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Flashcards in Neuropathology Deck (66):
1

What part of the CNS is most vulnerable to hypoxic damage?

Neurones

2

What damage to CNS is described here - activation of glutamate receptors results in uncontrolled calcium entry into cell, neurones cant use anaerobic glyclysis?

Hypoxic damage

3

What is the term for a reaction within the cell body that is associated with axonal injury?

Axonal reaction

4

What is the most important histopathological indicator of CNS injury regardless of cause?

Gliosis

5

What happens to astrocytes in gliosis?

Undergo hyperplasia and hypertrophy

6

Disruption to what cells often associates with a local proliferation of sub-ependymal astrocytes to produce small irregularities on the ventricular surfaces termed ependymal granulations?

Ependymal cells

7

How much cardiac output does the brain recieve?

15%

8

How much oxygen does brain consume?

20% of body oxygen

9

Blood is supplied to the brain via what two arteries?

Branches of internal carotid and vertebral arteries

10

What artery is affected with frontal lobe dysfunction, contralateral sesnory loss in foot and leg, paresis of arm and foot relative sparing of thigh and face?

Anterior cerebral artery

11

What artery is affected with hemiparesis, hemisensory loss, aphasia/dysphasia and apraxia?

Middle cerebral artery

12

What does vertebrobasilar - posterior supply (three things)?

Brainstem
Cerebellum
Occipital lob

13

Where does Webers syndrome affect?

Midbrain

14

Where does medial and lateral inferior pontine sundromes afect?

Pons

15

Where does lateral medullary syndrome affect?

Medulla

16

Where is affected to cause homonymous hemianopia with macular sparing?

Occipital lobe

17

Where is affected to cause ataxia,. nystagmous, intention tremor and pendular reflexes?

Cerebellum

18

Below systolic BP of what are autoregulatory mechanisms inadequate to compensate leading to parenchymal injury?

50 mmHg

19

What are watershed areas (hypoxic ischaemic damage)?

Junctions of arterial territories which are first to be deprived of blood

20

What is the term for sudden disturbance of cerebral function of vascular origin that causes death or lasts over 24 hours?

Stroke

21

What is the most common type of stroke?

Infarction - thrombotic

22

Most common cause of spontaneous subarachnoid haemorrhage?

Berry aneurysm rupture 90& in internal carotid artery territory

23

What is associated with severe headache, vomiting and loss of consciousness?

Subarachnoid haemorrhage

24

What is associated with lacunes - small cavities found in basal ganglia, thalami and pons of elderly?

Hypertension

25

Lucunar infarcts?

Hypertension and the brain

26

What disease has primary demyelination?

Multiple Sclerosis

27

What three toxins can cause demyelination?

Cyanide, CO, solvents

28

What type of demyelination are central pontine myelinosis, progressive multifocal leucoencephalopathy, subacute sclerosing panencephalitis, AIDS and axonal degeneration?

Secondary

29

What is the most common demyelinating disease?

Multiple Sclerosis

30

What sort of episodes does multiple sclerosis cause?

Relapsing and remitting flare up episodes

31

What is the morphology like in multiple sclerosis?

External appearance of brain and spinal cord usually normal, cut surface shows multiple areas of demyelination termed plaques

32

What matter does MS affect?

White matter

33

well-demarcated plaques in white matter?

MS

34

What CN is MS commonly seen in?

Optic nerve

35

What type of MS has yellow/brown demyelinated plaques with an ill-defined edge which blends into surrounding white matter?

Acute MS

36

What type of MS has plaques that are well demarcated, grey/brown lesions in white matter and classically sit around lateral ventricles?

Chronic MS

37

What patholkogical condition can huntingtons disease and picks disease cause?

Dementia (primary)

38

In Alzheimers disease what happens to the macroscopic pathology of the brain?

Decreased size and weight - cortical atrophy

39

In Alzheimers disease what happens to the macroscopic pathology of sulci?

Widening

40

In Alzheimers disease what happens to the macroscopic pathology of gyri?

Narrowing

41

What lobes are affected in Alzheimers?

Frontal
Temporal
Parietal

42

What happens to brainstem and cerebellum in alzheimers?

Normal

43

What disease has intracytoplasmic neurofibrillary tangles, Amyloid plaques (extracellular senile or neuritic plaques), amyloid angiopathy and extensive neuronal loss with astrocytosis?

Alzheimers disease

44

What protein is affected with neurofibrillary tangles in Alzheimrs?

Tau protein

45

What colour does perivascular amyloid stain in Alzheimers?

Congo red

46

What are the hallmarks of dementia with Lewy bodies?

Hallucinations and fluctuating levels of attention

47

What is degenerated in dementia with Lewy bodies - same as PD?

Substantia nigra

48

Name a neuropsychiatric disorder, onset common between 35-50 but can occur anytime?

Huntington's disease

49

What is the hungtintons disease triad?

1. Emotional disturbance
2. Cognitive disturbance
3. Motor disturbance

50

Chorea, myoclonus, clumsiness, slurred speech, depression, irritability and apathy?

Hungtintons disease - develop dementia later

51

What disease has teh microscopic appearance of loss of neurons in caudate nucleus and cerebral cortex accompanied by reactive fibrillary gliosis?

Hungtintons disease

52

A progressive dementia commencing in middle life (usually between 50 and 60 years) characterised by slowly progressing changes in character and social deterioration leading to impairment of intellect, memory and language

Pick's disease

53

What two lobes suffer extreme atrophy in picks disease?

Frontal and temporal

54

What are the histological hallmarks of Pick's disease?

Pick's cells (swollen neurons)
Pick's bodies (intracytoplasmic filamentous inclusions

55

What disease gives personality and behavioural changes, speech and communication problems, changes in eating habits and reduced attention span?

Pick's disease

56

What four things seperate multiinfarct dementia from Alzheimers?

1. Abrupt onset
2. Stepwise progression
3. History of hypertension/stroke
4. Evidence of stroke seen on CT or MRI

57

What is hydrocephalus?

Accumulation of excessive CSF within the ventricular system of the brain

58

What is the normal volume of CSF?

120 to 150ml

59

Where is CSF produced?

In choroid plexus in lateral and fourth ventricles of brain

60

What absorbs CSF?

Arachnoid granulations

61

What foramina does CSF travel through to get to the cisterna magna?

Foramina of Luschka
Foramina of Magendie

62

Where does non-communicating hydrocephalus occur?

Within ventricular system

63

Where does communicating hydrocephalus occur?

Outside ventricular system e.g. in SA space or at arachnoid granulations

64

What are the four most common herniation routes due to an increase in ICP?

1. subfalcine
2. Tentorial
3. Tonsillar
4. Transcalvarium

65

What are the most primary intracerebral tumours?

Gliomas - most commonly astrocytoma

66

What arteries are usually ruptured in extra dural haemorrahges - usually associated with skull fractures?

Meningeal arteries