Path VIII Flashcards

(54 cards)

1
Q

Abnormal neuronal glial proliferation can lead to what malformation

A

microcephaly or megalocephaly

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2
Q

abnormal neuronal migration can lead to what

A

periventricular nodular heterotopia
lissencephaly/subcortical band heterotopia
cobblestone Cx/ congenital muscular dystrophy

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3
Q

abnormal cortical organization leads to

A

polymicrogyria

focal cortical dysplasia

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4
Q

fetal alcohol syndrome affects what layers

A

ventricular zone and bipolar zone

disrupt myelin and migration of neurons

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5
Q

5 outcomes in malformations of cortical development

A

1: fewer or more than normal neurons
2: neurons fo not migrate at all from ventricles or half way
3: some neurons reach Cx but man do not
4: neurons overshoot Cx and are in subarachnoid space
5: late stage migration and cx organization disrupted

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6
Q

fewer or excessive normal neurons leads to

A

micro or megalocephaly

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7
Q

if neurons do not migrate from ventricles what is it called

A

periventricular heterotopia

nodular– nodules protrude into ventricle

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8
Q

if neurons migrate half way from ventricles it is called

A

subcortical band heterotopia

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9
Q

if many neurons do not reach Cx

A

lissencephaly
pachygyria
cobble stone Cx

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10
Q

lissencephaly

A

smooth brain no gyri

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11
Q

neurons overshoot Cx and go to subarachnoid space

A

marginal leptomeningeal glioneuronal heterotopia

cobblestone Cx

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12
Q

if late stage migration and cortical organization is disrupted

A

polymicrogyria

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13
Q

normal adult brain weight

A

1200-1400 gm

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14
Q

classificaiton for microcephaly

A

3 standard deviations below mean head circumference or less than 42 cm at full growth

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15
Q

genetic abnormality in lissencephaly

A

LIS1 mutation

sometimes assoc with microtubule motor proteins or microtubule dynamics

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16
Q

neurlogic disability with polymicrogyria

A

seizures, sever pyschomotor retardation, spasticity

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17
Q

what can cause polymicrogyria

A

ischemia, twinning, infections

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18
Q

how many layers of grey matter in polymicrogyria

A

4 or less

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19
Q

What is Focal Cortical Dysplasia

A

sporadic developmental malformation of cerebral Cx causing intractable seizures and cognitive impairment

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20
Q

core pathology of focal cortical dysplasia

A

abnormal cortical cytoarchitecture from loss of normal layering

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21
Q

most frequent path in brain tissure removed in epilepsy surgery in children

A

focal cortical dysplasia

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22
Q

most frequent lesion in adults with FCD

A

hippocampal sclerosis

23
Q

areas affected by fetal alcohol synrome

A

corpus callosum
cerebral Cx
hippocampus and cerebellum

24
Q

clinical signs fetal alcohol syndrome

A
loss of nasal bridge
epicanthal folds
minor ear abnormalities
indistinct philtrum
micrognathia
thin upper lip
plat midface and short nose
short palpebral fissures
25
lab values for neural tube defect
inc AFP | normal b HCG, inhibin A and estriol
26
lab values for trisomy 21
dec AFP inc b HCG inc inhibin A dec estriol
27
lab values for trisomy 18 (edwards)
dec AGP, b-HCG, inhibin A, estriol
28
what is a deformation
extrinsic cause of congenital anomaliy, mechanical stress usually
29
disruption
secondary breakdown of normal structure | e.g. oligohydramnios
30
what is a sequence congenital abnomaly
multiple defects from single thing | like Potter sequence
31
how does infection spread to subdural space
air sinuses or from middle ear
32
do antibiotics help subdural infections
no because the space is traversed by bridging arteries with no vascular supply of its own
33
Tx subdural abscess
evacuation and intravenous antibiotics
34
risk factors for meningitis
``` local infectino recent brain surgery recent head injury spinal abnormalities CSF shuntplacement UTI, UT abnormalities weakened immune system ```
35
differentiate bacterial CSF with viral
purulen high pressure high protein low glucose and polynuclear cells = bacterial aseptic normal pressure normal protein normal glucose and mononuclear cells = viral
36
clinical picture acute bacterial meningitis
acute onset in hours | fever lethargy, HA altered mental status, signs of meningeal irritation like neck stiffness
37
most common infection of CNS
acute leptomeningitis aka meningitis
38
how can meningitis cause hydrocephalus
pus blocks 4th ventricle
39
if see lymphocytes in virchow robbin space
viral meningitis
40
neutrophils in virchow robbin space
bacterial meningitis
41
clinical picture of acute aseptic viral meningitis
similar to bacterial with fever,lethargy, HA, altered mental status and signs of meningeal irritation
42
best course of action for fever, lethargy, HA, altered mental status and signs of meningeal irritation
lumbar tap
43
most common organism for aseptic meningitis
enterovirus
44
subtype enterovirus for aseptic meningitis
B71
45
what organisms cause bacterial meningitis | birth- 2 months
E coli Group B strep Listeria
46
what organisms cause bacterial meningitis | 2 mo- 5 yrs
strep pneumo meningococcus H flu
47
what organisms cause bacterial meningitis | older child/adult
strep pneumo | N meningitis
48
what organisms cause bacterial meningitis | elderly
Strep pneumo E coli Group B strep Listeria
49
organism that can cause epidemics of bacterial meningitis
N meningitis
50
Tx for bacterial meningitis
ampicillin and ceftriaxone
51
when do you not use ampicillin for meningitis 3 mo-7 yr
not ampicillin | only ceftriaxone
52
veins in bacterial meningitis
cloudy from neutrophils and pus | thick vessels
53
what type of inflammatory cell is found in acute pneumococcal meningitis
neutrophils
54
gross picture of brain with bacterial meningitis
pus on top