Multiple Sclerosis

Mechanism?

Symptoms?

▪ Demyelination of white matter in CNS

▪ paraparesis (weakness in legs), unsteady gait, diplopia (double vision), incontinence

Hypokalemia

Mechanism?

Symptoms?

▪ Low blood K+ increases gradient leading to hyperpolarization of neurons

▪ Less excitability, muscle weakness

Hyperkalemia

Mechanism?

Symptoms?

▪ High blood K+ causes lower gradient which leads to depolarization

▪ Increased neuronal activity, heart overstimulated and can stop

Myasthenia Gravis

Mechanism?

Symptoms?

Treatment?

▪ autoantibodies against ACh nicotinic receptors in NMJ

▪ Impaired swallowing, chewing, respiration

▪ acetylcholinesterase inhibitors

Syndrome of Inappropriate ADH Hormone

(SIADH)

Mechanism?

Symptoms?

▪ too much ADH

▪ enhanced water retention, hyponatremia, hypoosmolarity

Diabetes Insipidus

▪ Mechanism?

▪ Symptoms?

▪ too little water retention, either b/c of too little ADH (neurogenic) or inadequate response (nephrogenic)

▪ polyuria and polydipsia

Dwarfism

Mechanism?

Giantism

Mechanism?

Acromegaly

Mechanism?

Symptoms?

▪ benign pituitary tumor leads to oversecretion of GH in adults

▪ overgrowth of extremities, soft tissue swelling, jaw abnormalities, cadiac disease, **hyperglycemia**

Cushing's

Mechanism?

Symptoms?

▪ hypercortisolism from tumor that causes hypersecretion (disease if pituitary tumor, syndrome if adrenal tumor or other) or latrogenic

▪ muscle loss, immune suppression, adiposity central, hypertension, hyperglycemia, easy bruising

Addison's

Mechanism?

Symptoms?

▪ hypocortisolism from autoimmune destruction of adrenal cortex, genetic defects, or latrogenic

▪ hypotension, dehydration, n/v, weakness, increases pigmentation, depression

Inflammatory Bowel Syndrome-D

(IBS-D)

Symptom?

Treatment?

▪ diarrhea dominant

▪ give muscarinic antagonists (won't work for IBS-C)

Parkinson's

Mechanism?

Symptoms?

▪ substantia nigra destroyed and dopamine synthesis reduced in nigrostriadal tract, D1 and D2 receptors not stimulated to coordinate movement

▪ bradykinesia and dyskinesia

Parkinson's

Treatment Options?

1) DA receptor agonist

2) Irreversible MAO-B inhibitor

3) COMT inhibitor

4) Levadopa - converted to dopamine

Schizophrenia

Mechanism/Symptoms?

▪ + symptoms = hallucinations, disorganized speech, excessiveness b/c too much DA in mesolimbic

▪ - symptoms = withdrawal, bad at new situations, avoid pleasure b/c too little DA in mesocortical

Epilepsy

Mechanism?

Symptom?

Treatment?

▪ lose surround inhibition b/c interneuron doesn't release GABA on neurons in other networks

▪ seizures

▪ benzodiazepines (EX. lorazepam)

Hypocalcemia

Mechanism?

Symptoms?

▪ increases Na+ permeability, leads to depolarization

▪ tetany, convulsions, respiratory arrest

Hypercalcemia

Mechanism?

Symptoms?

▪ decreases Na+ permeability, causing hyperpolarization

▪ weakness, constipation, lethargy

Osteomalacia

Cause?

Name in kids?

Treatment?

▪ vit D deficiency in adults

▪ Rickets

▪ calcium and vit D

Osteoporosis

Cause?

Specific symptom?

Treatments?

▪ loss of bone density from postmenopause (low estrogen), age, regional, drugs

▪ kyphosis

▪ PTH analogs, estrogen, SERMs, bisphophonates (most common), calcitonin

Osteoarthritis

Mechanism?

Treatment?

▪ degeneration of cartilage on bone ends, bone spurs break off in synovial fluid

▪ NSAIDs

Rheumatoid Arthritis

Mechanism?

Treatments?

▪ abnormal immune response causes attack of synovial membrane

▪ NSAIDs and DMARDs (including immunosuppressants)

Gout

Mechanism?

Treatments?

▪ purine metabolism through xanthine oxidase yields uric acid, builds up and crystallizes in synovial fluid

▪ XO inhibitors, NSAIDs, Uricosurics (increase renal excretion), Uricase