Neuro Pathology/Histology Flashcards
(208 cards)
1
Q
This is an example of a [?] hemorrhage
A
subdural (blood cannot cross midline)
2
Q
This is an example of a [?] hemorrhage
A
epidural (blood cannot cross suture lines)
3
Q
This is an example of a [?] hemorrhage
A
subarachnoid (blood cannot cross midline)
4
Q
This is an example of a [?] hemorrhage
A
intraventricular and intraparenchymal
5
Q
In T1-weighted MRIs, the [white/grey] matter is darker; while in T2-weight MRIs, the [white/grey] matter is darker.
A
In T1-weighted MRIs, the grey matter is darker; while in T2-weight MRIs, the white matter is darker.
6
Q
Pathology?
A
multiple sclerosis (tan-colored demyelinated plaques in white matter)
7
Q
Pathology?
A
Wallerian degeneration
(axon degenerates distal to the point of injury and macrophages ingest debris)
8
Q
Pathology?
A
central chromatolysis
(cell body shows swelling, nuclear eccentricity, and dispersal of the Nissl substance to the periphery of the cell)
9
Q
Pathology?
A
trick question!!
normal astrocytes stained with GFAP
10
Q
Pathology?
A
reactive astrocytes stained with GFAP
11
Q
Pathology?
A
Rosenthal fibers
(chronically reactive astrocytic process; lots of proteins, so brightly eosinophilic)
12
Q
Pathology?
A
corpora amylacea
(elaboration of astrocytic processes seen in normal aging human brains; contain glucose polymers)
13
Q
Pathology?
A
Alzheimer type II astrocyte
(large, comma-shaped vacuolated nuclei; seen in hepatic encephalopathy as a reaction to circulating toxins from liver failure)
14
Q
Pathology?
A
trick question!!!
satellitosis
(normal clustering of up to 5-6 oligodendrocytes around neuronal cell bodies)
15
Q
Pathology?
A
ependymal granulation
(astrocytic response to ependymal damage in encephalitis or meningitis)
normal ependymal cells shown here for comparison
16
Q
Pathology?
A
gitter cells
(lipid-filled macrophages; a microglial response to injury)
17
Q
Pathology?
A
rod cells
(elongated nuclei seen in microglia as a response to injury)
18
Q
name the herniation categories
A
19
Q
Pathology?
A
hydrocephalus ex-vacuo
(compensatory enlargement of the ventricles)
20
Q
paraneoplastic syndromes can produce antibodies to neural tissue and result in ataxia; common in what cancers?
A
lung, ovarian, lymphatic, breast
21
Q
childhood neurological disorder that causes degeneration in the cerebellum and small, widened blood vessels on the skin
A
ataxis-telangiectasia
22
Q
inherited disorder that impairs the normal absorption of fats and fat-soluble vitamins from diet
A
abetalipoproteinemia
very rare inherited form of ataxia
23
Q
rare inherited disease that causes progressive nervous system damage and movement problems, including ataxia
A
Friedreich ataxia
24
Q
pathology of brain infarct: 12-18 hours
A
microscopic evidence of ischemia with cytoplasmic eosinophilia
25
pathology of brain infarct: 24 hours
softening macroscopically
26
pathology of brain infarct: 3 days
PMN response peaks
27
pathology of brain infarct: 7 days
monocyte/macrophage response peaks; macrophages are filled with fat vacuoles due to myelin
28
pathology of brain infarct: 2-3 weeks
astrocytosis (astrocytes act like fibroblasts to fill in void) => eventually results in cyst formation
29
[pathology] are minute aneurysms in small vessels that can rupture and cause hemorrhage; they are usually found in the basal ganglia
Charcot-Bouchard microaneurysms
30
Pathology?
laminar necrosis
(uneven cortex surface due to laminar necrosis caused by cerebral ischemia)
31
Pathology?
watershed infarct
(wedge-shaped areas of infarction that occur in regions of the brain and spinal cord that lie at the most distal fields of arterial irrigation; usually seen after hypotensive episodes)
32
Pathology?
shower embolization
(widespread hemorrhagic lesions involving the white matter seen after fractures)
33
Pathology?
