Exam 3 - nervous system pathology

Question 1

Coup and counter coup

Answer 1

coup = initial blow. site of impact

countercoup = opposite site of impact

Question 2

Epidural hematoma

Answer 2

• arterial bleed
• btwn bone and dura
• crescent-shaped on scans

Question 3

Subdural hematoma

Answer 3

• venous bleed
• btwn dura and arachnoid membrane (takes shape of brain)
• *slowly enlarging clot
• *consciousness fluctuates

Question 4

pt has a massive midline shift and follows shape of brain. what bleed is this?

Answer 4

Subdural hematoma

Question 5

TBI 2 phases

Answer 5

phase 1 = rotational forces. (hallmark of TBI)

phase 2 = inflammatory

Question 6

Global hypoxic injury

Answer 6

• not enough oxygen to brain
• cerebral atrophy -> apoptosis of neurons = **RED NEURONS
• watershed zones infarct

Question 7

What are the signs of a stroke?

Answer 7

FAST!!

• face fallen on one side
• arms - cannot raise
• speech - slurred
• time! to call 911

Question 8

Thrombotic stroke

Answer 8

MCA most common location

-pale infarctions on exam

Question 9

Embolic stroke

Answer 9

• ischemic due to embolus

- aka hemorrhagic stroke (***looks red)

Question 10

intracerebral hemorrhage

Answer 10

• HTN cause stress. get microaneurysms. ruptures. hemorrhage

- basal ganglia

Question 11

Worst headache of life

Answer 11

=berry aneurysm

Question 12

Stepwise progression of stroke symptoms

Answer 12

lacunar infarct

Question 13

Anencephaly

Answer 13

absence of most of brain and skull

Question 14

spina bifida

Answer 14

fetal spinal column doesnt close

Question 15

meningocele

Answer 15

herniation of meninges thru spinal column defect

Question 16

meningomyelocele

Answer 16

herniation of meninges and spinal cord thru spinal column defect

Question 17

Extension of the medulla and cerebellar vermis through the foramen magnum =

Answer 17

Arnold-Chiari malformation

Question 18

partial or complete absence of cerebellar vermis =

Answer 18

Dandy-Walker malformation

Question 19

Syringomyelia

Answer 19

• cyst in spinal cord

- loss of pain and temp sensation in arms and upper pec area

Question 20

MS

Answer 20

• most common demyelinated disease

- Pathogenesis is T helper cell mediated

Question 21

younger to middle aged female comes in with blurry vision and difficulty with urination what auto immune disorder should you be looking for?

Answer 21

MS!!!

Question 22

Pseudotumor cerebri

Answer 22

-idiopathic intracranial HTN
-diagnosis of exclusion
-Edema around optic nerve
Goal: lower CSF pressure

Question 23

Wernicke vs korsakoff

Answer 23

Wernicke = reversible

Korsakoff = irreversible

Question 24

Meningitis

Answer 24

• inflammation of pia mater
• starts with blood infection
• have fever, stiff neck, headache

Question 25

Encephalitis

Answer 25

inflammation of brain parenchyma | -fever, headache, impaired mental status

Question 26

Primary brain tumors in kids vs adults

Answer 26

kids = majority below tentorium cerebelli *** adults = majority above tentorium cerebelli ***

Question 27

Astrocytoma (kid/adult location)

Answer 27

-most common neuroglial tumor ``` kids = cerebellum adults = frontal lobe ```

Question 28

Glioblastoma

Answer 28

- high grade astrocytoma | - crosses corpus callosum

Question 29

Common cause of new seizures

Answer 29

meningioma

Question 30

Apendymoma (kids/adults location)

Answer 30

adults = cauda equina kids = fourth ventricle

Question 31

medulloblastoma

Answer 31

- malig - small cell - likes to seed the neuroaxis (invade other areas)

Question 32

Oligodendroglioma

Answer 32

- benign | - fried egg cells

Question 33

Lymphoma in CNS majority are

Answer 33

metastatic non-Hodgkins