- Hypoxia, hypoglycemia, toxic - hyperammonemia (wilson'c, chronic liver, alz type II - pharyngioma

Forebrain malformations are causd by what? - Mega/Microcepphaly

-Cephaly Fetal alcohol, HIV, Zika, Lissen: -

Exam2 Flashcards by Jordan Greenfield

You see Rosenthal fibers. What does this indicate and what 2 diseases are you thinking? How would you differentiate between the 2?

Long standing gliosis with Heat shock proteins

Pilocytic astrocytoma
Alexander disease

Pilocytic = children

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What is the astrocyte marker?

Microglia?

Astro: GFAP
Micro: CR3, CD68 (same as macros)

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A patient presents after a MVA. What 3 things are you watching for?

Diffuse axonal injury
Post traumatic hydrocephalus
Post traumatic encephalopathy

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A patient presents with headache, vomiting, and confusion. Pt dies before treatment. On autopsy we see edema, petechiae, and fibrinoid necrosis. What happened?

acute hypertensive encephalopathy

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15 yo Pt begins having seizures & hemorrhages. A CT is done and an AV malformation is suspected. Which?

Tortoise vessels that skip capillary circulation

10-30 yo

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A patient presents with ataxia, autonomic disturbance, stupor,a nd falls into a coma. On Genetic testing You see a PrP mutation. You find no spongiform pahtology

Familial Fatal insomnia

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Oligoclonal IgG bands in immunoelectrophoresis is diagnostic for what dz?

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You see true Rosettes. Whatcha thinking?

Homer Wright Rosettes

Ring enhancing lesions

Neurofibrillary tangles

Ependymoma or Retinoblastoma

Neuroblastoma in adrenal gland and Medulloblastoma

Aspergillus, Toxoplasma, glioblastoma

Alz, subacute sclerosing panencephalitis, progressive supranuclear palsy

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A pregnant woman with a history of neuro tumor presents in her 3rd trimester with nueological deficits. Wha ttype of tumor

Meningioma

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Neurofibrillary tangles?

Alz, Subacute sclerosing panencephalitis

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Which ones have degernating basal aganglia?

Cerebrum?

Huntington = Straitum
Parkinson = Substatia nigra
Wilson = Globus Pallidus
Hemiballism = Subthalamic nucleus

Cerebrum:
Alzheimer
Lewy Body Dementia

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You see hyperphosporylated tau in there, what all could it be?

Pick’s disease, Progressive supranuclear palsy, Alz

NOT Vascular dementia

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You see mega multnucleated cells, what could it be?

TB or HIV

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A 16-year-old boy with no prior medical problems has
complained of headaches for the past 9 months. There are no
abnormal findings on physical examination. CT scan of the
head shows enlargement of the lateral cerebral ventricles and
third ventricle. A lumbar puncture is performed with normal
opening pressure, and clear CSF is obtained, which has a
slightly elevated protein, normal glucose, and no leukocytes.

Ependyomma bc it occurs in 4th ventricle at his age.

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What things are likely to obstruct CSF?

Ependymomma –> in 4th ventricle
Pneumococcal meningitis –> Occurs in vertex, where arachnoid granulations are
Medulloblastoma –> occurs midline, by cerebellum

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3 causes of gliosis?

Hypoxia, hypoglycemia, toxic
hyperammonemia (wilson’c, chronic liver, alz type II
pharyngioma

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What are the 2 types of edema? What causes these typ es of edema?

Vasogenic:

BBB disruption
Intravascular –> intercellular
Localized –> inflammation neoplasms
Follows ischemic injury

Cytotoxic

Intracellular cell membrane injury
hypoxic or ischemic insult

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Forebrain malformations are causd by what?

Mega/Microcepphaly

-Cephaly
Fetal alcohol, HIV, Zika,

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CHiari I associaated with?
Chiari II?
Dandy Walker?

I = syringomyelia
II = meningomyelocele
III = spina bifida, noncommunicating hydrocephalus

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Genetically you have a baby with defect in filamin A and double cortin on X chromsome. What does this cause?

Neuronal heterotopia –> migrational defect –> Epilepsy

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Patient presents with dementia, dystaxia, and focal neuro deficits; PMH of HTN.

