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Neuro Midterm > Path > Flashcards

Path Flashcards

1
Q

spina bifida occulta

A

failure of posterior vertebral arch to close (caudal end)

- dimple or hair patch seen grossly

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2
Q

spina bifida cystica

A

failure of posterior vertebral arch to close (caudal end)

  • cystic protrusion of underlying tissue through the defect
  • can be meningocele or meningomyelocele
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3
Q

meningocele

A

protrusion of meninges

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4
Q

meningomyelocele

A

protrusion of meninges and spinal cord (worse, can cause neurological problems distal to the cyst if impinged)

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5
Q

rachischisis

A

posterior neuropore (neural tube) fails to close by week 27

  • vertebrae do not fuse
  • spinal cord remains exposed
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6
Q

meningoencephalocele

A

failure of posterior vertebral arch to close (cranial end)

- protrusion of meninges and brain

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7
Q

meningohydroencephalocele

A

failure of posterior vertebral arch to close (cranial end)

- protrusion of meninges, brain and CSF build up

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8
Q

anencephaly

A

absence of skull and brain

- “frog-like” appearance

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9
Q

“frog-like” appearance

A

anencephaly

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10
Q

“floppy baby”

A

Werdnig-Hoffman disease

  • degeneration of anterior motor horn
  • autosomal recessive
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11
Q

SOD1

A

Amyotrophic Lateral Sclerosis (ALS), some familial forms

- mutation in this gene for zinc-copper superoxide dismutase; leads to free radical damage in neurons

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12
Q

leptomeninges

A

pia and arachnoid maters

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13
Q

“worst headache of my life”

A

Subarachnoid hemorrhage

- sudden onset headache with nuchal rigidity

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14
Q

lumbar puncture: yellow hue to CSF

A

Subarachnoid hemorrhage

- yellow color (“xanthochromia”) from bilirubin (degeneration of RBCs)

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15
Q

A/w Marfan and ADPKD?

A

Subarachnoid hemorrhage

  • Lead to berry anyeurism (failure of tunica media to form at bend in artery) –> balloons, ruptures
  • Common location: anterior circle of Willis at branch points of the anterior communicating artery
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16
Q

Lens-shaped lesion on CT

A

Epidural hematoma

- Classically due to fracture of the temporal bone –> middle meningeal artery

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17
Q

Crescent-shaped lesion on CT

A

Subdural hematoma

- due to tearing of bridging veins btwn dura and arachnoid

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18
Q

Hematomas in elderly?

A

Subdural hematoma

- age-related cerebral atrophy stretches the veins –> more vulnerable to rupture

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19
Q

Unilateral blown pupil, down and out eye movement

A

Uncal herniation: displacement of temporal lobe uncus under the tentorium cerebelli
- compression of cranial nerve III (oculomotor)

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20
Q

HLA-DR2

A

A/w multiple sclerosis

  • seen in regions away from the equator
  • more common in women
21
Q

Lumbar puncture: oligoclonal IgG bands

A

Multiple sclerosis

22
Q

Lumbar puncture: opening pressure >200 mm H2O

A

increased ICP

- seen with meningitis or hydrocephalus

23
Q

“locked in” syndrome

A

Central pontine myelinolysis

  • focal demyelination of the pons
  • due to rapid intravenous correction of hyponatremia
  • presents as acute bilateral paralysis which spares the eyes
24
Q

epsilon-4 allele of apolipoprotein E

A

increased risk of Alzheimer’s

25
Q

epsilon-2 allele of apolipoprotein E

A

decreased risk of Alzheimer’s

26
Q

Presenilin 1 or 2

A

A/w familial cases of Alzheimer’s

27
Q

Alzheimer’s a/w what other diagnosis?

A

Down syndrome: APP receptor that causes the A-beta aggregates is coded on chromosome 21

28
Q

hydrocephalus ex vacuo

A

increased CSF to fill space from atrophied structures

e.g., seen with Alzheimer’s

29
Q

neurofibrillary tangles of tau protein

A

Alzheimer’s

- hyperphosphorylated tau protein forms intracellular aggregates

30
Q

eosinophilic inclusions of alpha-synuclein

A

Lewy bodies, seen with Parkinson’s and Lewy Body dementia

31
Q

CAG trinucleotide repeat

A

Huntington disease

  • repeat on Htt gene on chromosome 4
  • expansion over generations: anticipation
32
Q

“wet, wobbly and wacky”

A

Normal pressure hydrocephalus

  • triad of urinary incontinence, gait instability, and dementia
  • lumbar puncture will take off excess CSF for temporary relief
  • treatment: ventriculoperitoneal shunting
33
Q

ventriculoperitoneal shunting

A

treatment option for hydrocephalus

funnels excess CSF down to abdomen to be resorbed

34
Q

common cancers that metastasize to brain?

A

lung, breast, kidney

35
Q

“butterfly” lesion as seen in coronal image

A

Glioblastoma multiforme

- characteristically crosses the corpus callosum

36
Q

Histo: pseudopallisading

A

Glioblastoma multiforme

37
Q

tumor cells: GFAP positive

A

indicates presence of intermediate filament –> progenitor cells are astrocytes
A/w Glioblastoma multiforme and pilocytic astrocytoma

38
Q

Histo: whorled pattern

A

Meningioma

39
Q

Histo or CT: calcified necrotic cells

A

Psammoma bodies, seen with meningiomas

40
Q

Round mass attached to dura

A

Meningioma, arises from arachnoid cells that line the dura

- will press on brain but not invade tissue

41
Q

Sx: loss of hearing and tinnitus

A

Schwannoma

most frequently involves CN VIII at the cerebellopontine angle (hearing changes)

42
Q

Tumor cells: S-100 positive

A

Schwannoma

43
Q

Histo: “fried egg” appearance of cells

A

Oligodendroglioma

- myelin (lipid) washed away by slide prep; clear cytoplasm around nucleus looks like a fried egg

44
Q

cystic lesion with a mural nodule

A

Pilocytic astrocytoma

  • cyst with white, dense-looking mass extending from the wall
  • usually arises in cerebellum
45
Q

Histo: Rosenthal fibers

A

Thick eosinophilic processes of astrocytes

Seen with Pilocytic astrocytoma

46
Q

Histo: Homer-Wright rosettes

A

Small round blue cells clustered around a opening (looks like a gland)
Seen with Medulloblastoma

47
Q

“drop metastasis”

A

Metastasis to the cauda equina see with Medulloblastoma

- spreads via CSF

48
Q

Histo: Perivascular pseudorosettes

A

Seen with Ependymoma

Neuro Midterm (10 decks)

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