Lecture 21 Pathology for CNS 2 Flashcards Preview

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Flashcards in Lecture 21 Pathology for CNS 2 Deck (50):
1

Give examples of cerebrovascular diseases?

Strokes, TIA and intercerebral haemorrhage

2

How much for the brain weigh?

1-2% of body weight

3

How much O2% does the body use?

20%

4

When blood flow is reduced to brain, tissue survival depends on?

Collateral circulation, duration of ischaemia and magnitude/rapidity of flow reduction

5

Global hypoperfusion (blood flow reduce to whole brain) causes?

Hypotentsion or cardiac arrest -> generalised neuronal dysfunction

6

How many patients/year have stroke?

130,000

7

What are the risk factors for strokes?

Diabetes M, hypertension, hyperlididaemia, heart disease or previous TIA

8

Define TIA

Transient ischaemic attack is temp loss of function that resolves itself within 24 hours

9

Risk of having full stroke after TIA?

1 in 10 chance of having full stroke within 4 weeks if left untreated

10

Treatments for TIA?

Aspirin/clopidogrel as antiplatelets. Control BP and lower cholesterol

11

Define aphasia?

Loss of speech

12

Define hemianopia?

Loss of vision

13

What causes an intracerebral haemorrhage?

Hypertension 'capsular haemorrhage'. Arterial origin.

14

What causes a subarachnoid haemorrhage?

Spontaneous. 80% rupture of saccular aneurysms

15

What causes subdural haemorrhage?

Minor trauma (elderly). Anticoagulants. Bleeding from bridging veins between cortex & venous sinuses

16

What causes extradural haemorrhage?

Middle meningeal artery, post head injury

17

What are the symptoms of a intracranial haemorrhage?

Headache, rapid or gradual loss of consciousness

18

What are the symptoms of a subarachnoid haemorrhage?

Thunderclap headache. Spontaneous -> catastrophic

19

What are the symptoms of a subdural haemorrhage?

Fluctuant conscious level, minor trauma.

20

What are the symptosms of a extradural haemorrhage?

Head injury with #skull. Slowly decreasing conscious level.

21

What is dementia?

Irreversible clinical synddromewith widespread impairment of mental function

22

Who is at risk of dementia?

>65yo. 80,000 people in uk

23

Side effects of dementia?

Memory loss, speed of thought, language, understanding, disinterested, difficulties in controlling emotions.

24

What can mimic dementia?

Depression or delirium

25

What are the types of dementia?

Alzheimer's disease (70%), Vascular dementia (15%) and dementia with lewy bodies (15%). RARE cause (syphilis)

26

What assessments are done for dementia?

Ensure thyroid function is normal, CT scan, Check vit B12 (alcoholism)

27

What is alzheimer's disease due to?

AB amyloid accumulation. Tau - neurofibrillary tangles and plaques, loss of neurones and synapses.

28

What does alzhimers lead to?

defects in visual-spatial skills (gets lost), memory loss, decreasing cognition and ansognosia (lack of awareness)

29

What is alzhimers treated with?

cholinesterase inhibitors

30

What is epilepsy?

Recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain -> seizures.

31

What can cause epilepsy?

Space occupying lesions, stroke, alcohol withdrawal.

32

How can epilepsy be managed?

Sodium valproate, carbamazepine, phenytoin, lamotragine

33

What bacteria can cause meningitis?

Neisseria meningitides, pneumocococcus, meningococcus

34

Meningitis can be what?

Bacterial, viral or fungal

35

What are the symptoms of brain abscesses?

Headaches, seizures and temperaures

36

Radiologically what is found with a brain abscess?

Ring enhancing lesion

37

How are brain abscesses spread?

Via blood (embolus from bacterial endocarditis,IV drug users at risk) or directly (from infected ear)

38

What is parkinson's disease?

Movement disorder, sporadic or familial. 1 in 1000

39

What is the postural instability of parkinson's disease due to?

Progressive degeneration of the dopaminergic nigrostriatal system.

40

What are the clinical features of parkinson's disease?

Bradykinesis, rigidity, resting tremor, posterural instability

41

Define bradykinesis?

Slowed ability to start and continue movements & impaired ability to adjust the body's postition

42

What is the treatment for parkinson's disease?

L-dopa e.g modopar to replace the lost dopamine. (Start when necessary & lowest poss dose) OR anticholinergic drugs

43

What drug can induce parkinson's and how can it be helped?

Haloperidol and can be helped me procyclidine

44

Side effects of tumours?

Headaches, seizures, cognitive behaviour change, vomiting, altered consciousness

45

Where can the primary tumours be that cause brain tumours?

Breast, small cell lung cancer

46

What are the four types of brain tumours?

Meningiomas, astrocytomas, glioblastomas and pituitary tumours

47

Notes on meningiomas?

Slow growing, don't often infiltrate brain, surgically removed.

48

Notes on astrocytomas?

Range from WHO grade 1-IV. ^ malignant potential. Grade 4 fatal

49

Notes on glioblastoma?

Ring enhancing lesion in frontal lobe

50

Define transphenoidally

Surgery where instruments are inserted into part of the brain through nose