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Flashcards in Path VI Deck (51):
1

What are the prenatal ischemic lesions

poencephaly
shizencephaly
hydrancephaly

2

what is the difference of HIE in mature infants vs adults

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

3

most characteristic lesion in neonatal HIE

watershed areas because the vasculature is immature

4

moderate ischemia neonate HIE will cause what

cortical damage between major arterial territories
like cortex that arches from frontal to occipital poles

5

severe ischemia in neonate HIE will cause what

damage to deep nuclei and brainstem

6

causes of HIE in neonate

abruptio ppalcenta
difficult delivery
meconium aspiration
infection

7

what type of brain tissue lost in neonate HIE

grey and white matter

8

b/l atrophy in area of MCA
cardiopulm arrest at 6 mo

HIE

9

many cysts in neonate brain

multicycstic encephalopathy from HIE and autolysis of brain tissue

10

Periventricular leukomalacia in preterm infants

white matter lesions in frontal and occipital lobest

11

primary cause cerebral palsy

PVL

12

what area greatest affected by PVL

corpus callosum
deep white matter

13

why are periventricular areas susceptible to hypoxia

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

14

where is germinal matrix relative to ventrical wall

closest layer, then white matter then grey

15

when can brain waves be measured

8weeks

16

noncustic white matter injury

areas of ischemia that become scars

17

as a child with PVL matures what are clinical signs

tight limb musculature
contracted legs
poor feeding and positioning problems

18

PVL blue color on H&E

calcifications of necrotic areas

19

periventricular loss of brain tissue

PVL

20

White matter injury common in mature infants with what

congenital heart disease
transposition of great vessels
hypoplastic left heart syndrome

21

what cause white matter injury prenatally

chronic hypoxia,

22

germinal matrix hemorrhage common in what babies

premature with hyaline membrane disease and RDS

23

majority cause of morbidity and mortality in newborn period

germinal matrix hemorrhage

24

picture of babies head and almost all of it transilluminates

hydrancephaly

25

what cause hydranencephaly

ischemic large vessel to brain

26

kernicturus

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

27

why is unconj bilirubin bad

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

28

areas of brain that bilirubin stains

thalamus and basal ganglia

29

most critical period for malformations and disruptions

3-8 week of gestation

30

malformation

flawed development

31

characteristics of malformation

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

32

distruption

destruction of normal brain

33

characteristics of disruption

focal and asymmetric
gliosis
do not recur unless exposure recurs

34

when can inflammation and calcification happen with disruption

if event occurs after 1st trimester

35

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

the time of exposure
earlier= worse

36

CMV infection in first trimester causes what

microcephaly and polymicrogyria

37

CMV infection in third trimester causes what

encephalitis

38

Neural tube closure defects result in what

anencephaly
craniorachischisis
myelomeningocele

39

what can cause NT closure defects

folate
hyperglycemia
B12
zinc
maternal fever

40

what are the types of axial mesodermal defects

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

41

what can cause axial mesodermal defects

ciliopathies

42

what are the tail bud defects

spina bifida occulta
split cord (low)
hydromyelia

43

where does the human embryo have Nt closure

midway

44

what drugs are teratogenic folate antagonists

carbamazepine
fumonisin
trimethoprim

45

what deficincies can be teratogenic

folate
inositol
vit B12
zinc

46

maternal fever during what time period is teratogenic

3-4 weeks pregnancy

47

one of most common neural tube defects

anencephaly

48

biomarkers for anencephaly

inc AFP and ACHE in amniotic fluid and maternal blood

49

how is anencephaly detected

US

50

look for what other defect in anencephaly

spina bifida

51

deficiency in anencephaly

folic acid