old MCA infarct leading to cystic cavity
34
Pathology?
lacunar infarct
cavities due to lost tissue with scattered fat-laden macrophages and surrounding gliosis; may be clinically silent or cause severe neurological impairment
occur in the lenticular nucleus > thalamus > internal capsule > deep white matter > caudate nucleus > pons
35
Pathology?
brain edema with petechiae seen on autopsy following hypertensive encephalopathy
36
Pathology?
subarachnoid hemorrhage
usually caused by bleeding from cerebral aneurysms
37
Pathology?
arteriovenous malformation
38
Pathology?
cavernous hemangiomas
(greatly distended, loosely organized vascular channels with thin, collagenized walls
39
localize the stroke:
weakness and sensory loss (arm>leg); if dominant hemisphere, aphasia; eyes looking toward lesion
middle cerebral artery complete occlusion
40
localize the stroke:
Wernicke's receptive aphasia
temporoparietal branch occlusion of MCA
41
localize the stroke:
Broca's expressive aphasia
frontal branch occlusion of MCA
42
localize the stroke:
contralateral weakness
frontal motor strip branch occlusion of MCA
43
localize the stroke:
contralateral sensory loss
parietal sensory strip branch occlusion of MCA
44
localize the stroke:
hemineglect
nondominant parietal lobe branch occlusion of MCA
45
localize the stroke:
ideomotor apraxia
dominant parietal lobe branch occlusion of MCA
46
localize the stroke:
weakness and sensory loss leg>arm
anterior cerebral artery (rarer than MCA)
47
localize the stroke:
hoarse, difficulty swallowing, Horner's
PICA occlusion (Wallenberg syndrome), medial part of lateral medulla (nucleus ambiguous, descending sympathetics)
48
localize the stroke:
ipsilateral loss of pain and temperature for face; contralateral loss of pain and temperature for body; vertigo, nausea, vomiting, nystagmus
PICA occlusion (Wallenberg syndrome), lateral part of medulla (descending trigeminal, spinothalamic tract, vestibular nuclei)
49
localize the stroke:
ipsilateral ataxia
PICA occlusion (Wallenberg syndrome), far lateral medulla (inferior cerebellar peduncle)
50
localize the stroke:
Wallenberg + tinnitus and hearing loss
AICA occlusion
51
localize the stroke:
limited weakness, dysarthria
paramedian pontin infarcts (lacunae)
52
localize the stroke:
more weakness and dysarthria; eyes looking away from lesion
large hemi-pontine infarct (lagoonar infarct)
eyes look away from lesion if 6th nerve nucleus is hit
53
localize the stroke:
locked-in syndrome (fully away but quadriplegic except for vertical eye moments and blink)
basilar artery occlusion where whole pons is infarcted
54
localize the stroke:
diplopia (Weber syndrome)
top of the basilar artery occlusion (top of the basilar syndrome), midline midbrain
55
localize the stroke: homonomous hemianopsia (loss of the same half of vision in both eyes)
top of the basilar artery occlusion (top of the basilar syndrome), bilateral PCA
56
warning signs before full basilar occlusion: vestibular nuclei
vertigo
57
warning signs before full basilar occlusion: corticospinal tract
hemiparesis/bilateral leg weakness
58
warning signs before full basilar occlusion: corticobulbar tract
dysarthria
59
warning signs before full basilar occlusion: cerebellar peduncle/cerebellum
ataxia
60
warning signs before full basilar occlusion: vestibular nucleus
nystagmus
61
warning signs before full basilar occlusion: lower midbrain reticular activating system
loss of consciousness
62
posterior circulation stroke signs
dangerous D's: dizziness, dysphagia, dystaxia, diplopia, dysarthria, drop attacks
nasty N's: nausea, numbness, nystagmus
63
picornavirus family viruses are small, [enveloped/non-enveloped], [ss/ds] [RNA/DNA] viruses
picornavirus family viruses are small, non-enveloped, ss RNA viruses
they serve as their own mRNA (do not carry RNA polymerase)
64
picornaviruses that cause meningitis include [?]
