robin082006
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A 35-year-old woman presents with complaints of weakness and spasticity in her right leg. She also admits to difficulties with balance and malaise. The patient states that about 6 months ago, while taking a shower one morning, she noticed that she could not discriminate between hot and cold water on her right leg. She began to feel very tired, and had some difficulties passing urine. Several months ago she had noticed that the vision deteriorated in her right eye, although it recovered over a period of two months. On examination, abnormalities of the left eye and optic disc are present
Neurologic examination is significant for weakness, Iack of coordination, abnormally brisk reflexes in both legs, and difficulty walking were registered.
Which of the following is the pathological hallmark of this disease?
/ A. Ballooned cells and argyrophilic bodies
/ B. Concentrated, noninflammatory demyelination within the central pons
/ C. Demyelinated plaques with perivascular infiltration
/ D. GIiosis, foamy macrophages, Cowdry-A bodies
/ E. Noncaseating epithelioid granulomas
explain each ans
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| malinda
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well I am really weak at CNS robin..But I dont mind trying
I think it is multiple sclerosis.and C should be the answer.
I only know 1 other points.D should be HSV.balloned cells are seen in picks disease.and E may be may be is HIV.as TB will produce caseating granulomas.I am not sure
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| mjl1717
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yes demyelination with pervascular infil. think of M.S. DISTRACTORS that I know: non caseating epi theliod granuloma- sarcoid, Cowdry A -HSV. What B-Central pontine myelinosis?? Also where is Cowdry B found?
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| druas
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C. M/S
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| linaorvos
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I think A is Pick dz....
found...Cowdry B inclusion body: obsolete term for dropletlike masses of acidophilic material surrounded by clear halos within nuclei, without other nuclear changes during early stages of development of the inclusion as seen in poliomyelitis.
Edited by linaorvos on 02/11/06 - 05:05 PM
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| skyhigh
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B? b/c i don't see any indication of infiltration in the q.
but this doesn't answer loss of discrimination b/w hot and cold, so,
makes me choose C.
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| msyamp
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ya i go with C. Multiple sclerosis is plque disease with perivascular infiltration. it also has clinicl features of transient neurological deficits that sometimes become partially permanent that areDIVIDED IN TIME.
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| docarchana
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i think B is central pontine myelinosis. rapid correction of hyponatremia is the MC cause. can some one help with the other choices..
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| new_n_lost
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A = Ballooned neurons with argyrophilic bodies (Pick Bodies) PICK's Disease
B = Concentrated, noninflammatory demyelination within the central pons = Central Pontine Myelinolysis
C. Demyelinated plaques with perivascular infiltration = MS
D. GIiosis, foamy macrophages, Cowdry-A bodies = HSV
E. Noncaseating epithelioid granulomas = Sarcoid Lesion
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| docarchana
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thanx nnl. cowdry B in poliomyelitis as posted by linovaroas above.
goodluck.
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