Path VI

Question 1

What are the prenatal ischemic lesions

Answer 1

poencephaly
shizencephaly
hydrancephaly

Question 2

what is the difference of HIE in mature infants vs adults

Answer 2

neonates have local energy crisis
excitotoxicity
lactic acidosis
free radicals
smaller brain, more H20
less antioxidant defense
decreased myelin

Question 3

most characteristic lesion in neonatal HIE

Answer 3

watershed areas because the vasculature is immature

Question 4

moderate ischemia neonate HIE will cause what

Answer 4

cortical damage between major arterial territories

like cortex that arches from frontal to occipital poles

Question 5

severe ischemia in neonate HIE will cause what

Answer 5

damage to deep nuclei and brainstem

Question 6

causes of HIE in neonate

Answer 6

abruptio ppalcenta
difficult delivery
meconium aspiration
infection

Question 7

what type of brain tissue lost in neonate HIE

Answer 7

grey and white matter

Question 8

b/l atrophy in area of MCA

cardiopulm arrest at 6 mo

Answer 8

HIE

Question 9

many cysts in neonate brain

Answer 9

multicycstic encephalopathy from HIE and autolysis of brain tissue

Question 10

Periventricular leukomalacia in preterm infants

Answer 10

white matter lesions in frontal and occipital lobest

Question 11

primary cause cerebral palsy

Answer 11

PVL

Question 12

what area greatest affected by PVL

Answer 12

corpus callosum

deep white matter

Question 13

why are periventricular areas susceptible to hypoxia

Answer 13

the vessels penetrate from exterior surface and dive into brain
so inside has less blood supply

Question 14

where is germinal matrix relative to ventrical wall

Answer 14

closest layer, then white matter then grey

Question 15

when can brain waves be measured

Answer 15

8weeks

Question 16

noncustic white matter injury

Answer 16

areas of ischemia that become scars

Question 17

as a child with PVL matures what are clinical signs

Answer 17

tight limb musculature
contracted legs
poor feeding and positioning problems

Question 18

PVL blue color on H&E

Answer 18

calcifications of necrotic areas

Question 19

periventricular loss of brain tissue

Answer 19

PVL

Question 20

White matter injury common in mature infants with what

Answer 20

congenital heart disease
transposition of great vessels
hypoplastic left heart syndrome

Question 21

what cause white matter injury prenatally

Answer 21

chronic hypoxia,

Question 22

germinal matrix hemorrhage common in what babies

Answer 22

premature with hyaline membrane disease and RDS

Question 23

majority cause of morbidity and mortality in newborn period

Answer 23

germinal matrix hemorrhage

Question 24

picture of babies head and almost all of it transilluminates

Answer 24

hydrancephaly

Question 25

what cause hydranencephaly

Answer 25

ischemic large vessel to brain

Question 26

kernicturus

Answer 26

unconj bilirubinemia that results from hemolytic disease, hereditary spherocytosis and other hemolytic disorders inability liver to conjugate (crigler najjar)

Question 27

why is unconj bilirubin bad

Answer 27

can cross BBB and lipid soluble so penetrates neuronal and glial membraneas

Question 28

areas of brain that bilirubin stains

Answer 28

thalamus and basal ganglia

Question 29

most critical period for malformations and disruptions

Answer 29

3-8 week of gestation

Question 30

malformation

Answer 30

flawed development

Question 31

characteristics of malformation

Answer 31

midline or bilateral and symmetric no gliosis recurrence risk that can be calculated

Question 32

distruption

Answer 32

destruction of normal brain

Question 33

characteristics of disruption

Answer 33

focal and asymmetric gliosis do not recur unless exposure recurs

Question 34

when can inflammation and calcification happen with disruption

Answer 34

if event occurs after 1st trimester

Question 35

what is a key factor to how severe a malformation or disruption is

Answer 35

the time of exposure | earlier= worse

Question 36

CMV infection in first trimester causes what

Answer 36

microcephaly and polymicrogyria

Question 37

CMV infection in third trimester causes what

Answer 37

encephalitis

Question 38

Neural tube closure defects result in what

Answer 38

anencephaly craniorachischisis myelomeningocele

Question 39

what can cause NT closure defects

Answer 39

``` folate hyperglycemia B12 zinc maternal fever ```

Question 40

what are the types of axial mesodermal defects

Answer 40

closed defects-- high in spinal cord | with herniation of neural tissue- encephalocele, meningocele

Question 41

what can cause axial mesodermal defects

Answer 41

ciliopathies

Question 42

what are the tail bud defects

Answer 42

spina bifida occulta split cord (low) hydromyelia

Question 43

where does the human embryo have Nt closure

Answer 43

midway

Question 44

what drugs are teratogenic folate antagonists

Answer 44

carbamazepine fumonisin trimethoprim

Question 45

what deficincies can be teratogenic

Answer 45

folate inositol vit B12 zinc

Question 46

maternal fever during what time period is teratogenic

Answer 46

3-4 weeks pregnancy

Question 47

one of most common neural tube defects

Answer 47

anencephaly

Question 48

biomarkers for anencephaly

Answer 48

inc AFP and ACHE in amniotic fluid and maternal blood

Question 49

how is anencephaly detected

Answer 49

US

Question 50

look for what other defect in anencephaly

Answer 50

spina bifida

Question 51

deficiency in anencephaly

Answer 51

folic acid