poliovirus types 1, 2, 3; coxsackie virus; echovirus types 1-34
65
picornaviruses are spread via [?]
fecal-oral route
there are no animal reservoirs, but flies can mechanically transmit viruses
66
name the pathogen:
paralysis caused by destruction of anterior horn cells in spinal cord and brainstem motor neurons => asymmetric flaccid paralysis with no sensory loss
poliovirus types 1, 2, 3
bulbar polio affects the pharynx, vocal cords, and diaphragm => ventilatory support or death
67
treatment for picornavirus infection is supportive for immunocompetent and [drug] for infants and immunodeficient
pleconoril
68
what vaccines exist for poliovirus?
sabin vaccine (live-attenuated organisms from all 3 strains, discontinued in US)
salk vaccine (killed virus)
69
name the pathogen:
vesicular lesions (hand, foot, and mouth disease) and herpes-like vesicles in buccal mucosa
Group A coxsackie virus
70
name the pathogen:
meningitis, myocarditis, pericarditis
Group B coxsackie virus
71
name the pathogen:
leading cause of viral meningitis; also causes a rash (maculopapular, petechial, or vesicular); usually self-limiting
echovirus types 1-34
72
name the pathogen:
protozoan parasite that accesses host through the nose, travels along olfactory nerve to the brain to cause primary amebic meningoencephalitis
Naegleria fowleri
73
though usually fatal within 3-6 days, some cases of N. fowleri have been successfully treated with [drug]
amphotericin B + miltefosine
74
name the pathogen:
long, very thin spirochet with hook on one or both ends; highly motile; transmission via contact with water, food, or soil contaminated with infected urine => entry via ingestion or abrasian
Leptospira interrogans
75
name the pathogen:
leptospirosis: ranges from subclinical to mild flu-like symptoms, meningitis, or severe system disease (Weil's disease)
Leptospira interrogans
76
Dengue virus is [enveloped/non-enveloped], [ss/ds] [RNA/DNA] virus
Dengue virus is an enveloped, ss RNA virus
(genome serves as mRNA)
77
Dengue virus transmission is via [vector]
urban mosquito Aedes aegypti; common in tropical areas
78
name the pathogen:
fever, chills, headache, myalgias, bone pain; rash frequently present; typically extremely painful and runs its course in 5-7 days
Dengue virus
79
Dengue virus immunity is characterized by [?], which cause a more severe secondary infection
enhancing antibodies
infection with a second serotype => formation of immune complexes that are internalized via Fc receptors on macrophages => more efficient infection and increased replication
80
secondary infection with a different serotype of [virus] can cause [clinical syndrome] due to the action of enhancing antibodies
secondary infection with a different serotype of Dengue virus can cause dengue hemorrhagic fever (DHF) or dengue shock syndrome
81
[virus family] are enveloped, ambisense RNA
Arenaviruses
82
Arena viruses are enveloped, ambisense RNA viruses that cause [clinical syndromes]
Lassa, Machupo, Junin
83
Filoviruses are [enveloped/non-enveloped], [positive/negative] sense [RNA/DNA] viruses that cause [clinical syndromes]
Filoviruses are enveloped, negative sense RNA viruses that cause Marburg and Ebola
84
minor outbreaks of [virus] in the US have been associated with contact with aerosolized mouse feces/urine
hantaan virus
85
their vector is the deer mouse, and outbreaks of [virus] coincide with high rainfall
sin nombre virus
86
name the pathogen:
hemorrhagic fever or pulmonary shock syndrome (coagulopathy, petechial hemorrhage, bleeding from gums/eyes/ears/GI tract, DIC, organ failure, death)
hantaan virus
87
name the pathogen:
pulmonary shock syndrome (pulmonary edema, respiratory failure, death)
sin nombre virus
88
[virus] viral particles are bull-shaped
rhabdovirus
89
rhabdovirus is [enveloped/non-enveloped], [ss/ds] [RNA/DNA] virus
rhabdovirus is an enveloped, ss negative sense RNA virus
90
[virus] can be identified by the excess nucleocapsid material that accumulates in host cytoplasm (Negri bodies)
rhabdovirus
91
name the pathogen:
virus remains near bite site and replicates in local tissue, then infects peripheral nerves => retrograde axonal transport to dorsal root ganglia => travels up CNS to brain
rhabdovirus
92
name the pathogen:
prodromal phase: once virus reaches peripheral nerves; fever, nausea, vomiting, headache, lethargy
neurologic phase: once virus reaches CNS; depression, anxiety, hallucinations, hydrophobia, photophobia, hypersalivation, paralysis, delirium, seizures
rhabdovirus
93
rhabdovirus infections can be treated with [?]
