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  #1  
Old 08-22-2011
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Default CNS

A 35-year-old patient has progressive physical and cognitive disability. He reports muscle weakness, urinary incontinence, dysphagia and ataxia. These symptoms spontaneously improve for several weeks, only to worsen again. Histologic examination of this personís CNS axons will reveal decreased:
A. Astrocytes
B. Ependymal cells
C. Schwann cells
D. Oligodendroglia
E. Microglia
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  #2  
Old 08-22-2011
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oligodendroglia. as looks like MS
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  #3  
Old 08-22-2011
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Default i agree with oligodendrocytes but not ms

please do MS patients have dementia?
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oligodendroglia. as looks like MS
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Old 08-22-2011
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Originally Posted by nativedoc2 View Post
please do MS patients have dementia?
There has been a lot of recent research into changes in cognition due to MS and it is now evident that such changes do occur and that they are more common than was previously thought. Cognition is about our abilities in thinking things through and how well our memory works.

Cognition is also about how to focus and to maintain our attention; the way we learn and remember new things; how we think reason and solve problems. It also concerns how we plan and carry out our activities; the way we understand and use language and how well we recognise objects, assemble things together and judge distances.

The brain damage in MS is different to that in e.g. Alzheimerís type dementia and so the problems shown are different. Although the problems may not amount to full dementia they can cause significant disruption to the lives of patients. In studies of MS patients with and without cognitive dysfunction, those with have been shown to be more significantly impaired with respect to work, sexual and social functioning and basic activities of daily living.
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Old 08-23-2011
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Default normal pressure hydrocephalus!

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Originally Posted by ricko335 View Post
A 35-year-old patient has progressive physical and cognitive disability. He reports muscle weakness, urinary incontinence, dysphagia and ataxia. These symptoms spontaneously improve for several weeks, only to worsen again. Histologic examination of this personís CNS axons will reveal decreased:
A. Astrocytes
B. Ependymal cells
C. Schwann cells
D. Oligodendroglia
E. Microglia
it sounds like normal pressure hydrocephalus to me if not then it is MS!
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Old 08-23-2011
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yea, i was thinking hydrocephalus too.
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Old 08-23-2011
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D. Oligodendroglioma - as classic presentation of MS.
Symtoms on -off.
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Old 08-23-2011
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Default re........

Quote:
Originally Posted by ricko335 View Post
A 35-year-old patient has progressive physical and cognitive disability. He reports muscle weakness, urinary incontinence, dysphagia and ataxia. These symptoms spontaneously improve for several weeks, only to worsen again. Histologic examination of this personís CNS axons will reveal decreased:
A. Astrocytes
B. Ependymal cells
C. Schwann cells
D. Oligodendroglia
E. Microglia

d) oligodendroglioma occurs in 30-50yrs of old pts.
involves white matter of cerebral hemispheres...


>>>exclude (b) option > ependymoma :which occurs in childrens at 4th ventricle which can leads obstrutive type of hydrocephalous(non comunicating hydroceph)...
{obstructive type of hydroceph most comonly ocurs at foramen of monro and cerebral aqueduct of 4th }

>>>>>>>normal presure hydrocephalous (comunicating hydroceph form): leads triad of dementia,ataxia and urinary incontinence..
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Old 08-23-2011
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D. Oligodendroglia
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Old 08-23-2011
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Quote:
Originally Posted by ricko335 View Post
A 35-year-old patient has progressive physical and cognitive disability. He reports muscle weakness, urinary incontinence, dysphagia and ataxia. These symptoms spontaneously improve for several weeks, only to worsen again. Histologic examination of this personís CNS axons will reveal decreased:
A. Astrocytes
B. Ependymal cells
C. Schwann cells
D. Oligodendroglia
E. Microglia
it should be D
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Old 08-24-2011
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The correct answer is D.
This person has symptoms of multiple sclerosis, which manifests with sensorial, visual, cerebellar and motor symptoms. A history of remission and relapse is common in this condition. Patients with MS have a demyelination syndrome characterized by decreased numbers of oligodendroglia, which are involved in CNS axon myelination. Oligodendroglias are also destroyed in cerebral palsy and progressive multifocal leukoencephalopathy
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  #12  
Old 08-24-2011
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Quote:
Originally Posted by salz View Post
it sounds like normal pressure hydrocephalus to me if not then it is MS!
This would make complete sense if the patient didn't have waxing and waning of symptoms! Good Differential!

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Old 08-24-2011
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Quote:
Originally Posted by ricko335 View Post
A 35-year-old patient has progressive physical and cognitive disability. He reports muscle weakness, urinary incontinence, dysphagia and ataxia. These symptoms spontaneously improve for several weeks, only to worsen again. Histologic examination of this personís CNS axons will reveal decreased:
A. Astrocytes
B. Ependymal cells
C. Schwann cells
D. Oligodendroglia
E. Microglia
D would be correct. MS is possible. Progressive nature of symptoms and relative remission interval...
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Old 08-24-2011
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Why does the patient have dysphagia ?.
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Old 08-28-2011
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Originally Posted by mayursn39 View Post
Why does the patient have dysphagia ?.

Studies indicate that as many as half of all MS patients experience some difficulty in swallowing. Dysphagia occurs more frequently in advanced stages of MS, although it can occur at any time during the disease course.

The probability of swallowing-relevant cortical/subcortical areas/connections being affected increases with a higher lesion load and the number of brainstem nuclei/central pattern generators (CPGs) involved in MS. In patients with MS who are not severely disabled but suffer from neurogenic dysphagia symptoms, some of the MS lesions are probably situated in strategically-relevant regions for swallowing, such as the medullary CPGs. This hypothesis may explain the association between neurogenic dysphagia severity and overall disability and/or brainstem signs.

http://www.msforum.net/journal/download/20041122.pdf
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