PPT20204 HUCM

Revision 2 HUCM

Endocrine and Nervous system Pathology

Open Ended

A 35-year-old man has a 2 day history of worsening generalized headache and increasing obtundation. He now complains of stiffness in his neck. On physical examination vital signs include temperature 38.7⁰ C, pulse 85/minute, respirations 23/minute, and blood pressure 130/85 mm Hg. A CBC reveals a WBC count of 16,850/microliter. Serum electrolytes include a sodium of 145 mmol/L, potassium 4.3 mmol/L, chloride 103 mmol/L, CO₂ 26 mmol/L, urea nitrogen 18 mg/dL and glucose 88 mg/dL. A lumbar puncture yields cloudy cerebrospinal fluid with a glucose of 32 mg/dL, protein 146 mg/dL, and cell count of 3800 WBC and 122 RBCs. He receives antibiotic therapy and improves.

(a) Based on the clinical findings, name the possible disease for this man. Support your answer with relevant clinical findings.

(5 marks)

(b) Enumerate the possible complications of his condition.

(5 marks)

(c) Briefly discuss the pathogenesis of the disease.

(10 marks)

All answers are available in nervous system lecture notes

Multiple Choice

The amyloid cascade hypothesis states:

• Deposition of tau, the main component of the plaques, is the causative agent of Alzheimer’s pathology and that the neurofibrillary tangles, cell loss, vascular damage, and dementia follow as a direct result of this deposition

• Deposition of Aβ, the main component of the plaques, is the causative agent of Alzheimer’s pathology and that the neurofibrillary tangles, cell loss, vascular damage, and dementia follow as a direct result of this deposition

• Deposition of tau, the main component of the tangles, is the causative agent of Alzheimer’s pathology and that the plaques, cell loss, vascular damage, and dementia follow as a direct result of this deposition

• Deposition of Aβ, the main component of the tangles, is the causative agent of Alzheimer’s pathology and that the plaques, cell loss, vascular damage, and dementia follow as a direct result of this deposition

Multiple Choice

Which protein is most commonly associated with neurofibrillary tangles?

• Tau

• Actin

• APP

• β-secretase

Multiple Choice

What are the arrows pointing to in the image?

• 1 = amyloid plaque. 2 = neurofibrillary tangle

• 1 = amyloid plaque. 2 = lewy body

• 1 = mitochondria. 2 = nucleus

• 1 = neurofibrillary tangle. 2 = amyloid plaque

Multiple Choice

The two characteristic pathologies of Alzheimer's disease are...

• Lewy bodies and neurofibrillary tangles

• Amyloid plaques and neurofibrillary tangles

• Ubiquitinated inclusions and amyloid plaques

• Amyloid plaques and lewy bodies

Multiple Choice

Which of the following is a symptom of parkinson's disease

• Fast speaking

• Hyper activity

• Bradykinesia(slow movement)

Multiple Choice

What causes parkinson's

• Sensory neuron death

• Motor neurones apathy

• Decreased acetylcholine

• Loss of dopamine producing cells

Multiple Choice

Which of the following symptoms would lead to a diagnosis of parkinson's disease

• Tremor

• Rigidity

• Postural instability

• All of the above

Open Ended

A 45-year-old woman has recently developed hypertension. Weight increase and menstruation irregularity have been present for several months, according to a review of systems. She is heavy and has a plethoric appearance on inspection. The blood pressure is 165/98 millimeters of mercury. There are multiple bruises on both lower legs and prominent purplish striae on the abdomen.

a) Name the possible disease for the patient based on the physician's observations.

b) Discuss the etiology of this disease.

c) Discuss the clinical signs that the patient may encounter and explain the pathophysiology of each feature.

Multiple Choice

· Hypothalamic Dopamine Deficiency

· Stimulation of Lactotrophs

· Lactotroph Insensitivity to dopamine

Which of the following etiology-related of the above disorders?

• Addison Disease

• Hyperprolactinoma

• Cushing Syndrome

• Growth Hormone Adenoma

Multiple Choice

Hypersecretion of adrenal cortex. Bronze skin, water and electrolyte problems.

• Cushing's

• Addisons

• Graves

• Hashimoto's

Multiple Choice

Autoimmune disease of the thyroid

• Cushing's
• Hashimoto's
• Addisons
• Graves disease

Multiple Choice

The following is an example of?

• Graves disease

• Addison disease

• Acromegly

• Hypothyroidism

Multiple Choice

Graves disease is caused by

• hyperfunction of thyroid hormone

• hypo function of thyroid hormone

• hyperfunction of growth hormone

• hypo function of growth hormone

Multiple Choice

Hypofunction of the posterior pituitary gland causes which disease state?

• Addisons

• Diabetes insipidus

• Syndrome of inappropriate

  
  

  antidiuretic hormone

  
  

  (SIADH) secretion

• Graves Disease

Multiple Choice

Requires dialysis & possibly kidney transplant

• Renal Calculi

• Urethritis

• Kidney Failure

• Edema

Multiple Choice

Damage to the filtration portion of the kidney

• PKU

• Glomerulonephritis

• Cystitis

• Acute Kidney failure