rabies immune globulin (RIG) from human serum
94
rhabdovirus vaccine is [?]
inactivated virus prepared from purified virus
95
Streptococcal agalactiae are gram [positive/negative] cocci in [chains/clusters], [?]-hemolytic, catalase [positive/negative], and [?] resistant
Streptococcal agalactiae are gram positive cocci in chains, B-hemolytic, catalase negative, bacitracin resistant
96
the number one cause of neonatal sepsis and meningitis is [?]
Streptococcal agalactiae
97
name the pathogen:
respiratory distress, fever, lethargy, hypotension; pneumonia => bacteremia => meningitis
Streptococcal agalactiae
98
Streptococcal agalactiae is treated with [?]
penicillin or ampicillin IV, sometimes and aminoglycoside
99
one of the two most common causes of neonatal sepsis and meningitis, [?] has an antiphagic K1 capsular polysaccharide
Escherichia coli
100
[?] is the most common cause of non-neonatal meningitis in children <6 years old
Streptococcus pneumoniae
frequent cause of cortical deafness/deficits
101
unimmunized children <2 years old are at risk for meningitis from [?]
Haemophilus influenzae
102
Neisseria meningitidis is a gram [positive/negative] [shape] transmitted via [?]
Neisseria meningitidis is a gram negative diplococci transmitted via airborne droplets
103
name the pathogen:
meningococcemia (skin involvement - petechial rash, may produce purpura); meningitis; fulminating meningitis; Waterhouse-Friedrichsen syndrome (DIC and shock)
Neisseria meningitidis
104
Neisseria meningitis tests:
[?] is positive for glucose only, while [?] is positive for glucose and maltose
N. gonorrhoeae is positive for glucose only, while N. meningitidis is positive for glucose and maltose
105
Neisseria meningitidis infection is treated with [?]
penicillin G (alternatives = ceftriaxone, chloramphenicol)
106
prophylaxis for close contacts of someone infected with Neisseria meningitis includes [?]
rifampin
107
Pathology?
acute pyogenic meningitis (S. pneumoniae; suppurative inflammation)
108
Pathology?
H. influenzae meningitis (basal inflammation)
109
Pathology?
Neisseria meningitidis
last photo is Waterhouse-Frederichson syndrome: overwhelming meningococcemia leads to massive hemorrhage in the adrenal glands
110
Pathogen?
S. pneumoniae
gram positive cocci arranged in pairs (gram positive diplococci)
111
Pathogen?
Neisseria fowleri
gram negative cocci arranged in pairs (gram negative diplococci)
112
Pathogen?
H. influenzae
(gram negative rod)
113
Pathology?
brain abscess
centrally liquefactive necrosis, surrounded by fibrous capsule, associated cerebral edema
114
Pathology?
brain abscess
centrally liquefactive necrosis, surrounded by fibrous capsule, associated cerebral edema
115
Pathology?
tuberculous meningoencephalitis
creamy or gelatinous exudate centered at the base of the brain
116
Pathology?
caseating granuloma in tuberculous meningoencephalitis
117
Pathology?
obliterative endarteritis
severe proliferating endarteritis; a complication of tuberculous meningoencephalitis
118
Pathology?
tuberculoma
inflammation may become localized and form a mass-like lesion; a complication of tuberculous meningoencephalitis
119
Pathology?
