Neuropathology

Question 1

When are balloon cells and Hirano bodies seen together?

Answer 1

Pick’s disease

Question 2

What happens to frontal and temporal lobes in Pick’s disease?

Answer 2

Asymmetrical atrophy

Question 3

What are pick cells?

Answer 3

Swollen cortical pyramidal cells

Question 4

What is the spongiform encephalopathy secondary to in CJD?

Answer 4

Neutropil vacuolation

Question 5

Protective factor against Alzheimer’s dementia

Answer 5

Smoking
NSAIDs
Oestrogen
Premorbid intelligence and education

Question 6

Macroscopic changes in Alzheimer’s

Answer 6

Enlargement of lateral and 3rd ventricles
Global brain atrophy
Reduction in brain weight
Sulcal widening

Question 7

Microscopic changes in cerebral cortex in Alzheimer’s

Answer 7

Neuronal loss
Senile plaques
Neurofibrillary tangles
Reactive astrocytosis
Shrinking of dendritic branching

Question 8

Stain used in detection of Pick bodies

Answer 8

Anti-tau antibodies

Question 9

Which memories are lost in dissociative amnesia?

Answer 9

Loss of memory of personal events well rehearsed

Question 10

Histological changes of dementia pugilistica

Answer 10

Neuronal loss

Neurofibrillary tangles

Question 11

Macroscopic changes in dementia pugilistica

Answer 11

Thinning of corpus callosum
Perforation of septum pellucidum
Ventricular enlargement

Question 12

What are lewy bodies made of?

Answer 12

Alpha synuclein

Ubiqutin

Question 13

What are lewy bodies made of?

Answer 13

Alpha synuclein

Ubiqutin

Question 14

Where would you find the degenerative changes associated with Wernicke’s encephalopathy?

Answer 14

Gliosis and small haemorrhages in structures surrounding the third ventricle and aqueduct - mamillary bodies, hypothalamus, mediodorsal thalamic nucleus, colliculi and midbrain tegmentum

Question 15

Findings in CSF of somebody with Alzheimer’s

Answer 15

Reduced beta-amyloid
Increased tau and phosphorylated tau
Increased tau-to-amyloid ratio

Question 16

MRI findings of somebody with aggression and stereotyped motor behaviour

Answer 16

Hypoplastic cerebellum

Question 17

What are hirano bodies made of?

Answer 17

Intracellular aggregates of actin and actin-associated proteins

Question 18

What is Binswanger’s disease?

Answer 18

Subcortical vascular dementia

Question 19

What is Binswanger’s characterised by?

Answer 19

Presence of many small infarctions of the white matter that spares the cortical regions

Question 20

Is there correlation between number of lewy bodies and cognitive decline?

Answer 20

There is no simple correlation

Question 21

Which antibody could be used to identify Lewy bodies?

Answer 21

Antibody to protease ubiquitin

Question 22

What stain could you use to identify lewy bodies?

Answer 22

Antibodies to alpha-synuclein

Question 23

What are lewy body neurites?

Answer 23

Nerve cell processes that contain alpha-synuclein

Question 24

List 5 tauopathies

Answer 24

1. AD
2. Pick’s disease
3. PSP
4. Corticobasal degenerations
5. Frototemporal dementia with parkinsonism

Question 25

List 3 synucleinopathies

Answer 25

1. PD 2. DLB 3. MSA

Question 26

Most common type of frontotemporal dementia

Answer 26

Frontal lobe degeneration type

Question 27

Pathology of frontal lobe degeneration of FTD

Answer 27

Spongiform degeneration or microvacuolation of the superficial neutropil seen chiefly in layers III and V of the cortex

Question 28

Loss of which type of cells occurs in frontal lobe degeneration type of FTD

Answer 28

Large cortical nerve cells | Minimal gliosis

Question 29

How is Pick's disease characterised?

Answer 29

Preponderance atrophy in the frontotemporal regions

Question 30

What are the 3 types of FTD?

Answer 30

1. Frontal lobe degeneration type 2. Pick's type 3. Motor neurone disease type

Question 31

What are Pick's bodies?

Answer 31

Masses of cytoskeleton elements

Question 32

What are Pick's cells?

Answer 32

Abnormal swollen oval-shaped neuronal cells with loss of Nissl's substance and peripherally displaced nucleus

Question 33

Pathology associated with Pick's type FTD

Answer 33

Loss of large cortical cells Abundant gliosis Pick's bodies

Question 34

How does MND type of FTD differ from the others?

Answer 34

Cerebral atrophy is less marked

Question 35

What are the 3 forms of CJD?

Answer 35

1. Sporadic 2. Familial 3. Variant

Question 36

What type of CJD is related to bovine spongiform encephalopathy?

Answer 36

Variant

Question 37

Microscopic pathology of CJD

Answer 37

Spongiform encephalopathy secondary to neutropil vacuolisation

Question 38

Where is prion protein coded?

Answer 38

Chromosome 20

Question 39

Which stain can be used to identify prion protein?

Answer 39

Immunoperoxidase

Question 40

What is there accumulation of in vCJD?

Answer 40

Prion protein

Question 41

What is the best test for vCJD?

Answer 41

MRI

Question 42

Features of classic CJD - age & course

Answer 42

Elderly | Short course

Question 43

Is pulvinar sign seen in classic CJD?

Answer 43

No

Question 44

In which type of CJD can prion protein be isolated from tonsillar tissue?

Answer 44

vCJD

Question 45

What is the most common psychiatric presentation in AIDS?

Answer 45

HIV-related dementia

Question 46

Where is the primary auditory cortex?

Answer 46

Heschl's gyrus

Question 47

What gross pathological changes occur in the brain in schizophrenia?

Answer 47

Brain weight, length and volume of cerebral hemispheres decrease

Question 48

What enlarges in the brain in schizophrenia?

Answer 48

Lateral ventricles

Question 49

What would reduced in the parahippocampla gyrus or hippocampus?

Answer 49

White matter

Question 50

What histological changes would you see in schizophrenia?

Answer 50

Reduced cell numbers or cell size in hippocampus and DLPFC

Question 51

MRI in bipolar and unipolar mood disorders

Answer 51

White matter hyperintensities particularly in deep subcortical white matter

Question 52

Which group of people with mood disorders are white matter hyperintensities most associated?

Answer 52

Elderly - linked to risk factors for vascular disease

Question 53

In terms of prognosis, what do white matter hyperintensities suggest?

Answer 53

Poor prognosis