Hypertensive ecephalopathy

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IN intracranial hemorrhage, which parts of the brain are affected most commonly?

Putamen>Thalamus> pons> Cerebellum

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What vascular malformations occur in the cerebellum and pons? What does this mean?

Cavernous malformations;

They have low flow without arteriovenous shunting?

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What’s it called when you have a gaggle of blood vessels all weird in your lumbosacral region?

venous angioma, foix alajouanine

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bacteria or fungi in the sinuses gets into the subdural space. What is this called and what does it cause?

Called: Subdural empyema Causes: Mass effect - occlusion and brain infarction.

Pt presents with spine compression; how does this happen and whats it called

Extradural abscess, caused by osteomyelitis or surgical procedure

Startle myoclonus is seen in what?

CJD

A female pt presents with bilateral optic neuritits and spinal cord demyleination. WHat is the dz and what isthe MOA

Neuromyelitis optica, Devic disease Abs against aquaporin, destroys astrocytes --> BBB destroyed

Pt presents after getting an MMR vaccination with headache, and lethargy. She slips into a coma and dies. WHat happened?

Periventricular demyleination due to acute disseminated encephalomyelitis.

Patient has a respiratory infection, recovers, then dies. After autopsy, the physician notes demyelination of CNS. dz?

Acute necrotizing hemorrhagic encephalomyelitis.

A 50-70 yo male patient has a shuffling gait, vertical gaze palsy, truncal rigidity, exaggerated gag reflex, tongue spasticity and UMN weakness. Is there tau?

Progressive supranuclear palsy 4R tau straight filaments

What are the Parkinson's Diseases

``` PD Lewy Body Dementia MSA Postencephalitic Parkinson Progresive Supranuclear Palsy Corticobasal Degeneration ```

What dz can MPTP cause?

Parkinson

What Parkinsonian disease is characterized by early dementia (less than a year) and has lewy bodies in the cortex?What other symptoms can you expect to see?

Lewy Body Dementia Hallucinations

What Parkinsonian disease is characterise by alpha synuclein inclusions in oligodendrocytes? What other symptoms can you expect to see?

Mutiple System atrphy Straitonigral circuit = Parkinsonism Olivopontocerebellar cirtcuit = ataxia ANS = orthostatic hypotension

What Parkinsonian disease is characterise by asymmetric movement disorder? What other symptoms can you expect to see?

Ccorticobasal degeneration. Not sure on the rest.

I'll name build ups, you name diseases. Galactocerebrosidase Galactocerebrosidase + Psychosine Hexosaminidase Arylsulfatase A long chain fatty acids Aspartoacylase A

Gaucher Krabbe disease Tay Sachs Metachromatic leukodystrophy Adrenleukodystrophy Canavan disease

What is the most common mitochondrial abnormality? and what does it result in? Next most common?

MELAS Mitochondrial encephalomyopathy with muscle weakness from lactic acid and stroke like episodes MERRF: Myoclonic Epilepsy with Red Ragged Fibers

A pt is post op from an ileal resection. Sx are numbness, weakness and ataxia, paraplegia.

B12 deficiency that demyelinates SCD: Spinocerebellar tracts, Corticospinal tracts and Dorsal tracts.

How does CO poisoning work?

Layers III and V of cerebral cortex. Bilateral necrosis globus pallidus

Pt dx with brain tumor. Lab results show +EMA and vimentin. What is the mutation and the dz?

Atypical teratoid/rahbdoid tumor IV | SNF5/INI1

Pt presents with a .5 lesion on the medial inferior part of the eye lid. Histo shows peripheral palisading. Is this malignant or benign?

Basal Cell Carcinoma Most Common Malignancy malignant

Pt has a profusely thickened eyelid, where is it likely to spread?

Parotid and submandibular glands

What does PTP mean? LTP

PTP: increased frequency of EPSP in post synapse LTP: increased strength

What does CREB do and what does this mean for pre and post synapse?

Calmodulin uses PKA to activate CREB which activates transcription of receptors Post --> Pre: Calcineurin --> NO --> cGMP --> more NT release POst: Calmodulin --> cAMP --> more AMPAr --> more Na influx

Grid and place cells are found where?

