CNS Pathoma Flashcards
(125 cards)
1
Q
Neural tube defects are associated with
A
Low folate levels prior to conception
2
Q
How can neural tube defects can be detected?
A
Elevated AFP in amniotic fluid and maternal blood
3
Q
If a failure to close happens at the cranial end we call it
A
Anencephaly
4
Q
Anencephaly=
A
Absence of skull and brain
5
Q
Anencephaly results in maternal ________
A
Polyhydramnios
6
Q
Description of Anencephaly gross pathology
A
Frog like appearance
7
Q
Failure of posterior vertebral arch to close is called
A
Spina bifida
8
Q
Spina bifida leads to
A
Meningocele
Meningomyeleocele
9
Q
Congenital stenosis of the channel that drains CSF from 3rd to 4th ventricle is called
A
Cerebral aqueduct stenosis
10
Q
Cerebral aqueduct stenosis leads to
A
Accumulation of CSF in the ventricles
11
Q
Cerebral aqueduct stenosis presents with
A
Enlarging head circumference
12
Q
Congenital failure of the cerebellar vermis to develop is called
A
Dandy-Walker malformation
13
Q
Dandy-Walker malformation presents with
A
Massively dilated 4th ventricle with absent of cerebellum
14
Q
Congenital extension of cerebellar tonsils through foramen magnum
A
Arnold-Chiari malformation
15
Q
CNS developmental anomalies list
A
Anencephaly Spina bifida Cerebral aqueduct stenosis Dnady-Walker malformation Arnold-Chiari malformation type II
16
Q
Spinal cord lesions list
A
Syringomyelia Poliomyelitis Werding-Hoffman disease Amyotrophic Lateral Sclerosis (ALS) Friedreich Ataxia
17
Q
Cystic degeneration of the spinal cord
A
Syringomyelia
18
Q
Syringomyelia arises with
A
Trauma
Arnold-Chiari malformation
19
Q
Syringomyelia presents with
A
Sensory loss of pain and temparture
20
Q
Syringomyelia can cause _______ syndrome
A
Horner
21
Q
Horner syndrome =
A
Ptosis
Miosis
Anhidrosis
22
Q
Horner syndrome will happen due to
A
Disruption of the lateral horn of the hypothalamospinal tract
23
Q
Poliovirus will cause
A
Poliomyelitis
24
Q
Poliomyelitis =
A
Damage to anterior motor horn
25
Poliomyelitis presents with
Lower motor neuron signs
26
Main difference btw ALS and syringomyelia
| ALS=
Syringomyelia will show lack of sensory impairment
| Amyotropic Lateral Sclerosis
27
Most cases of ALS are ______
Sporadic
28
Familial cases of ALS will have
Zinc-Copper superoxide dismutase mutation
29
Degenerative disorder of the cerebellum and spinal cord is called
Friedreich ataxia
30
Meningitis =
Inflammation of the leptomeningis
31
Leptomeningis=
Pia and Arachnoid
32
Meningitis is most commonly due to
Infectious agent
33
Neonate meningitis causes
GBS
E.Coli
L. Monosytogenes
34
Children meningitis causes
N. Meningitdis
35
Adults meningitis causes
Sterp. Pneumo
36
Most common viral cause of meningitis
Coxsackivirus
37
Meningitis presents as
Headache
Neck stiffness
Fever
38
Bacterial meningitis CSF features
Neutrophils
| Low glucose
39
Viral meningitis CSF features
Lymphocytes
| Normal glucose
40
Fungal meningitis CSF features
Lymphocytes
| Normal glucose
41
Complications of meningitis are seen in _________ meningitis
Bacterial
42
What can be the cause of Global cerebral ischemia?
Low perfusion
Shock
Anemia
Repeated episodes of hypoglycemia
43
Regional ischemia that results in neurologic deficit for > 24h is called
Ischemia stroke
44
Regional ischemia that results in neurologic deficit for < 24h is called
Transient Ischemic Attack TIA
45
Subtypes of Ischemic stroke
Thrombotic
Embolic
Lacunar
46
Thrombotic stroke results in ______ infarct at the _______
Pale
| At the periphery of the cortex
47
Embolic stroke results in a ______ infarct at the ________
Hemorrhagic
| At the periphery of the cortex
48
Lacunar stroke involves which blood vessels
Small vessels of the brain
49
In Lacunar stroke, the small vessels of the brain go through ___________ change
Hyaline arteriolosclerosis
50
Lacunar stroke most commonly involves ______ vessels
Lenticulostriate
51
Ischemic stroke leads to _______ necrosis
Liquefactive
52
Earliest change in ischemic stroke
Red neurons
53
1 month post ischemic stroke gross pathology will look like
Fluid filled cystic space surrounded by gliosis
54
Bleeding into the brain is called
Intracerebral hemorrhage
55
Intracerebral hemorrhage is usually due to
Rupture of Charcot-Bouchard microaneurysms
56
Most common site of intracerebral hemorrhage
Basal ganglia
57
Bleeding into the subarachnoid space is called
Subarachnoid hemorrhage
58
Subarachnoid hemorrhage presents as
Sudden headache with nuchal regidity
59
LP of subarachnoid hemorrhage will show
Xanthochromia (Yellow hue due to bilirubin breakdown)
60
Subarachnoid hemorrhage happens most frequently due to
Rupture of Berry aneurysm
61
Most frequent location of Berry aneurysm
Anterior circle of Willis (Branch point of anterior communicating artery)
62
Berry aneurysm is associated with what diseases
ADPKD
