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Semester 5 November > Anatomical Pathology > Flashcards

Anatomical Pathology Flashcards

0
Q

T1 MRI shows

A

Lipid

Anatomy

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1
Q

Intracellular inclusions seen in Parkinson’s

A

Lewy bodies

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2
Q

T2 shows

A

Water

Nature of lesion

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3
Q

Mechanisms of cerebral oedema

A

Cytotoxic

Vasogenic

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4
Q

Cytotoxic oedema is…

A

Increased intracellular fluid secondary to cell membrane injury.
Eg hypoxia, toxins

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5
Q

Vasogenic oedema is…

A

Disrupted BBB leading to increased intercellular fluid.
Eg localized - adjacent to inflam, tumour
Generalized - entire brain

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6
Q

Egs of ring enhancing lesions

A

Abscess
Metastatic tumour
Late hemorrhage
Late infarct

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7
Q

Neonatal bacteria causing meningitis

A

E. coli

L monocytogenes

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8
Q

Childhood meningitis organisms

A

H influenzae
S pneumoniae
N meningitidis

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9
Q

CNS reaction types to viruses

A
  1. Acute myelo/meningo/encephalitis
  2. Post vaccinal/ acute perivenous demyelination
  3. SSPE
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10
Q

Types of extra cerebral haemorrhage

A

Epidural
Subdural
Subarachnoid

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11
Q

Causes of subarachnoid haemorrhage

A

Rupture of berry aneurysm
Idiopathic
Blood dyscrasias
Rupture of AV malformation

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12
Q

Define berry aneurysm

A

Internal elastic laminate damage with developmental arterial media defect at bi/trifurcation

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13
Q

Types of Intracerebral haemorrhage

A

Primary and secondary

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14
Q

Cause of primary intracerebral haemorrhage

A

Rupture of Charcot-Bouchard micro aneurysms of penetrating cerebral arteries

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15
Q

Who is most atrisk for primary Intracerebral haemorrhage

A

Middle aged to elderly hypertensives

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16
Q

Causes of secondary Intracerebral haemorrhage

A 
Mycotic aneurysms
AV malformations
Thrombocytopenia 
Neoplasms
Vasculitis
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17
Q

Types of lesions in traumatic haemorrhage

A

Focal (contusions, lacerations, coup and contrecoup)

Diffuse (diffuse axonal injury)

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18
Q

Most common site of brain tumour in children

A

Posterior fossa

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19
Q

Common midline brain tumours

A

Germinoma
Pituitary adenoma
Craniopharyngioma
Meningioma

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20
Q

Common CP brain tumours

A

Acoustic schwannoma

Meningioma

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21
Q

Common peri ventricular brain tumours

A

Ependymoma

Neurocytoma

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22
Q

Common parenchymal tumours

A

Glial - astrocytoma, oligodendroma, glioblastoma

Neuronal - neurocytoma

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23
Q

Common metastatic brain tumours

A

Ca lung, breast, colon
Melanoma
Choriocarcinoma

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24
Q

Therapy given for leukaemia in brain

A

Intrathecal cytotoxic therapy

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25
Q

Adaptive mechanisms for raised ICP

A

Reduce CSF
Pressure atrophy of brain
Reduce blood volume

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26
Q

False localizing sign in raised ICP

A

Kernohan’s notch

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27
Q

Cushing’s triad

A

Raised systolic BP
Bradycardia
Irregular breathing

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28
Q

Methods used to decrease ICP

A 
Decrease CO2 (keep normocapnic) as CO2 dilated blood vessels
Mannitol creates osmotic gradient taking water out of neurons
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29
Q

Major risk factors for stroke

A

HPT
Atherosclerosis
Previous stroke

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30
Q

Other risk factors for stroke

A

DM, CF, CAD, Afib

31
Q

Three causes of ischemia in brain

A

Embolism
Thrombus
Hypotension

32
Q

Types of infarct (5)

A 
White matter infarction
Laminar infarction
Watershed infarction
Pale infarction
Haemorrhagic infarction
33
Q

Mechanisms of haemorrhagic infarct in brain

A

Reperfusion of pale infarct

SSS thrombosis

34
Q

Aetiology of anencephalocoele

A

Folate deficiency
Maternal DM
Anti epileptics
Alcohol

35
Q

Grading in brain tumour increases with

A

Pleomorphism
Vascularity
Mitotic activity

36
Q

Features of CNS blastoma

A

Large nucleus
Little cytoplasm
Minimal to no differentiation

37
Q

Malformation

A

Morphological defect of part of an organ that resulted from abnormal developmental process

38
Q

Deformation

A

Abnormal shape or position of body part due to abnormal MECHNICAL forces

39
Q

Disruption

A

Morphological defect coming from breakdown or interference of originally normal development

40
Q

Causes of malformations

A

Genetic
Teratogens
Multifactorial

41
Q

Why NTDs higher in Transkei

A

Fumonism

Fungal mycotoxin in contaminated maize

42
Q

Area of disorganized tissue in anencephaly

A

Cerebrovasculosa

43
Q

Two treatment options for hydrocephalus

A

Endoscopic 3rd ventriculostomy

Ventriculoperitoneal shunt

44
Q

Factors that reduce life expectancy in NTD

A

Chiari malformations
Hydrocephalus
Neurogenic bladder
Scoliosis

45
Q

Charcot Bouchard aneurysms show

A

Intimate thickening
Medial fibrosis
Rupture of elastic lamina

46
Q

Components of ring enhancing lesion

A

Central black = necrosis
White ring = leaking vessels
Black outer ring = vasogenic oedema

