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Pathology > Lecture 21 Pathology for CNS 2 > Flashcards

Lecture 21 Pathology for CNS 2 Flashcards

1
Q

Give examples of cerebrovascular diseases?

A

Strokes, TIA and intercerebral haemorrhage

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2
Q

How much for the brain weigh?

A

1-2% of body weight

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3
Q

How much O2% does the body use?

A

20%

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4
Q

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

A

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

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5
Q

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

A

Hypotentsion or cardiac arrest -> generalised neuronal dysfunction

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6
Q

How many patients/year have stroke?

A

130,000

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7
Q

What are the risk factors for strokes?

A

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

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8
Q

Define TIA

A

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

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9
Q

Risk of having full stroke after TIA?

A

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

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10
Q

Treatments for TIA?

A

Aspirin/clopidogrel as antiplatelets. Control BP and lower cholesterol

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11
Q

Define aphasia?

A

Loss of speech

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12
Q

Define hemianopia?

A

Loss of vision

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13
Q

What causes an intracerebral haemorrhage?

A

Hypertension ‘capsular haemorrhage’. Arterial origin.

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14
Q

What causes a subarachnoid haemorrhage?

A

Spontaneous. 80% rupture of saccular aneurysms

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15
Q

What causes subdural haemorrhage?

A

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

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16
Q

What causes extradural haemorrhage?

A

Middle meningeal artery, post head injury

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17
Q

What are the symptoms of a intracranial haemorrhage?

A

Headache, rapid or gradual loss of consciousness

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18
Q

What are the symptoms of a subarachnoid haemorrhage?

A

Thunderclap headache. Spontaneous -> catastrophic

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19
Q

What are the symptoms of a subdural haemorrhage?

A

Fluctuant conscious level, minor trauma.

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20
Q

What are the symptosms of a extradural haemorrhage?

A

Head injury with #skull. Slowly decreasing conscious level.

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21
Q

What is dementia?

A

Irreversible clinical synddromewith widespread impairment of mental function

22
Q

Who is at risk of dementia?

A

> 65yo. 80,000 people in uk

23
Q

Side effects of dementia?

A

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

24
Q

What can mimic dementia?

A

Depression or delirium

25
Q

What are the types of dementia?

A

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

26
Q

What assessments are done for dementia?

A

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

27
Q

What is alzheimer’s disease due to?

A

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

28
Q

What does alzhimers lead to?

A

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

29
Q

What is alzhimers treated with?

A

cholinesterase inhibitors

30
Q

What is epilepsy?

A

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

31
Q

What can cause epilepsy?

A

Space occupying lesions, stroke, alcohol withdrawal.

32
Q

How can epilepsy be managed?

A

Sodium valproate, carbamazepine, phenytoin, lamotragine

33
Q

What bacteria can cause meningitis?

A

Neisseria meningitides, pneumocococcus, meningococcus

34
Q

Meningitis can be what?

A

Bacterial, viral or fungal

35
Q

What are the symptoms of brain abscesses?

A

Headaches, seizures and temperaures

36
Q

Radiologically what is found with a brain abscess?

A

Ring enhancing lesion

37
Q

How are brain abscesses spread?

A

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

38
Q

What is parkinson’s disease?

A

Movement disorder, sporadic or familial. 1 in 1000

39
Q

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

A

Progressive degeneration of the dopaminergic nigrostriatal system.

40
Q

What are the clinical features of parkinson’s disease?

A

Bradykinesis, rigidity, resting tremor, posterural instability

41
Q

Define bradykinesis?

A

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

42
Q

What is the treatment for parkinson’s disease?

A

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

43
Q

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

A

Haloperidol and can be helped me procyclidine

44
Q

Side effects of tumours?

A

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

45
Q

Where can the primary tumours be that cause brain tumours?

A

Breast, small cell lung cancer

46
Q

What are the four types of brain tumours?

A

Meningiomas, astrocytomas, glioblastomas and pituitary tumours

47
Q

Notes on meningiomas?

A

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

48
Q

Notes on astrocytomas?

A

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

49
Q

Notes on glioblastoma?

A

Ring enhancing lesion in frontal lobe

50
Q

Define transphenoidally

A

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

Pathology (25 decks)

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