| Marfan syndrome
63
CT scan of Epidural hematoma
Lens shaped lesion
64
Epidural hematoma usually happens due to
Fraction of the temporal bone with rupture of the middle meningeal artery
65
Subdural hematoma is usually due to
Tearing of bridging veins between Dura and Arachnoid
66
Types of brain herniation
Tonsillar
Subfalcine
Uncal
67
Tonsillar herniation can cause
Compression of brain stem -> Cardiopulmonary arrest
68
PNS myelination
Schwann sells
69
CNS myelination
Oligodendrocytes
70
Inherited mutations in enzymes necessary for production or maintenance of myelin
Leukodystrophies
71
Multiple sclerosis is caused by
Autoimmune destruction of CNS myelin and oligodendrocytes
72
Multiple sclerosis is associated with
HLA-DR2
73
Clinical featured of Multiple Sclerosis
| Optic nerve
Blurred vision in one eye
74
Clinical featured of Multiple Sclerosis
| Brainstem
Vertigo and scanning speech
75
Diagnosis of MS
MRI shows plaques
| LP shows increased lymphocytes
76
Treatment of acute attack of MS
High dose steroids
| IFN-B
77
Progressive mpMultifocal Leuko-Encephalitis is due to
JC virus infection of oligodendrocytes
78
Central demyelination of pons is called
Central pontine myelinolysis
79
Central pontine myelinolysis classically presents as
Locked in syndrome
80
Central pontine myelinolysis is due to
Rapid IV correction of hyponatremia
81
CNS metastatic lesion usually presents as
Multiple, well circumscribed lesions
82
3 most common cancer that like to metastasize to the brain
Lung
Breast
Kidney
83
Most abundant glial cell
Astrocytes
84
Astrocytes make up the
BBB
85
CNS tumors in adults usually occurs ________ the tentorium
Above
86
What is the most common malignant tumor in adult
| CNS
Glioblastoma Multiforme
87
Glioblastoma Multiforme is a tumor of
Astrocytes
88
Special feature of Glioblastoma Multiforme
Crosses the corpus callosum (Butterfly lesion)
89
Which tumor produces butterfly lesion
Glioblastoma Multiforme
90
Histology of Glioblastoma Multiforme
A lot of necrosis
| Endothelial cell proliferation
91
Benign tumor of the Arachnoid cells
Meningioma
92
What is the most common benign CNS tumor in adults
Meningioma
93
Meningioma expresses ________ receptor
Estrogen
94
Meningioma histology picture
Whorled pattern
| Psammoma bodies
95
Schwannoma involves especially which CN?
8th at the CPA (Cerebellar Pontine Angle)
96
Schwanomma is __ positive
S100
97
Bilateral Schwanomma is seen in
NF2
98
Degeneration of cortex leads to
Dementia
99
Degeneration of brainstem and basal ganglia leads to
Movement disorders
100
Dementia=
Memory loss
Cognitive dysfunction
No loss of consciousness
101
Early onset AD is seen in
Familial cases
| Down syndrome
102
Familial cases of AD
| What mutation?
Presenilin 1 / 2
103
Why Down syndrome patient are prone to AD?
Amyloid Precursor Protein is found on chr. 21
104
__ allele of _____ is associated with increased risk of AD
E4
| Apo.E
105
___ is associated with decreased risk to AD
E2 allele of Apo.E
106
Morphological changes in AD
Cerebral atrophy
Neuritic plaques
Neurofibrillary tangles
Loss of cholinergic neurons in the nucleus basalis of Meynert
107
What are neuritic plaque?
Extracellular core compromised of AB amyloid with entangled neuritic processes
108
What is neurofibrillary tangle?
Intracellular aggregates of fibers composed of hyperphosphorylated tau protein
109
What is Tau protein
Microtubule associated protein
110
Multifocal infarction and injury due to HTN/Atherosclerosis/Vasculitis can cause
Vascular dementia
111
Pick disease is a degenerative disease of
Frontal and temporal cortex
112
Pick disease is characterized by
Round aggregates of tau protein in neurons of the cortex
113
Pick disease is characterized by what symptoms
Behavioral and language
114
Parkinson disease=
Degenerative loss of Dopaminergic neurons in the substantia nigra of the basal ganglia
115
Basal ganglia helps to regulate ________
Movement
116
Clinical features of Parkinson disease (4)
TRAP
Tremor
Rigidity
Akinesia
Postural instability
117
Histology of Parkinson disease
Loss of pigmented neurons in sustantia nigra
| Round, eosinophilic inclusions of a-synuclein (Lewy body)
118
______ is a common feature of late Parkinson
Dementia
119
Describe Huntington disease
Degeneration of GABAergic neuron in the caudate nucleus of the basal ganglia
120
What is the genetics background of Huntington
AD
Chr. 4
Expanded CAG repeats in the Huntington gene
121
Further expansion of repeats during spermatogenesis leads to _________ in Huntington
Anticipation
122
Rapid movements=
Chorea
123
Degenerative disease due to prion protein=
Spongiform encephalopathy
124
Prion protein is normally expressed in
CNS neurons in an a-helical configuration
125
Spongiform encephalopathy arises with conversion to a
Beta pleated conformation of the prion protein
