women or men more often have multiple sclerosis? - correct answer✔✔Women (2-3:1)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Which disease has the following risk factors:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




-Epstein-barr virus (EBV) |||\\\ |||\\\




-Live above the 37th parallel
|||\\\ |||\\\ |||\\\ |||\\\




-Caucasian

-Female

-Vitamin D deficiency: Decreased time between clinical isolated syndrome (CIS) and 2nd
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




exacerbation

-Smoking - correct answer✔✔Multiple Sclerosis |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




What is the main pathophysiological theory for multiple sclerosis? - correct answer✔✔It's an
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




autoimmune/neurodegenerative disease: |||\\\ |||\\\




-inflammation

-demyelination/remyelination

-permanent axonal damage |||\\\ |||\\\




What are the Myelin forming cells of the CNS? - correct answer✔✔Oligodendrocytes
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




What do T-Helper cell types 1 & 17 do? - correct answer✔✔Pro-inflammatory
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




What does T-Helper cell type 2 do? - correct answer✔✔Anti-inflammatory
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\

,Which T cell types exhibit plasticity? - correct answer✔✔T-Helper 17 & T-Regulatory
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




What is the pathophysiology of Multple Sclerosis? - correct answer✔✔1. Autoreactive T cells
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




express Very Late Antegen-4 (VLA-4, aka α4-integrin) on their cell surface and secrete Matrix
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Metalloproteinases (MMP). |||\\\




2. VLA-4 binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain barrier
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




(BBB) and MMP results in dysregulation of the BBB, allowing cell entry into the CNS.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




3. Once in the CNS, pro-inflammatory cytokines (TNF-α, INF-γ, and Osteopontin [OP]) are
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




secreted resulting in inflammation and further T cell entry into the CNS.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




4. T cells in the CNS interact with microglia, astrocytes, and macrophages to produce reactive
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




oxygen species and nitric oxide causing CNS damage.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




5. B cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that form
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




membrane attack complexes with complement causing cell lysis. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




In MS, autoreactive T cells express ____________ on their cell surface and secrete
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




______________. - correct answer✔✔Autoreactive T cells express Very Late Antegen-4 (VLA-4, |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




aka α4-integrin) on their cell surface and secrete Matrix Metalloproteinases (MMP).
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




In MS, VLA-4 binds to ____________ receptors on the blood brain barrier (BBB) and MMP
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




results in dysregulation of the BBB, allowing cell entry into the CNS. - correct answer✔✔VLA-4
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain barrier (BBB)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




and MMP results in dysregulation of the BBB, allowing cell entry into the CNS.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




In MS, once T cells enter the CNS, pro-inflammatory cytokines (__________, _________, and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




_______________) are secreted resulting in inflammation and further T cell entry into the CNS. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\

,- correct answer✔✔Once in the CNS, pro-inflammatory cytokines (TNF-α, INF-γ, and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Osteopontin [OP]) are secreted resulting in inflammation and further T cell entry into the CNS. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




In MS, T cells in the CNS interact with __________, ___________, and _________________ to
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




produce reactive oxygen species and nitric oxide causing CNS damage. - correct answer✔✔T
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




cells in the CNS interact with microglia, astrocytes, and macrophages to produce reactive
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




oxygen species and nitric oxide causing CNS damage. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




In MS, _______ cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




form membrane attack complexes with complement causing cell lysis. - correct answer✔✔B
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that form membrane
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




attack complexes with complement causing cell lysis.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Which disease presents in the following way: |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




**Visual changes, optic neuritis (Often the 1st sign/symptom) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




-Paresthesias

-Gait issues/falls |||\\\




-Foot drop |||\\\




-Dysdiadochokinesia

-Fatigue

-Weakness

-Impaired coordination |||\\\




-Cognitive changes |||\\\




MRI:

***Gadolinium enhanced lesions |||\\\ |||\\\




LUMBAR PUNCTURE TEST: |||\\\ |||\\\

, -Increased IgG |||\\\




-Increased Myelin basic protein (MBP) |||\\\ |||\\\ |||\\\ |||\\\




-Increased CSF protein - correct answer✔✔Multiple Sclerosis |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Which cognitive test is most commonly used to diagnose MS? - correct answer✔✔Symbol
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Digit Modalities Test (SDMT)
|||\\\ |||\\\ |||\\\




What is the primary diagnostic test for MS? - correct answer✔✔MRI with or without contrast
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




The McDonald Criteria is used to diagnose MS, and involves lesions disseminated in
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




________________ and _______________. - correct answer✔✔Disseminated in time (DIT) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




Disseminated in space (DIS) |||\\\ |||\\\ |||\\\




What does the McDonald Criteria for diagnosing MS Disseminated in time (DIT) require? -
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




correct answer✔✔One of the following: |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




1. Gadolinium-enhancing lesions (compared to baseline MRI).
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




2. Simultaneous presence of Gadolinium-enhancing and non-enhancing lesions.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




The McDonald Criteria for diagnosing MS Disseminated in space (DIS) requires the presence of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




lesions in 2 out of what four areas? - correct answer✔✔1. Periventricular
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




2. Juxtacortical
|||\\\




3. Infratentorial
|||\\\




4. Spinal cord
|||\\\ |||\\\




Which type of MS is were the patient has MRI features of MS, but does not meet the DIS, and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\




have no symptoms? - correct answer✔✔Radiographically Isolated Syndrome (RIS)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\

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