Nurs 6501 Advanced Pathophysiology Final Exam with accurate solutions available and graded A+

Do women or men more often have multiple sclerosis? - ANSWomen (2-3:1) Which disease has the following risk factors: -Epstein-barr virus (EBV) -Live above the 37th parallel -Caucasian -Female -Vitamin D deficiency: Decreased time between clinical isolated syndrome (CIS) and 2nd exacerbation -Smoking - ANSMultiple Sclerosis What is the main pathophysiological theory for multiple sclerosis? - ANSIt's an autoimmune/neurodegenerative disease: -inflammation -demyelination/remyelination -permanent axonal damage What are the Myelin forming cells of the CNS? - ANSOligodendrocytes What do T-Helper cell types 1 & 17 do? - ANSPro-inflammatory What does T-Helper cell type 2 do? - ANSAnti-inflammatory What is the pathophysiology of Multple Sclerosis? - ANS1. Autoreactive T cells express Very Late Antegen-4 (VLA-4, aka α4-integrin) on their cell surface and secrete Matrix Metalloproteinases (MMP). 2. VLA-4 binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain barrier (BBB) and MMP results in dysregulation of the BBB, allowing cell entry into the CNS. 3. Once in the CNS, pro-inflammatory cytokines (TNF-α, INF-γ, and Osteopontin [OP]) are secreted resulting in inflammation and further T cell entry into the CNS. 4. T cells in the CNS interact with microglia, astrocytes, and macrophages to produce reactive oxygen species and nitric oxide causing CNS damage. 5. B cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that form membrane attack complexes with complement causing cell lysis.