Neurofibromatosis

Neurofibromatosis

Karyna's Playlist

Karyna's Playlist

Premature ventricular contraction
Ventricular tachycardia
Ventricular fibrillation
Atrial fibrillation
Atrial flutter
Heart failure
Transposition of the great vessels
Heart blocks: Pathology review
Premature atrial contraction
Long QT syndrome and Torsade de pointes
Abnormal heart sounds
Restrictive cardiomyopathy
Mycobacterium tuberculosis (Tuberculosis)
Restrictive lung diseases
Restrictive lung diseases: Pathology review
Rheumatic heart disease
Myocarditis
Pericarditis and pericardial effusion
Endocarditis
Angina pectoris
Myocardial infarction
Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Pleural effusion
ECG axis
Cor pulmonale
Sarcoidosis
Acute respiratory distress syndrome
Idiopathic pulmonary fibrosis
Hypersensitivity pneumonitis
Aortic valve disease
Pulmonary valve disease
Mitral valve disease
Tricuspid valve disease
Aortic dissection
Turner syndrome
Ehlers-Danlos syndrome
Marfan syndrome
Respiratory distress syndrome: Pathology review
Peripheral artery disease
Pulmonary embolism
Lymphatic system anatomy and physiology
Pulmonary hypertension
Pulmonary arterial hypertension (NORD)
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
Lung cancer
Pancoast tumor
Pneumothorax
Influenza virus
Respiratory syncytial virus
Carcinoid syndrome
Measuring cardiac output (Fick principle)
Shock
Asthma
Zones of pulmonary blood flow
Oxygen-hemoglobin dissociation curve
Emphysema
Bundle branch block
Coarctation of the aorta
Atrial septal defect
Ventricular septal defect
Wolff-Parkinson-White syndrome
Brugada syndrome
Atherosclerosis and arteriosclerosis: Pathology review
Tetralogy of Fallot
Renal system anatomy and physiology
Prerenal azotemia
Postrenal azotemia
Diabetes mellitus
Urea recycling
Hyperkalemia
Renal cell carcinoma
Polycystic kidney disease
Kidney stones
Neurogenic bladder
Primary adrenal insufficiency
Cushing syndrome
Adrenal gland histology
Hyperaldosteronism
Pheochromocytoma
Ketone body metabolism
Horseshoe kidney
Nephroblastoma (Wilms tumor)
Vesicoureteral reflux
Renal failure: Pathology review
Hyponatremia
Chronic kidney disease
Urinary tract infections: Pathology review
Lower urinary tract infection
Hypokalemia
Nephrotic syndromes: Pathology review
Growth hormone deficiency
Precocious puberty
Delayed puberty
Graves disease
Hyperthyroidism
Acromegaly
Gigantism
Pituitary adenoma
Sheehan syndrome
Pituitary apoplexy
Hypocalcemia
Hypercalcemia
Hypernatremia
Regulation of renal blood flow
Measuring renal plasma flow and renal blood flow
Hyperparathyroidism
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Hypothyroidism
Hypothyroidism: Pathology review
Osmotic diuretics
Nephritic syndromes: Pathology review
Metabolic acidosis
Thyroid cancer
Subacute granulomatous thyroiditis
Hashimoto thyroiditis
Multiple endocrine neoplasia
Hypoparathyroidism
Diabetes insipidus
Growth hormone and somatostatin
Testicular tumors: Pathology review
Testicular cancer
Testis, ductus deferens, and seminal vesicle histology
Diabetic nephropathy
Polycystic ovary syndrome
Klinefelter syndrome
Osteoporosis
Osteomalacia and rickets
Paget disease of bone
Multiple endocrine neoplasia: Pathology review
Hypothyroidism medications
Prader-Willi syndrome
Thyroid storm
Peptic ulcer
Bowel obstruction
Peutz-Jeghers syndrome
Diverticulosis and diverticulitis
Pancreatic cancer
Gastric cancer
Esophageal cancer
Acute pancreatitis
Chronic pancreatitis
Cirrhosis
Hepatocellular carcinoma
Crohn disease