pott disease
vertebral tuberculosis (collapse of vertebral bodies with resultant spinal cord compression); complication of tuberculous meningoencephalitis
120
HIV is a spherical, [enveloped, non-enveloped], [ss/ds] [RNA/DNA] virus
HIV is a spherical, enveloped, positive sense ss RNA virus
121
genome elements found in retroviruses:
[?]: encodes RT, IN, and protease
[?]: encodes gp120 and gp41
[?]: encodes nucleocapsid, capsid, matrix proteins
[?]: regulates viral gene expression
pol: encodes RT, IN, and protease
env: encodes gp120 and gp41
gag: encodes nucleocapsid, capsid, matrix proteins
long terminal repeat: regulates viral gene expression
122
genome elements unique to HIV-1:
[?]: boosts expression of viral genes
[?]: promotes viral RNA transport from nucleus to cytoplasm
tat: boosts expression of viral genes
rev: promotes viral RNA transport from nucleus to cytoplasm
123
[?] is a structural protein that makes up most of the HIV viral core (capsid); measurement provides indication of viral load
p24
124
HIV viral DNA is detectable [?] after infection, p24 is detectable [?] after RNA
HIV viral DNA is detectable 10 days after infection, p24 is detectable 4-10 days after RNA
125
Pathogen?
toxoplasma gondii
intracellular tachyzoite within macrophage
126
Pathogen?
toxoplasma gondii
bradyzoite or cyst in brain tissue
127
Pathogen?
cryptococcus neoformans
India ink stain
128
Pathogen?
pneumocystis jirovecii
trophozoites stained with giemsa (can also be visualized with Gomeri stain)
129
Pathogen?
kaposi's sarcoma
non-tender, purple-reddish maculopapular skin lesions caused by human herpes virus 8
130
Pathology?
Primary CNS lymphoma
single lesion; contrast enhancing
131
Pathology?
toxoplasmosis
multiple ring-enhancing lesions
132
Pathology?
progressive multifocal leukoencephalopathy
lesions occur int he white matter and DO NOT have an enhancing rim
133
name the pathogen:
obligate intracellular parasite found within macrophages; main reservoir is the house cat, intermediate hosts include sheep and cattle
toxoplasma gondii
134
name the pathogen:
reactivation disease in immunocompromised individuals includes encephalitis, cerebral mass lesions, pneumonitis, chorioretinitis, and systemic disease
toxoplasma gondii
135
in infected pregnant women, newborns, and infants, toxoplasmosis is treated with [?]
pyrimethamine, suladiazine
136
name the pathogen:
asexual growth as budding yeast at both 25 and 37 degrees (NOT dimorphic); found in the excrete of pigeons (NO person-to-person transmission)
cryptococcus neoformans
137
name the pathogen:
primary infection occurs in the lung (usually asymptomatic); hematogenous spread => meningitis, disseminated disease (skin and bone lesions, brain abscess), leading cause of fungal meningitis
cryptococcus neoformans
138
name the pathogen:
primitive fungus that lacks ergosterol; transmitted via droplet inhalation
pneumocystis jirovecii
139
name the pathogen:
onset usually insidious; bilateral diffuse interstitial pneumonitis (ground glass appearance radiographically) with plasma cell infiltrates
pneumocystis jirovecii
140
name the pathogen:
identified in tissue specimen or lavage fluids using Gomeri silver stain or Giemsa stain
pneumocystis jirovecii
141
pneumocystis jirovecii is treated with [?]
TMP/SMX
resistant to antifungal drugs due to absence of ergosterol
142
cytomegalovirus is a large [enveloped/non-enveloped], [ss/ds] [RNA/DNA] virus
cytomegalovirus is a large, enveloped, linear ds DNA virus
buds from nuclear membrane
143
name the pathogen:
ubiquitous; transmitted via direct person-to-person contact, sexually, blood transfusions, tissue transplants, and from mother to infant before/during/after birth; can be isolated from tears, saliva, pharynx, semen, cervical secretions, peripheral blood leukocytes, amniotic fluid, and urine
cytomegalovirus
144
name the pathogen:
usually asymptomatic; reactivation disease in immunocompromised host = interstitial pneumonia, retinitis, esophagitis, GI tract upset
cytomegalovirus
145
cytomegalovirus treatment
ganciclovir, cidofovir, foscarnet
146
primary CNS lymphoma is a diffuse, large cell non-Hodgkin lymphoma of B cell origin caused by [?]
