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gen path final > Neuropath 2 > Flashcards

Neuropath 2 Flashcards

1
Q

_______________ are an inflammation of arachnoid, pia mater and CSF in the subarachnoid space

A

Leptomeningitis

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2
Q

a _____________ is a focal suppurative infection of the brain

A

Cerebral abscess

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3
Q

what is Encephalitis ?

A
  • diffuse inflammation, infections

- usually viral

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4
Q

characteristics of Acute Bacterial Meningitis (ABM):

A
  • Inflammation of leptomeninges, spreads through subarachnoid space
  • Caused by pyogenic bacteria
  • Fever, headache, stiff neck, common presenting complaints
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5
Q

what are the risk factors for ABM?

A

extremes of age, debilitated state, poor hygiene, crowded living conditions.

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6
Q

what are the microscopic characteristics of ABM?

cell types present, staining characteristics

A
  • Meningial exudate contains large number of neutrophils and necrotic cellular debris.
  • Gram stain usually shows organisms
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7
Q

characteristics of CHRONIC Tuberculosis Meningitis:

A
  • clinical = > 2-3 weeks of headache,lethargy, nausea & vomiting
  • Gelatinous exudate, may appear nodular
  • Cranial nerve palsies, epilepsy
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8
Q

what are the microscopic characteristics of Tuberculosis Meningitis?

(cell types present, staining characteristics)

A
  • Lymphocytes, macrophages, and multinucleated giant cells form GRANULOMAS
  • Mycobacteria may be demonstrable by ACID FAST STAIN
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9
Q

Characteristics of Cryptococcal Meningitis:

SUBacute meningitis

A
  • microbe = Spherical budding yeast, found in soil and bird excreta
  • clinical = Low grade fever, debility, headache.
  • Slimy exudate, capsular material
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10
Q

T/F: only immunocompromised individuals are likely to acquire cryptococcal meningitis

A

FALSE

  • both healthy and immunocompromised can get it
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11
Q

how can bacteria spread to the brain to cause an abscess?

A

Hematogenous or contiguous spread

dental root or ear infections

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12
Q

characteristics of brain abscesses:

A
  • cause = Usually bacterial (S.milleri), also candida
  • Fever, focal neurologic deficits (mortality 20%)
  • Cavity contains pus and surrounded by a thick wall of granulation tissue and fibrosis
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13
Q

characteristics of encephalitis:

A
  • Diffuse inflammation of brain parenchyma
  • VIRAL in origin
  • Usually FATAL without treatment
  • Inflammation and viral inclusion bodies
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14
Q

what is the most common causative agent of Encephalitis?

A

Herpes viruses

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15
Q

what is the KEY MICROSCOPIC characteristics of Encephalitis:

A
  • PERIVASCULAR LYMPHOCYTOSIS
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16
Q

T/F: Demyelination disorders-interfere with the integrity of myelin sheath perturbing normal brain electrical activity

A

true

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17
Q

_____________ is the most common primary demyelinating disorder

A

Multiple Sclerosis

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18
Q

Clinical signs of multiple sclerosis:

A

** visual disturbances, speech and gait abnormalities **

  • symptoms begin in YOUNG ADULTS
  • waxing and waning of signs and symptoms
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19
Q

what causes MS? what are the hallmark histological signs of it in the brain?

A
  • Probably autoimmune in origin (T-cell mediated )

- Hallmark = Irregular areas of demyelination, called MS PLAQUES.

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20
Q

_____________ is the most common cause of Dementia in the elderly

A

Alzheimer’s disease

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21
Q

T/F: there is a strong familial risk for Alzheimer’s disease

A

FALSE

  • only 10% are familial linked
  • most cases have unknown cause
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22
Q

characteristics of Alzheimers disease:

A
  • Grossly, atrophic brain (↓ volume and weight)
  • ventricular dilatation.

** Microscopically - senile or neuritic plaque

** neurofibrillary tangle

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23
Q

what is neurofibrillary tangle ?

A

filamentous aggregates within neuronal cytoplasm

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24
Q

what are the characteristics of the senile and neutritic plaques found in Alzheimer’s?

A

aggregates of thickened, tortuous processes with central amyloid deposits

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25
Q

what is the clinical presentation of someone with Parkinson’s disease?

A
  • RIGIDITY
  • expressionless face
  • stooped posture
  • fine TREMOR
26
Q

what causes Parkinson’s disease?

A

Degeneration of dopamine secreting pigmented neurons of the SUBSTANTIA NIGRA in the midbrain.

27
Q

Name the gross and microscopic characteristics of Parkinson’s disease:

A
  • Gross: mildly atrophic brain

- Microscopic: intracytoplasmic, eosinophilic inclusions within the PIGMENTED neurons

28
Q

what are the intracytoplasmic, eosinophilic inclusions of the brain called in someone with parkinson’s?

where are they found?