Ulcerative colitis
Inflammatory bowel disease: Pathology review
Gastrointestinal system anatomy and physiology
Irritable bowel syndrome
Gastrointestinal bleeding: Pathology review
Cervical cancer: Pathology review
Salmonella (non-typhoidal)
Salmonella typhi (typhoid fever)
Shigella
Norovirus
Cytomegalovirus infection after transplant (NORD)
Rotavirus
Autoimmune hepatitis
Portal hypertension
Hemochromatosis
Non-alcoholic fatty liver disease
Wilson disease
Bacillus cereus (Food poisoning)
Primary sclerosing cholangitis
Gastric motility
Primary biliary cholangitis
Wernicke-Korsakoff syndrome
Appendicitis
Chronic cholecystitis
Intussusception
Pyloric stenosis
Jaundice: Pathology review
Biliary colic
Ascending cholangitis
Gallstone ileus
Endometriosis
Endometrial cancer
Amenorrhea: Pathology review
Urinary incontinence
Human papillomavirus
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Menopause
Menstrual cycle
Ovarian germ cell tumors
Premature ovarian failure
Ovarian cysts and tumors: Pathology review
Penile conditions: Pathology review
Hypospadias and epispadias
Antiphospholipid syndrome
Miscarriage
Pregnancy
Testicular and scrotal conditions: Pathology review
Treponema pallidum (Syphilis)
Uterine leiomyoma: Clinical sciences
Celiac disease
Lactose intolerance
Uterine disorders: Pathology review
Esophageal disorders: Pathology review
Gastroesophageal reflux disease (GERD)
Eosinophilic esophagitis (NORD)
Scleroderma
Volvulus
Hepatitis A and Hepatitis E virus
Hepatitis B and Hepatitis D virus
Hepatitis C virus
Viral hepatitis
Congenital gastrointestinal disorders: Pathology review
Vaginal and vulvar disorders: Pathology review
Gardnerella vaginalis (Bacterial vaginosis)
Postpartum thyroiditis
Placenta previa
Stages of labor
Preeclampsia & eclampsia
Epstein-Barr virus (Infectious mononucleosis)
HIV (AIDS)
Approach to adnexal masses: Clinical sciences
Benign breast conditions: Pathology review
Mastitis: Clinical sciences
Prostate cancer
Prostate disorders and cancer: Pathology review
Clostridium difficile (Pseudomembranous colitis)
Breast cancer
Hirschsprung disease: Year of the Zebra
Congenital cytomegalovirus (NORD)
Ovarian cyst
Thrombophlebitis
Endometritis
Complications during pregnancy: Pathology review
Folate (Vitamin B9) deficiency
Lichen planus
Meningitis
Seizures: Pathology review
Antiplatelet medications
Platelet plug formation (primary hemostasis)
Coagulation (secondary hemostasis)
Hemophilia
Von Willebrand disease
Platelet disorders: Pathology review
Thrombotic thrombocytopenic purpura
Immune thrombocytopenia
Hemolytic-uremic syndrome
Disseminated intravascular coagulation
Heparin-induced thrombocytopenia
Neisseria meningitidis
Central nervous system infections: Pathology review
Epidural hematoma
Subdural hematoma
Parkinson disease
Movement disorders: Pathology review
Concussion and traumatic brain injury
West Nile virus
Seizures and epilepsy
Ischemic stroke
Intracerebral hemorrhage
Subarachnoid hemorrhage
Vasculitis: Pathology review
Arteriovenous malformation
Tourette syndrome
Delirium
Frontotemporal dementia
Dementia: Pathology review
Dementia with Lewy bodies
Anatomy clinical correlates: Cerebral hemispheres
Huntington disease
Pyramidal and extrapyramidal tracts
Cerebral palsy
Non-hemolytic normocytic anemia: Pathology review
Microcytic anemia: Pathology review
Autoimmune hemolytic anemia
Intrinsic hemolytic normocytic anemia: Pathology review
Extrinsic hemolytic normocytic anemia: Pathology review
Macrocytic anemia: Pathology review
