Exam 1: IS: Introduction to Clinical Neurology and Neuropathology (Neuropathology section) Flashcards

1
Q

red neuron change

A

Ischemia:

  • Neurons are the most sensitive cell to ischemic injury
  • Acutely, acidosis develops and the basophilic Nissl in the cytoplasm disperses. This causes the cytoplasm to be red (“red neuron change”).

*In image: Red Neuron Change- Acidosis causes disruption of Nissl substance. Eosinophilia (i.e. red change) develops.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chromatolysis/axonal reaction

A

Axonal Injury/Transection:

In injury to the very proximal axon, the neuronal cell body can show changes including swelling and rounding of the cell body, peripheral displacement of the nucleus, and peripheral dispersion of the Nissl substance.

*In image: Chromatolysis/Axonal Injury – Note the described changes in Figure 22-1 C from Kumar V, Abbas AK, Aster JC. Basic Pathology, 9th ed., 2013. These include swelling of cell body and peripheral dispersal of Nissl substance. Compare with histology slides of normal neurons.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

abnormal accumulations of proteins or pigments

A

Inclusions in nucleus and/or cytoplasm of affected cells:

  • DegenerativeLewy body in Parkinson disease, Neurofibillary tangle in Alzheimer disease
  • ViralLarge intranuclear inclusions in cytomegalovirus (CM)
  • Pigment – Accumulation of lipofuscin in aging

*In image: Cytoplasmic inclusion - Neurofibrillary tangle in Alzheimer Disease is an example of an inclusion. The tangle is composed of hyperphosphorylated tau, a microtubule associated protein. The presence of this tangle disrupts the normal cellular processes in the neuron. The neuron is dysfunctional and will eventually degenerate/die. Neuronal loss results.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Glial - Astrocytes

Name 3 times Astrocytes inclusions are seen in the brain

A

***GFAP is an antigen that appears on glial cells (not on neurons) and stains brown if (+)***

1) Gliosis – Reaction to injury (akin to fibrosis elsewhere)

  • Gemistocytic astrocytes – hyperplastic astrocytes with prominent cytoplasm.
  • Alzheimer Type 2 Astrocytes – Hepatic encephalopathy

2) Cellular Swelling – Acute Ischemia/Toxic Exposures
3) Degenerative Diseases

Glial Inclusions in astrocytes and/or oligodendroglial cells in progressive supranuclear palsy (PSP) and multiple system atrophy (MSA).

*In image: Note that this is a GFAP (glial fibrillary acid protein) stain, an immunochemical stain that stains astrocytes. The positive cells stain brown. Note the stellate processes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Glia - Oligodendroglial Cells

Name 2 times Oligodendroglial inclusions are seen in the brain

A

***Luxol fast blue PAS stains for myelin. Normal myelin is dark blue***

Problems with the Oligodendroglial Cells result in loss of myelin. The loss of salutatory conduction results in neurologic dysfunction.

1) Loss of myelin/Decreased production

  • Demyelinating Diseases (MS, demyelinating neuropathies)
  • Leukodystrophies (Genetic Diseases)
  • Infections (HIV, PML)
  • Toxic (Carbon Monoxide)

2) Viral inclusions

Progressive Multifocal Leukoencephalopathy (PML)

*In image: Note that this is a GFAP (glial fibrillary acid protein) stain, an immunochemical stain that stains astrocytes. The positive cells stain brown. Note the stellate processes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Glia - Ependymal Cells

Name 1 times Ependymal inclusions are seen in the brain

A

Ependymal cells line the ventricles. With injury (hydrocephalus), the ependymal cells can form elevations as a reaction. CMV has a propensity for infecting ependymal cells lining the ventricle.

1) Viral Inclusions (CMV)

*In image: Note that this is a GFAP (glial fibrillary acid protein) stain, an immunochemical stain that stains astrocytes. The positive cells stain brown. Note the stellate processes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Glia - Microglial Cells

Name 1 times Microglial Cells proliferations are seen in the brain

A

***In normal brain sections stained with H&E, microglia cells blend into the background.***

1) Proliferations seen often with viral infections

  • Microglial nodules
  • Rod Cells (Syphilis)
  • Neuronophagia (Polio)

*In image: Microglial nodule in viral encephalitis (infection of brain). In normal brain sections stained with H&E, microglia cells blend into the background.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Blood Cells - Neutrophils

Are seen or associated with what infections or disorders?

A

Acute infections

Limited in CVA’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Blood Cells - Lymphocytes

Are seen or associated with what infections or disorders?

A

Viral infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Blood Cells - Macrophages/Microglia

Are seen or associated with what infections or disorders?

A

Liquefactive Necrosis in CVAs

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Stains - H & E

is normally used for?

A

Most important and general-purpose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Stains - Luxol Fast Blue

is normally used for?

A

Myelin stains blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stains - Silver Stains (.g. Bielchowsky)

is normally used for?

A

Alzheimer plaques and tangles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stains - Glial Fibrillary Acid Protein (GFAP)

is normally used for?

A

Glial differentiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly