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  #1  
Old 10-19-2012
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Arrow Billy Step 1 Questions # 37

A study is conducted to identify causes of neuronal loss in patients 18 to 90 years old who died in the hospital from a
natural manner of death and who had autopsies performed. Histologic sections are taken from multiple areas of the brain
in each patient. The sections are analyzed for the appearance of red, shrunken neurons, decreased numbers of neurons,
or absent neurons. A subset of patients is identified in which the hippocampal pyramidal cells, the cerebellar Purkinje cells,
and the superior parasagittal neocortical pyramidal cells are affected. The medical records of these patients are reviewed
to determine what risk factors for neuronal loss were present before death. What condition is most likely to be the major
cause of neuronal loss in this subset of patients?


□ (A) Autoimmunity
□ (B) Chemotherapy
□ (C) Diabetes mellitus
□ (D) HIV infection
□ (E) Global hypoxia
□ (F) Lead ingestion
□ (G) Poor nutrition
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  #2  
Old 10-19-2012
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will go with E) global hypoxia....

all the regions mentioned in the stem are susceptible to damage by hypoxia

thanks
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Old 10-19-2012
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Default my answer :)

(E) Global hypoxia
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Old 10-19-2012
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Default my answer E

.........yep watershead areas affected
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Old 10-20-2012
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Correct Answer E is correct

The neurons that are most sensitive to anoxia reside in the hippocampus, along with the Purkinje cells and the
larger neocortical neurons. In addition, the first areas in the neocortex to be affected are the “watershed” areas between
the three major cerebral circulations, including the watershed located superiorly between the anterior cerebral and middle
cerebral circulations, as in this study. “Red” shrunken neurons, especially in the areas mentioned, are typically seen in the
early stages of global hypoxia, as may occur in a severe hypotensive episode. Focal hypoxia leads to infarcts.
Autoimmunity can lead to vasculitis and subsequent hypoxemia. Chemotherapy tends to damage actively dividing cells
more severely. Diabetes mellitus causes atherosclerosis, which can lead to hypoxemia. HIV infection can produce an
encephalitis, and there can be opportunistic infections of the CNS. Lead poisoning leads to encephalopathy, not ischemia.
Poor nutrition with a deficiency of thiamine (vitamin B1) can lead to Wernicke disease, which affects the mamillary bodies
and periaqueductal gray matter most severely.
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Old 10-20-2012
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Default

Best guess
Global hypoxia?
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One day i will infect these microbes and they will search for "Anti-MEbiotic"....
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