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Sickle cell disease (NORD)
Hodgkin lymphoma
Anemia of chronic disease
Aplastic anemia
Chronic granulomatous disease
Leukocyte adhesion deficiency
Immunodeficiencies: Phagocyte and complement dysfunction: Pathology review
Myelodysplastic syndromes
Blood transfusion reactions and transplant rejection: Pathology review
Myeloproliferative disorders: Pathology review
Chronic leukemia
Leukemias: Pathology review
Essential thrombocythemia (NORD)
Alzheimer disease
Normal pressure hydrocephalus
Febrile seizure
Traumatic brain injury: Pathology review
Demyelinating disorders: Pathology review
Neurocutaneous disorders: Pathology review
Tuberous sclerosis
Syringomyelia
Neurofibromatosis
Spina bifida
Clostridium botulinum (Botulism)
Early infantile epileptic encephalopathy (NORD)
Acute leukemia
Lymphomas: Pathology review
Waldenstrom macroglobulinemia (NORD)
Fibromyalgia
Alpha-thalassemia
Beta-thalassemia
Factor V Leiden
Headaches: Pathology review
Adult brain tumors
Pediatric brain tumors
Idiopathic intracranial hypertension: Year of the Zebra
Pediatric brain tumors: Pathology review
Adult brain tumors: Pathology review
Chiari malformation
Spinal cord disorders: Pathology review
Myalgias and myositis: Pathology review
Myasthenia gravis
Brown-Sequard Syndrome
Multiple sclerosis
Muscular dystrophy
Spinal muscular atrophy
Plasma cell disorders: Pathology review
Superior vena cava syndrome
Cardiac tamponade
Muscular dystrophies and mitochondrial myopathies: Pathology review
Guillain-Barre syndrome
Charcot-Marie-Tooth disease
Lambert-Eaton myasthenic syndrome
Cauda equina syndrome
Anatomy clinical correlates: Posterior blood supply to the brain
Bell palsy
Wernicke-Korsakoff syndrome: Year of the Zebra
Vascular dementia
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Alcohol use disorder
Helicobacter pylori
Rheumatoid arthritis
Polymyalgia rheumatica
Introduction to the lymphatic system
Pasteurella multocida
Gout
Bacterial and viral skin infections: Pathology review
Coxiella burnetii (Q fever)
Bartonella henselae (Cat-scratch disease and Bacillary angiomatosis)
Brucella
Borrelia species (Relapsing fever)
Rickettsia rickettsii (Rocky Mountain spotted fever) and other Rickettsia species
Francisella tularensis (Tularemia)
Borrelia burgdorferi (Lyme disease)
Shock: Pathology review
Attention deficit hyperactivity disorder
Autism spectrum disorder
Disruptive, impulse control, and conduct disorders
Bipolar and related disorders
Somatic symptom disorder
Malingering, factitious disorders and somatoform disorders: Pathology review
Amnesia, dissociative disorders and delirium: Pathology review
Atopic dermatitis
Rheumatoid arthritis and osteoarthritis: Pathology review
Systemic lupus erythematosus
Ehrlichia and Anaplasma
Seronegative and septic arthritis: Pathology review
Sjogren syndrome
Personality disorders: Pathology review
Psychiatric emergencies: Pathology review
Riedel thyroiditis
Narcolepsy (NORD)
Psychological sleep disorders: Pathology review
Schizophrenia
Eating disorders: Pathology review
Schizophrenia spectrum disorders: Pathology review
Cluster A personality disorders
Reactive arthritis
Plasmodium species (Malaria)
Trypanosoma cruzi (Chagas disease)
Generalized anxiety disorder
Panic disorder
Trauma- and stress-related disorders: Pathology review
Obsessive-compulsive disorder
Zika virus
Yellow fever virus
Atypical antipsychotics
Typical antipsychotics
Phenylketonuria (NORD)
Antepartum assessment - Fetus: Nursing