Epstein Barr virus
147
name the pathology:
lethargy, headache, personality changes, memory loss, confusion, weakness, seizures, cranial nerve involvement
primary CNS lymphoma (caused by EBV)
148
progressive multifocal leukoencephalopathy is caused by [?]
polyoma virus JC
149
polyoma virus JC is a [enveloped/non-enveloped] [ss/ds] [RNA/DNA] virus that causes [?]
polyoma virus JC is a non-enveloped ds DNA virus that causes progressive multifocal leukoencephalopathy
150
name the pathology:
EMG:
slow repetitive nerve stimulation => decremental response
fast RNS or exercise => incremental response
Lambert-Eaton myasthenic syndrome (LEMS)
151
Lambert-Eaton myasthenic syndrome symptoms can be treated with [?]
pyridostigmine (cholinesterase inhibitors)
152
name the pathology:
EMG:
slow repetitive nerve stimulation => decremental response
fast RNS or exercise => no incremental response
myasthenia gravis
153
myasthenia gravis is treated with [?]
pyridostigmine
immunosuppressants (steroids, azathioprine, mucophenylate, IVIG, and plasma exchange)
thymectomy
154
name the neuropathy:
pain, paresthesia, and sensory loss in thumb, index, and lateral half of ring fingers of affected hand; weakness of thumb abduction and atrophy of thenar eminance
median nerve entrapment (carpal tunnel syndrome)
155
name the neuropathy:
decreased grip and problems with finger dexterity; numbness of little finger and half of ring finger
ulnar neuropathy
156
name the neuropathy:
wrist drop, finger drop, and weakness of supination; mild elbow flexion weakness
radial neuropathy
157
name the neuropathy:
weakness of tow and foot dorsiflexion and foot eversion; sensory loss over dorsum of foot and lateral distal lower extremity
peroneal neuropathy
158
name the neuropathy:
paresthesia of lateral thigh
lateral femoral cutaneous neuropathy
159
name the radiculopathy:
weakness of shoulder abduction, elbow flexion, wrist flexion/extension; sensory loss of lateral forearm, thumb, and index finger; loss of biceps and brachioradialis reflex
C6 radiculopathy
160
name the radiculopathy:
weakness of elbow and wrist extension, sensory disturbance of middle finger, pain in neck and dorsum of forearm, loss of triceps reflex
C7 radiculopathy
161
name the radiculopathy:
acute back pain radiating around the anterior aspect of the thigh down into knee and occasionally down the medial aspect of lower leg as far down as the arch of the foot
L2, 3, 4 radiculopathy
162
name the radiculopathy:
back pain that radiates down lateral aspect of the leg into the dorsum foot; decreased strength in foot dorsiflexion, toe extension, and foot eversion; leg abduction weakness in severe cases; atrophy of extensor digitorum brevis muscle of foot and tibialis; reflexes are normal
L5 radiculopathy
163
name the radiculopathy:
pain radiates down posterior aspect of leg into foot from the back; weakness of plantar flexion, leg extension, and knee flexion; sensation reduced on posterior leg and lateral edge of the foot; loss of ankle reflex
S1 radiculopathy
164
Pathology?
necrotic muscle fiber amid normal ones
165
Pathology?
increase in inflammatory cells to digest dead myocyte
166
Pathology?
regenerating muscle (central enlarged nuclei with prominent nucleoli in a basophilic cytoplasm)
167
Pathology?
fiber type grouping (muscle fiber response to injury/atrophy followed by regeneration)
compare to normal checkerboard pattern (here)
168
Pathology?
