7: Neuropathology 3

Question 1

Which glial cells cover neurons in myelin in the CNS?

Answer 1

Oligodendrocytes

Question 2

Which structures are found between myelinated sections of CNS neurons?

Answer 2

Nodes of Ranvier

Question 3

What channels are found in the Nodes of Ranvier?

Answer 3

Ion channels

Question 4

What is meant by saltatory conduction?

Answer 4

The way an action potential jumps between Nodes of Ranvier in CNS neurons

Question 5

What is the most important primary demyelinating disease you need to know about?

Answer 5

Multiple sclerosis

Question 6

Which demyelinating disease has a typical onset between 30 and 40?

Answer 6

Multiple sclerosis

Question 7

In which age of patient does MS tend to present?

Answer 7

30s - 40s

Question 8

The lesions seen in MS are said to be“disseminated in ___ and ___”.

Answer 8

disseminated in time and space

Question 9

What is the typical course of MS?

Answer 9

Relapsing and remitting

Question 10

MS tends to affect the (white matter / grey matter) of the brain.

Answer 10

white matter

Question 11

What are demyelinating lesions called in MS?

Answer 11

Plaques

Question 12

What do MS plaques look like grossly?

Answer 12

Small, irregular, translucent

but well-demarcated

Question 13

Where can MS plaques be found?

Answer 13

Virtually anywhere in the CNS

Question 14

Which cell types can be seen in active MS plaques?

Answer 14

Inflammatory cells

Microglia - brain’s immune cells

Question 15

Inflammatory cells and microglia can be seen in (active / inactive) MS plaques.

Answer 15

active

Question 16

Which pathological process is ongoing in active MS?

Answer 16

Demyelination

Question 17

In which process do glial cells hypertrophy, increase in number and then scar?

Answer 17

Gliosis

Question 18

Which pathological process is seen in inactive MS plaques?

Answer 18

Gliosis

Question 19

Which evidence of MS can be seen in the CSF of affected patients?

Answer 19

Oligoclonal bands

Question 20

What is the most common type of dementia?

Answer 20

Alzheimer’s disease

Question 21

What happens grossly to the brain in Alzheimer’s disease?

Answer 21

Widespread atrophy

Question 22

Which lobes atrophy in Alzheimer’s disease?

Answer 22

Frontal lobe

Temporal lobes

Parietal lobes

Question 23

As the brain atrophies in Alzheimer’s disease, what do the ventricles do to compensate?

Answer 23

Dilate

Causing a form of hydrocephalus

Question 24

Which brain areas, responsible for memory, are particularly affected in Alzheimer’s disease?

Answer 24

Hippocampus

Temporal lobes

Question 25

**Neurofibrillary tangles** are a histological feature of Alzheimer's disease. What protein are they made of?

Answer 25

**Tau protein**

Question 26

What is a **starch-like protein** which is distributed around the body in certain diseases?

Answer 26

**Amyloid**

Question 27

**Neuritic plaques** are a feature of Alzheimer's disease. What abnormal, starch-like protein are they made of?

Answer 27

**Amyloid**

Question 28

What are three **microscopic features** of Alzheimer's disease?

Answer 28

**Widespread atrophy** **Neurofibrillary tangles** - tau protein **Neuritic plaques** - amyloid

Question 29

Which two **abnormal proteins** are implicated in the onset of **Alzheimer's disease**?

Answer 29

**Amyloid** **Tau**

Question 30

Which type of **dementia** presents with **hallucinations**?

Answer 30

**Lewy body dementia**

Question 31

**Lewy body dementia** is associated with which other **neurodegenerative disease?**

Answer 31

**Parkinson's disease**

Question 32

Which basal ganglion **degenerates** in Parkinson's disease and Lewy body dementia?

Answer 32

**Substantia nigra**

Question 33

Which protein are **Lewy bodies** made of?

Answer 33

**Alpha synuclein**

Question 34

Which neurodegenerative disease causes **chorea**, **sensory disturbance** and **dementia?**

Answer 34

**Huntington's disease**

Question 35

What is the **mode of inheritance** of **Huntington's disease?** ## Footnote **Which gene is implicated?**

Answer 35

**Autosomal dominant** **Huntingtin gene**

Question 36

Which **mutation** causes Huntington's disease?

Answer 36

**CAG triplet repeats**

Question 37

How many **CAG triplet repeats** do you need to develop symptoms of Huntington's disease?

Answer 37

**\> 35** so 36 or more

Question 38

Which brain structures, responsible for **modifying movement information**, atrophy in Huntington's disease?

Answer 38

**Basal ganglia**

Question 39

What is **Pick's disease** also known as?

Answer 39

**Frontotemporal dementia**

Question 40

In its early stages, how does **frontotemporal dementia present**?

Answer 40

**Changes in behaviour and personality**

Question 41

Which **rare neurodegenerative disease** is **frontotemporal dementia** closely related to?

Answer 41

**Motor neuron disease (MND)**

Question 42

What is **vascular dementia**?

Answer 42

**Decline in cognition caused by a series of cerebral infarctions over time**

Question 43

**Vascular dementia** can be differentiated from other types of dementia by its ___ onset and ___ progression.

Answer 43

**abrupt onset** **stepwise progression**

Question 44

Patients with **vascular dementia** will have a past history of ___ disease.

Answer 44

**cardiovascular disease** e.g hypertension **cerebrovascular disease** - stroke

Question 45

Which **type of stroke** tends to cause **vascular dementia?** ## Footnote **Which area of the brain is implicated?**

Answer 45

**Lacunar stroke** **Basal ganglia**