Flashcards

Neurofibromatosis

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Questions

USMLE® Step 1 style questions USMLE

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Start
A 19-year-old man comes to the clinic due to a feeling of unsteadiness over the past few months. At first, the patient felt more clumsy and often bumped into furniture around the house. More recently, he has been feeling wobbly and often loses his balance. Additionally, the patient states that over this same time period, he needs to raise the volume on the television in order to hear it better. He denies any trauma and does not use tobacco, alcohol, or illicit drugs. Family history is unremarkable. Vitals are within normal limits. On physical examination, the patient has difficulty standing with the feet together and almost falls. He is unable to hear whispering voices bilaterally. An MRI is obtained and shows a 2 cm lesion at the right cerebellopontine angle and a 3.5 cm lesion at the left cerebellopontine angle. This patient is at risk for developing which of the following?  

Transcript

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With neurofibromatoses, neuro refers to the nerves, fibro- refers to fibrous tissue, and -oma means growth, or tumor.

So neurofibromatosis refers to fibrous tumors originating from the nervous system.

The body’s central nervous system is made up of the brain and the spinal cord, which are surrounded by three protective layers called the meninges.

Part of the central nervous system are the cranial nerves, which originate in the brainstem and innervate the head and neck, and the spinal nerves, which originate in the spinal cord, and supply the rest of the body.

Each nerve is surrounded by a nerve sheath, which is produced by cells called fibroblasts.

Inside, each nerve there are several fascicles, and each fascicle, in turn, is made up of several axons.

The axons are the long projections of neurons, that carry the information as electrical signals running up and down their length.

Along the axon there are cells called Schwann cells, which produce a myelin cover for the axon.

The myelin helps electrical signals travel along the axon faster.

Now, neurofibromatoses are genetic diseases which cause non-cancerous growths to form in the body’s nerve tissue, and there are two types - type I and type II.

They’re caused by inheriting faulty copies of either the NF1 or NF2 gene, which are found on chromosomes 17 and 22, respectively.

Just remember, NF1 goes with chromosome 17 and NF2 goes with chromosome 22.

Both of these have an autosomal dominant inheritance pattern, so a child only needs one faulty copy from either parent to get the disease.

Normally, these are tumor suppressor genes, which means they stop cells from dividing uncontrollably.

So when there’s a mutation in the gene, it leads to uncontrolled growth of fibromas which are growths that have multiple cell types including neurons, Schwann cells, and other supporting connective tissue.

Neurofibromatosis type I, is also called von Recklinghausen’s syndrome typically affects the nerves in the extremities and the skin.

It causes lots of neurofibromas, which are benign tumors that grow from the nerve sheath and are made of a mixture of Schwann cells, fibroblasts, and immune cells.Usually, they grow just beneath the skin surface, but they can also grow along peripheral and spinal nerves.

Cutaneous neurofibromas typically start forming in childhood and increase in number over time. They appear as a painless, mobile lumps under the skin.

On top of that, people with type I neurofibromatosis often have skin markings called café-au-lait spots, which are flat patches that are the color of milky coffee.

These spots typically appear on the back, the buttocks, and the thighs in the first year of life, and increase in number over time.

Also, on an eye exam, there are small tan colored bumps called Lisch nodules can be seen on the iris.

These nodules almost always appear by the age of 6, but don’t usually cause any sight problems.

Key Takeaways

Neurofibromatosis is a genetic disorder characterized by fibrous tumors that affect the development and function of the nervous system. There are three known types of neurofibromatosis: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis.

NF1 is due to a mutation in the NF1 gene on chromosome 17, and generally affects the skin and extremities. NF1 causes cutaneous neurofibromas (benign tumors that grow from the nerve sheath), caf-au-lait spots (flat patches with milky-coffee color), and Lisch nodules (small tan colored bumps). NF2 is caused by a mutation in the NF2 gene on chromosome 22, and is associated with bilateral acoustic neuromas that can cause tinnitus, and bilateral gradual loss of hearing. NF2 is also associated with multiple meningiomas in the brain and spinal cord.

Schwannomatosis is a rare form of neurofibromatosis, characterized by multiple schwannomas, pain, and numbness in the affected areas. Unlike NF2, schwannomatosis spare the vestibular nerve.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Neurofibromatosis" Orthopaedics and Trauma (2015)
  6. "Review Article : Molecular and Cellular Mechanisms Underlying the Cognitive Deficits Associated With Neurofibromatosis 1" Journal of Child Neurology (2002)
  7. "The Neurofibromatosis 2 Tumor Suppressor Gene Product, Merlin, Regulates Human Meningioma Cell Growth by Signaling through YAP" Neoplasia (2008)