``` Place = hippocampus, recognizing things Grid = Entorhinal cortex for spacing and orientation ```

Vasogenic edema generally follows what/

Ischaemia

diffuse axonal injury follows what?

Blunt force trauma

years after a brain trauma you can be susceptible to

epilepsey, psych disorder, meningioma, infection

years after a brain trauma you can be susceptible to.. ? due to..? What do you see on histo and labs

epilepsey, psych disorder, meningioma, infection due to post truamatic hydrocephalus; chronic traumatic encephalopathy (CTE) hydrocephalus, diffuse axonal injury, amyloid plaques, thin corpus callosum

Intraparenchymal hemorrhage is most often caused by

HTN and amyloid angiopathy

TB complications?

Arachnoid fibrosis → hydrocephalus | Inflammation infiltrating blood vessels → Obliterative endarteritis → infarction

The following are characteristics of demyelinating syndromes. name teh syndrome. - Pt has the cold, the rhinovirus, then 1-2 weeks later, dies. Autopsy = lipid laden macrophages and periventricular demyelination - Abs against aquaporin - Sudden CNS demylination after respiratory infection? - Rapid correction of hypontremia

- acute disseminated necephalomyelitis - Devic Desease, Neuromyelitis optica - Acute necrotizing hemorrhagic encphlomyelitis - Central Pontine mylinolysis

What vitamin deficiency can result in completel paraplegia

b12

difference between Korsakoff and Wernicke?

Korsakoff: confabulation Wernicke: Cardiac failure

Cherry red spot

Central retinal artery occlusion

Transtentorial herniation can result in?

Basilar artery --> Duret hemorrhages

Batwing deformity?

Agenesis of corpus callosum

Which neuronal fossa malformation can cause hydrocephalus? What else is this associated with?

Hydrocephalus: Chiari II. Meningomyelocele

premie pt with bulging fontanelle, coma, seizures.

Intraparenchymal hemoorhage, thalamus/caudate get messed up from fgerminal matrix

In neonatal ischemic infarcts, what happens?

Periventricular leukomalacia - chalky Multicystic leukoencephalopathy in cerebral hemispheres Basal ganglia --> reactive gliosis --> status marmoratus (hyperdense basal ganglia) --> choreoathetosis

What's it called when a skull fracture crosses a suture line?

Diastatic

Pt presents with a blunt force trauma and falls into a coma. CT shows deep white matter regions. What type of injury?

Diffuse axonal injury = axon swelling --> replaced by fibrosis and gliosis

You have inflammation in the parenchymaa with multinucleated giant cells and granulomas.

Primary angiitis

on CT it looks like axons AND myelin are the pattern of injury.

Binswanger disease

What can occur late after subarachnoid hemorrhage?

3-10 days after hemorrhage - vasospasm = hydrocephalus

Acute Chronic Kidney Disease puts you at risk for what?

Saccular aneurysm = subarachnoid hemorrhage

Most common cause of conjunctivitis? | Most common cause of aseptic meningitis?

Adenovirus Coxsackie virus

Chronic bacterial meningnitis is caused by

TB, Treponema, Borrelia

Paretic disesae is associated with what?

Neurosyphlilis Severe dementia, deulsions of grandeur f/ iron deposits

Tooth pulling can result in?

brain abscess f/ strep and staph

Osteomyelitis or surgical procedure can put you at risk for what?

Extradural abscess get into epidural sapce

Bacteria gets into subdural space and causes an occlusion resulting in infarction. Called?

Subdural empyema

Bergmann gliosis is seen in

Ethanol poinsoning

What are the symptoms of glioblastoma?

serpentine necrosis | pseudopalisading VEGF glomeruloid body

Which spreads to the cornea? Pterygium or Pinguecula

Ptergium

Band Keratopathycan be calcific or actinic. What is the difference?

Calcium in bowman's Actinic - UV light exposure

Sarcoidosis is associated with what?

Granulomatous uveitis

Elschnig spots, macular stars and cotton wool spots are found

Hypertensive retinopathy

Salmon patches, iridescent spots nd black sunburnt lesions

Retinal detachment from sickle retinoapthy

Exam2 Flashcards

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