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Year 2 neuro exam 1 > Path IV > Flashcards

Path IV Flashcards

1
Q

HIE

A

hypoxic ischemic enecephalopathy

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2
Q

HIE initially attacks what part of brain

A

grey matter

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3
Q

why is brain so sensitive to hypoxia

A

no energy stores

O2 and glucose supplied by circulation

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4
Q

what happens with reperfusion of ischemic event in brain

A

intracell edema
vascular injury
interstitial edema
release of intracellular vasoactive matabolites

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5
Q

how long of ischemic event till neuronsbegin to die

A

4-5 minutes

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6
Q

5+ minutes of global ischemia in brain leads to

A

thalamic and brain stem damage

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7
Q

what part of neuro system is more resistant to hypoxia

A

spinal cord

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8
Q

what are anoxic neurons

A

shrunken eosinophilic cytoplasm and pyknotic nuclei

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9
Q

what causes anoxic neurons

A

ischmia more than 4 minutes

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10
Q

what is Tx for anoxic neurons

A

reperfusion

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11
Q

what is neuronophagia

A

anoxic neurons surrounded by microglial cells

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12
Q

what are red neurons

A

dead neurons

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13
Q

if patient dies shortly after ischemia what will micro brain look like

A

normal because the reperfusion causes problems

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14
Q

reperfusion edema can be seen where clinically

A

papilledema

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15
Q

what is gliosis

A

process of CNS scarring from astrocytes

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16
Q

alzheimer type II astrocytes

A

hepatic encephalopathy

large nuclei and large vacuoles on H&E stain

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17
Q

GFAP stain

A

astrocytes

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18
Q

what cells are very sensitive to HIE

A

CA1 of hippocampus

layters 3,5,6 neoCx, purkinje cells, striatal neurons

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19
Q

diffuse cortical thalamic or combine neuronal loss in HIE results in what

A

dementia

vegetative state

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20
Q

damage to brainstem cause what

A

brain death

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21
Q

why are certain ares for susceptible to HIE

A

areas with neurons that produce more glutamate

22
Q

what cells are in CA1 of hippocampus

23
Q

holzer stain

A

can see hippocampal sclerosis

24
Q

if lose CA1

A

memory problems

25
what supplies CA1
anterior temporal branch posterior cerebral artery
26
what occurs in nonperfused brain after HIE
cerebral autolysis | blank on radionucletotide scan
27
what else gets damaged in severe HIE
glial cells also damaged
28
what converts selective neuronal necrosis to total tissue necrosis in brain
lactic acidosis
29
what is cerebral infarction
focal brain necrosis from complete and prolonged ischemia that focally affects all tissue elements, neurons, glia and vessels
30
what are the parts of an infarct
the core where there is dense ischmia( non revivable) | and the penumbra (moderate ischmia, delayed infarction GIVE O2!)
31
what is a blan infarct
swelling and disintegration of area
32
what is a hemorrhagic infarct
disintegration of lesion from an embolus/ thrombus with reperfusion of blood into affected area 10% time
33
what are lacunar infarcts
cystic cavities from previous hemorrhagic bleeds
34
what are common causes of cerebral infarcts
atherosclerosis atherosclerosis with thrombus formation small vessel disease embolism
35
what are the small vessel disesases
HTN, DM, age, cerebral amyloid angiopathy
36
if see pink thickening around vessels, do what stain
congo red to rule out amyloid
37
small vessel disease usually result in what type cerebral infarcts
lacunar and hemorrhagic bleeds
38
what aa supply basal ganglia area
lenticulate striate off of middle cerebral
39
what areas does the anterior choroidal a supply
medial globus pallidus, post limb internal capsule, tail caudate and optic tract
40
man in barrel syndrome
watershed infarcts
41
where are the watershed areas
ACA-MCA MCA-PCA
42
what cause watershed infarcts
severe drops in BP | hypovolemia like GI bleed
43
what type of watershed is caused by sudden occlusion of internal carotid a or carotid stenosis
ACA-MCA | both fed by int carotid
44
clinical Sx watershed infarct
proximal arm and leg weakeness | can cause transcortical aphasia synrome
45
when does liquefaction take place after ischemic stroke
3 weeks
46
when do you see distinct border for necrosis on gross specimen of ishcmic stroke
2-10 days
47
microscopic brain 24 hr post ischemic stroke
red neurons
48
48 hrs microscopic post ischemic stroke
neutrophils
49
gliosis time frame post ischemic stroke
1-2 weeks
50
when does hemorrhagic conversion or evolutions occur after 5-10% ischemic strokes
within first week

Year 2 neuro exam 1 (23 decks)

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