A

LEWY bodies

- found inside pigmented neurons
in the substantia nigra

29
Q

Huntington’s disease is characterized as a spontaneous, involuntary movement disorder known as _______.

A

Chorea

30
Q

Characteristics of Huntington’s Disease:

A
  • Hereditary- Autosomal dominant
  • mutation on CHROMOSOME 4
  • progressive
  • FATAL disorder
31
Q

Gross appearance of Huntington’s disease:

A

** ATROPHY of the BASAL ganglia

  • eg., caudate nucleus, putamen
  • in advanced cases, the globus pallidus
32
Q

Symptoms of central nervous center tumors are a reflection of what?

A

Symptoms reflect their SITE OF ORIGIN rather than pathologic type

33
Q

T/F: location is more important than tumor type when dealing with the CNS

A

true

34
Q

what is a primary CNS tumor? what about a secondary?

A

Primary: Arise from cells of the brain, spinal cord or their coverings.

Secondary (metastatic): from lung, breast, prostate etc

35
Q

what is the most prevalent type of CNS tumor?

A

Astrocytomas

36
Q

In what region of the brain are most CNS tumors found in ADULTS?

A

cerebral hemisphere

37
Q

describe grades 2, 3 and 4 of CNS tumors:

WHO grades

A

grades II (well differentiated)

grade III (anaplastic)

grade IV (glioblastoma)

38
Q

characteristics of grade 2 Astrocytomas:

A

Mild hyper-cellularity

nuclear pleomorphism

39
Q

characteristics of grade 3 Astrocytomas:

A

increased cellularity

mitotic figures

40
Q

Characterstics of grade IV Glioblastoma s:

A

Necrosis

microvascular proliferation

41
Q

Oligodendroglioma have what characteristics?

where are they found, what is the appearance of cells

A
  • Cerebral hemisphere, well circumscribed
  • Calcified
  • Cells = uniform, round nuclei and PERINUCLEAR HALO
  • perinuclear halo = FRIED EGG appearance
42
Q

____________ are CNS tumors with well circumscribed lesions, arising from VENTRICULAR wall

A

Ependymoma

43
Q

perivascular ______________ are characteristic of Ependymomas

A

perivascular pseudorosettes

44
Q

T/F: most Ependymoma’s are fast growing

A

False

Slow growing (usually grade II)

45
Q

what are perivascular pseudorosettes? where are they found?

A

= Elongated cells with processes radiating around blood vessels

found in patients with Ependymomas

46
Q

_____________ are CNS tumors derived from the arachnoid matter

A

Meningiomas

47
Q

Gross and microscopic characteristics of Meningiomas:

A
  • Gross = Firm, lobulated lesions with a pushing border with underlying brain
  • ***** Histo =
    1) cellular WHORLS
    2) PSAMMOMA bodies
48
Q

what 2 histological features are characteristic of Meningiomas?

A

1) cellular whorls

2) Psammoma bodies

49
Q

T/F: the brain is a common site for metastatic lesions

A

True

50
Q

what 3 cancer types are most likely to metastasize to the CNS?

A

lungs, breast and cutaneous melanomas

51
Q

characteristic of Pilocytic Astrocytomas:

A

A) PEDIATRIC CNS tumor
B) Grade I tumor
C) Usually in the cerebellum & cystic

D) Astrocytes with thin, hair like processes

52
Q

___________ fibers are characteristic findings of Pilocytic Astrocytomas

A

Rosenthal fibers

  • thin, hair like processes coming off astrocytes
53
Q

characteristics of Medulloblastoma s:

A

A) PEDIATRIC brain tumor
B) found in cerebellum
C) grade IV tumor
D) Cells disseminate through CSF

54
Q

Cells of Medulloblastomas form what characteristic shapes?

A

Homer-Wright rosettes

55
Q

name the possible treatments for brain tumors

A

Contingent on location and histologic grade:

1) stereotactic radiosurgery
2) Intrathecal chemotherapy
3) Proton beam radiation

56
Q

what is the term for treating brain cancer with both radiation and surgery?

A

stereotactic radiosurgery

57
Q

Huntington’s disease is a Spontaneous, involuntary movement disorder known as _______.

A

Chorea

58
Q

T/F: location is more important than tumor type when dealing with the CNS

A

true

59
Q

T/F: the brain is a common site for metastatic lesions

A

True

60
Q

“cowdry typa A inclusions” are associated with what disease?

A

Encephalitis caused by the HERPES virus

61
Q

BOTH of the PEDIATRIC tumors that we talked about are likely to be found in what area of the brain?

A

cerebellum

gen path final (8 decks)

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