47
Q

Why may subdural present late (even after bleed stops)

A

Breakdown of blood -> increased osmolarity -> fluid drawn into subdural region -> increased volume

48
Q

Why aspirin contraindicated in subdural haemorrhage

A

Inhibits COX which in turn decreases amounts of PGG2 and PGH2. These are substrates for the formation of TXA2 which causes platelet aggregation and vessel vasoconstriction

49
Q

Define macerated

A

Dead in utero and undergoing autolysis.

Dissolution of tissue due to enzyme breakdown following death

50
Q

Five likely malformations in FASD

A 
Heart defects
Skeletal abnormalities
Microcephaly
Congenital hydronephrosis
Anal agenesis
51
Q

Common causes of congenital anomalies

A

Drugs - thalidomide, warfarin, retinoic acid
Alcohol
Maternal DM
Congenital infections = TORCHS

52
Q

Features of congenital syphilis

A 
Hydrops fetalis + placental oedema
Pancreatitis
HSM with pericellular fibrosis
Osteochondritis
Skin lesion
Pneumonia alba
53
Q

Cancers caused by alcohol in fetus

A

Embryonal tumours
Blastomas eg neuroblastoma
Extra renal Wilm’s tumour
Malignant mesenchymoma

54
Q

Neurons most susceptible to ischemia

A
  • pyramidal cells of hippocampus
  • neocortex
  • purine cells of cerebellum
55
Q

Golden rules for primary brain tumours

A
  • malignant tumours don’t show distant metastasis
  • benign tumours don’t show distant metastasis
  • benign can kill patients, malignant don’t always
  • if parenchymal tumour can be shelled out, high grade malignant lesion
56
Q

What pathology associated with subfalcine herniation?

A

ACA compression

57
Q

Signs in congenital hydrocephalus

A
  • macrocephaly
  • widely separated sutures
  • huge fontanelles
  • relatively small face
  • intellectual impairment, spastic paresis
  • cerebellar ataxia
58
Q

3 branches of ophthalmic nerve

A

Lacrimal
Frontal
Naso ciliary

59
Q

Long term eye complications of diabetes

A
  • diabetic retinopathy

- diabetic cataracts

60
Q

Long term complications of diabetes in the foot

A
  • gangrene (microangiopathy)
  • diabetic foot
  • peripheral neuropathy
61
Q

Why are diabetics at risk for UTIs

A
  • raise urinary sugar is a good culture medium for organisms

- obstruction of urethral from papillary necrosis

62
Q

Mechanism for micro proteinuria in diabetics

A
  • glycosylation of the BM of the glomerulus making it more permeable to proteins
63
Q

Possible causes of easy bruising in leukemia

A
  • thrombocytopenia
  • splenomegaly (platelet sequestration)
  • direct plt dysfunction
  • DIC
64
Q

Causes of granulomatous lymphadenopathy

A
  • TB
  • sarcoidosis
  • fungal infection
  • syphilis
65
Q

Cardiac diseases that could result in cerebral infarct

A
  • cardiomyopathy

- bacterial endocarditis

66
Q

How ntds cause congenital hydrocephalus

A
  • obstruction of foramen magnum by displaced cerebellum from the tethered cord
67
Q

Complications of an untreated lumbar meningomyelocoele

A
  • leg paraplegia
  • urinary incontinence
  • fecal incontinence
  • ascending meningitis
68
Q

Name of haemorrhage in adrenals

A

Waterhouse friderichsen syndrome

69
Q

CNS effects in FAS

A
  • microcephaly
  • mental retardation
  • hypotonia
  • poor coordination
  • hyperactivity
  • sleep disorder
  • spastic tetraplegia
  • seizures
  • hydrocephalus
70
Q

Factors contributing to persistence of ulcers in diabetic foot

A
  • peripheral neuropathy - repeated trauma and damage
  • macroangiopathy (poor blood flow - poor healing)
  • microangiopathy (poor blood flow)
  • poor efflux of neutrophils from vessels
  • raised glucose (prolif of bacteria)
71
Q

Mechanism of AF leading to stroke

A
  • decreased flow in atrial chamber
  • increased thrombotic tendency
  • thromboembolism
  • MCA (straightest pathway)
72
Q

Mechanism of AF in chronic rheumatic heart disease

A
  • myocarditis (damage and fibrous repair)
  • MS (damage and repair by fibrosis)
  • muscle hypertrophy ( increased o2 demand)
  • interruption of electrical pathway
73
Q

Congenital abnormalities associated with FAS

A
  • congenital heart defect
  • skeletal abnormality
  • microcephaly
  • congenital hydronephrosis
  • anal agenesis
74
Q

Ocular signs in raised ICP

A
  • pupillary dilation
  • papilloedema
  • CN 3 weakness

Semester 5 November (14 decks)

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