Duchenne muscular dystrophy (dystrophin absent) or Becker muscular dystrophy (dystrophin defective)
myofiber hypertrophy => myofibers degenerate and replaced by adipose tissue and endomysial fibrosis
169
Pathology?
mitochondrial myopathy
ragged red fibers due to aggregates of abnormal mitochondria
170
Pathology?
inclusion body myositis
trichrome stain = myofibers containing rimmed vacuoles (inclusions with reddish granular rimming)
171
autosomal recessive (22q) deficiency in lysosomal enzyme arylsulfatase A
metachromatic leukodystrophy
172
autosomal recessive (14q31) deficiency in galactocerebroside-b galactosidase
Krabbe globoid cell leukodystrophy
173
X-linked recessive loss of function mutations in ABCD1, which encodes a protein needed to transport fatty acids into peroxisomes
adrenoleukodystrophy
174
Pathology?
Krabbe globoid cell leukodystropy
deficiency in galactocerebroside-b galactosidase
CNS and PNS demyelination with yellow/gray discoloration of white matter; globoid cells (large, multinucleated macrophages filled with abnormal lipid breakdown products)
175
Pathology?
Wernicke Korsakoff
small mamillary bodies; petechiae in mammillary bodies
176
Pathology?
vitamin B12 deficiency
degeneration of spinal white matter, which is concentrated in the posterior and lateral columns of the spinal cord
177
Pathology?
degeneration of cerebellar vermis due to chronic ethyl alcohol use
178
Pathology?
hepatic encephalopathy
liver failure leads to disturbed consciousness, asterixis, and elevated serum ammonia => Alzheimer type II astrocytes in brain (large gray matter astrocytes with intranuclear glycogen)
179
the only medication currently approved for primary progressive MS is [?]
ocrelizumab
180
Pathology?
multiple sclerosis plaque
181
Pathology?
multiple sclerosis plaque
182
Pathology?
multiple sclerosis plaque showing macrophages and lymphocutes
183
Pathology?
perivascular lymphocytes in MS plaque
184
Pathology?
gliosis seen in a healed MS plaque
185
Pathology? (right image; left is normal comparison)
Parkinson disease
loss of pigmented catecholaminergic neurons
186
Pathology?
Lewy body in a substantia nigra neuron (Parkinson disease)
187
Pathology?
Lewy body in a substantia nigra neuron (Parkinson disease)
188
Pathology?
Huntington's disease
gross: small brain with severe atrophy of caudate nucleus and putamen
histology: protein aggregates containing huntingtin in neurons of striatum and cerebral cortex
189
Pathology?
diffuse astrocytoma
increased density of astrocytes without the histological features associated with high grade astrocytomas
190
Pathology?
glioblastoma
necrosis shows a pseudo-palisaded appearance
191
Pathology?
glioblastoma
some areas firm and others are soft due to necrosis
primary GBM = de novo in older patients, typically IDH-wildtype; secondary GBM = arise from lower grade precursor lesion in younger patients, IDH mutations
192
Pathology?
pilocytic astrocytoma
gross: most common in cerebellum; limited infiltration of surrounding brain
histology: long, thin, "hairlike" processes that form dense fibrillary meshworks; rosenthal fibers and eosinophilic granular bodies
DO NOT have IDH mutatations
common in children and young adults
193
Pathology?
oligodendroglioma
fried egg appearance
IDH mutation and 1p/19q codeletion REQUIRED for diagnosis
194
Pathology?
ependymoma
micro: rosettes
195
Pathology?
medulloblastoma
predominantly in children; exclusively in cerebellum
micro: very densely cellular with sheets of anaplastic cells and rosettes
196
Pathology?
meningioma
predominately benign tumors of adults
197
Pathology?
meningioma
micro: psammoma bodies
198
Pathology?
traumatic neuroma
micro: mixture of axons, Schwann cells, and connective tissue
199
Pathology?
schwannoma
Antoni A: highly ordered cellular component
Antoni B: loose myxoid component
200
Pathology?
neurofibroma
201
Pathology?
plexiform neurofibroma
202
Pathology?
malignant peripheral nerve sheath tumor
203
Pathology?
lacunar infarcts
204
Pathology?
lacunar infarcts
fat-laden (foamy) macrophages and gliosis surrounding a cavity
205
Pathology?
Alzheimer's
brain atrophy
206
Pathology?
Alzheimer's
dystrophic neurites around central amyloid core
207
Pathology?
Alzheimer's
neurofibrillary tangle within neuron
208
Pathology?
frontotemporal degeneration
