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Pathology Pt. 5 > Nervous System 2 > Flashcards

Flashcards in Nervous System 2 Deck (47)
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Where are most CNS tumors found?

Intracranial tumors are most common (amongst those, supratentorial are most common); tumors of the spinal cord are much less common


True or false: CNS tumors are the second most common form of malignancy in children after leukemias.



Do primary CNS tumors often metastasize?

Nope; metastasis to the brain is much more common


What two types of tumors are the most common primary intracranial tumors in children?

Cerebellar astrocytoma and medulloblastoma


Name the three most common primary intracranial neoplasms in adults in descending order.

1. Glioblastoma multiforme
2. Meningioma
3. Acoustic neuroma


Glioblastoma multiforme is a form of ______ and represents the highest grade ______. Its peak incidence is at the ages of...?

its a form of glioma and represents the highest grade astrocytoma

peak incidence is in late middle-ages


Glioblastoma multiforme most commonly originates in the _______ _______.

cerebral hemisphere


What is the prognosis for glioblastoma multiforme?

Very poor; death in


What microscopic morphological changes are seen in a glioblastoma multiforme (5)?

1. Anaplasia
2. Pleomorphism
3. Hyperchromatism
4. Vascular changes; endothelial hyperplasia
5. Areas of necrosis and hemorrhage surrounded by a "PSEUDO-PALISADE" arrangement of tumor cells


What is a meningioma?

Benign, slow-growing tumor usually attached to the dura and arising around the meningothelial cells of the arachnoid.


Meningiomas most often occur after _____ years of age and is more frequent in ______ (males or females).

30 years old

more common in females


Where exactly in the brain are meningiomas often found?

In the convexities of the cerebral hemispheres and the parasaggital region


Describe the gross morphological appearance of a meningioma.

Well-defined, dural-based masses that compress the brain but can be easily separated from it.


Some meningiomas infiltrate the brain; this is associated with increased risk of ______.



Describe the microscopic morphological changes seen in a meningioma.

Variable; WHORLED PATTERN of concentrically-arranged SPINDLE CELLS and laminated calcified PSAMMOMA BODIES


What is the prognosis of a meningioma dependent upon (3)?

1. Size
2. Location/surgical accessibility
3. Histologic grade


Multiple sclerosis is a chronic primary disease of _______ characterized by a repalsing-remitting of the disease over many years.

chronic primary disease of myelin (white matter)


Which disease is the most common form of demyelinating disease? What is its prevalence?

multiple sclerosis (1 in 1,000 prevalence)


At what ages and in which gender does MS occur most often?

Most often begins between 20-30 years of age, 2X more common in women than men


What is the etiology of multiple sclerosis?

Unknown; multifocal - environmental, genetic factors result in loss of tolerance to myelin.


Risk of getting MS is ___-fold higher when the disease is present in a 1st degree relative, and there is also increased incidence in association with certain _____ haplotypes.

15-fold higher risk if 1st degree relative has it. Increased incidence in peeps with certain HLA haplotypes


What morphological changes are seen in the case of MS (7)?

1. Affects white matter
2. Confined to CNS
3. Depletion of myelin-producing oligodendrocytes
4. Multiple focal areas of demyelination scattered throughout the CNS
5. T cells (CD4+ and CD8+) and macrophages infiltrate the plaques
6. Axons are preserved
7. Reactive gliosis


Describe the clinical features of MS (6).

1. Multiple episodes of relapse and remission (although recovery is not complete)
2. Gradual, stepwise accumulation of neuro deficits
3. Lower extremity weakness
4. Visual and sensory disturbances
5. Retrobulbar pain
6. Loss of bladder control


What is often found in the CSF of a patient with MS? What other lab finding is characteristic of MS?

CSF shows mildly elevated protein level with increased proportion of gamma-globulin.

Other finding: oligoclonal bands in Ig representing Abs against a variety of targets


What does Luxol fast blue do? What disease is this useful in observing the effects of?

It stains myelin - useful in detecting MS


What is the most common cause of dementia in the elderly?



Describe the pathogenesis of Alzheimer's.

Begins subtly as impairment of higher intellectual function and alterations in mood and behavior. Loss of memory is the most frequent early sign. Memory loss and aphasia (trouble with speech) progress onwards.


What is the most frequent cause of death in Alzheimer's patients?

Pneumonia or other infections


The majority of Alzheimer's cases are ______, but a familial form is recognized, making up ___ to ___% of cases.

most cases are sporadic

familial makes up 5-10% of cases


Name the four genetic factors associated with Alzheimer's.

1. Apolipoprotein E: e4 allele increases risk and early onset, E2 allele is protective.
2. Presenilin-1: mutations increase risk for early-onset.
3. SORL1: associated with late onset.
4. Trisomy: patients with Down syndrome experience extensive senile plaque formation and early onset AD because the gene for amyloid precursor protein (APP) is on chromosome 21.