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Medicine (MD/DO)
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USMLE Step 1
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Pathology
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Demyelinating Disorders

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Pathology | Medicine (MD/DO) School Study Aid

Demyelinating Disorders
9 Picmonics to Learn | 25 mins
Multiple Sclerosis Features and Mechanisms
Features
More Common in Women
Presents in 20's and 30's
Northern Europeans
Mechanism
Unknown mechanism, genetic factor
HLA-DRB1
Autoimmune Demyelination of CNS
White Matter of Brain and Spinal Cord
T Cell Mediated Inflammation
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2 mins
Multiple Sclerosis Symptoms and Diagnosis
Symptoms
Optic Neuritis
Internuclear Ophthalmoplegia
Scanning Speech
Urinary and Fecal Incontinence
Motor Issues (Intention Tremor, Paresis)
Numbness and Pain
Depression
Relapsing Symptoms
Diagnosis
Gold Standard = Plaques on MRI
Increased CSF Immunoglobulins (IgG)
Oligoclonal Bands
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4 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
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2 mins
Vitamin B12 (Cobalamin) Mechanism and Deficiency
Mechanism
Cobalamin
Large reserve pool in the liver
Homocysteine to methionine
Methylmalonyl CoA to succinyl CoA
Deficiency Signs and Symptoms
Macrocytic Megaloblastic Anemia
Hypersegmented Neutrophils
Neurologic defects
Posterior column
Lateral corticospinal tract
Spinocerebellar tract
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5 mins
Metachromatic Leukodystrophy
Pathophysiology
Autosomal Recessive
Arylsulfatase A Deficiency
Increased Cerebroside Sulfate
Signs and Symptoms
Demyelination
Ataxia
Dementia
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1 min
Guillain-Barre Syndrome Assessment
Assessment
Ascending Paralysis
Muscle Weakness
Paresthesias (Pins and Needles)
Diplopia
Difficulty Speaking
Dysphagia
Labile Blood Pressure
Loss of Bowel and Bladder Control
Considerations
Aggressive Airway Management
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2 mins
Polyomavirus
Characteristics
Non-enveloped
Double-stranded DNA
Circular
Disease
BK Virus
Kidney Damage
JC Virus
Progressive Multifocal Leukoencephalopathy (PML)
HIV/AIDS
Oligodendrocyte
Demyelination of CNS
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4 mins
Charcot Marie Tooth Disease
Pathophysiology
Hereditary Motor Sensory Neuropathy
Autosomal Dominant
PMP22 Duplication
Schwann Cell Dysfunction
Clinical Features
Distal Muscle Weakness
Foot Drop
Calf Muscle Atrophy
Scoliosis
Hammertoes
Pes Cavus
Diagnosis
Onion-skin Appearance on Nerve Biopsy
Electrodiagnostic Studies
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5 mins
Internuclear Ophthalmoplegia
ETIOLOGY
Multiple Sclerosis
Medial Longitudinal Fasciculus
Mechanism
CN VI Nucleus
CN III Nucleus
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2 mins

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