Patho Flashcards
(121 cards)
1
Q
Most important indicator of injury
A
Gliosis
2
Q
Responsible for Scar and repair formation
A
astrocytes
3
Q
3 types of herniation
A
Cingulate
Uncinate
Tonsillar
4
Q
Cingulate (Subfalcine) herniation
A
Compression of anterior cerebral artery ; displacment of cingulate gyru under edge of falx cerebri
5
Q
3rd CN compromised-pupil dilation & impaired eye movement
A
Uncinate (Transtentorial)
herniation
6
Q
In an uncinate herniation the ____ may be compressed
A
Posterior cerebral artery
7
Q
Displacement of cerebellar tonsils through foramen magnum
A
Tonsillar herniation
8
Q
Affected ateries of each herniation:
Cingulate
Uncinate
A
cingulate = anterior cerebral artery uncinate = Posterior cerebral artery tonsilar = no atery = brain stem
9
Q
Affected ateries of each herniation:
Cingulate
Uncinate
A
cingulate = anterior cerebral artery uncinate = Posterior cerebral artery tonsilar = no artery = brain stem
10
Q
Occlusion of a main-named artery supplying the brain, MOST occurring where?
A
REGIONAL CEREBRAL INFARCTION ; Most commonly outside the cranial cavity, esp. in adults
11
Q
First 24-48 hours in a cerebral infarc
CVA-ischemic
A
- Pale/ anemic infarcts
- Focal swelling,
- Blurring of gray vs white matter
12
Q
1-2 weeks later s/p a cerebral infarc
CVA-ischemic
A
- Soft liquefactive necrosis
- Macrophages infiltrate
- Astrocytes –> scar tissues
- fluid-filled cystic spaces bounded by gliosis
13
Q
CVA - hemorrhagic –> what is one underlying cause
A
Hypertension
14
Q
Large hematomas typically occur in ___ causing _____?
A
basal ganglia or thalamus
inc IP
15
Q
Large hematomas often ruptures into ??
A
ventricular system
16
Q
CVA - hemorrhagic another cause –> ??
A
Sacualr/Berry aneurysm
17
Q
Sacualr/Berry aneurysm Can be seen in patients with ??
A
Marfan or Ehlers-Danlos syndromes
18
Q
Artery most often ruptured with berry aneursym?
A
Ant Communication ( 45%)
19
Q
Sacualr/Berry aneurysm leads to a _____ when it ruptures?
A
Subarachnoid hemorrhage
20
Q
1 Dx sign of Subarachnoid hemorrhage
A
Bld in CSF
21
Q
3rd most common cause of death in western countries
A
CVD
22
Q
Most frequent manifestation of a sudden episode of neurological deficit
A
Stroke
23
Q
Marfan or Ehlers-Danlos syndromes
A
berry aneurysm
24
Q
Etiologies of Subarachnoid hemorrhage (4)
A
Berry aneurysm AVM rupture Trauma Hemorrhagic diatheses Stroke (5%) " Subarch hem are bld BATHS"
25
in a Subarachnoid hemorrhage ____die immediately, typically with acute hydrocephalus
~ 30%
26
If a pt with a subarch hem dsnt die immediately long term effect is??
Chronic hydrocephalus ; Due to blockage, fibrosis in the CSF pathways
27
Two types of injury/ Trauma to CNS
- Non-missile trauma (Close head; Non-penetrating/Blunt)
| - Missile trauma (Open head; Penetrating)
28
Hemorrhage in space between dura and arachnoid mater is a ??
SUBDURAL HEMATOMA
29
SUBDURAL HEMATOMA is caused by by traumatic tearing of ???
“bridging veins”
"If I take a BRIDGE to get toSUB-way the DURAtion is long and moves SLOWLY
30
Blood accumulates slowly and enlarges with delayed signs and symptoms in which hematoma?
subdural
31
Almost always result of skull fracture is wht hematoma (temporal bone)?
EXTRADURAL (EPIDURAL) HEMATOMA
32
Which artery usauly tears in an epidural hematoma?
Often middle meningeal artery
| "SPLIT (skull fx) IN THE MIDDLE(middle menegeal a) MAKE THE TWO BRAINS JIGGLE"
33
Inc IP ; LOC ; Coma; Death = sequence is which hematoma?
epidural
34
Portals of entry for CNS infections (4)
- Hematogenous (most common) ;
- Trauma
- Local spread from paranasal sinuses, dental infections;
- Peripheral nerves
35
______ is Inflammation of the meninges (including arachnoid and pia maters)
MENINGITIS
36
Infectouis organism spreads via?
spread via CSF route
37
Three main types of Meningitis?
```
Acute purulent meningitis (acute pyogenic)
Bacterial infection
Aseptic meningitis
Viral infection
Chronic meningitis
TB and other organisms
```
38
Three main types of Meningitis?
1. Acute purulent / acute pyogenic (Bacterial)
2. Aseptic meningitis (Viral)
3. Chronic meningitis (TB & other)
39
headache, neck stiffness, photophobia = symptoms of which meningitis?
Acute purulent /acute pyogenic ( bacterial)
40
fever, AMS; Lumbar puncture: Lymphocytosis = symptoms of which meningitis?
Asceptic ( viral)
41
Infection centered on the dura =?
EPIDURAL AND SUBDURAL INFECTIONS
42
Causative organisms of EPIDURAL AND SUBDURAL INFECTIONS are?
Streptococci
Staphylococci aureus
Gram-negative organisms (incl anaerobs)
43
complications of epidural and subdural infections are?
Extradural (epidural) abscess
| & Subdural abscess
44
Name the 6 viral dz of the CNS
```
Herpes ( type1,2, Zoster , 5 CMV)
HIV/AIDS
Polio
Rubeola (Measles)
*Rubella (German measles) and Zika virus
*Rhabdovirus
```
45
FUNGAL INFECTIONS OF THE CNS are (4)
Candidiasis
Aspergillosis (branch on angles)
Phycomycoses (Mucormycoses, Zygomycoses) - (branch on 90degrees; DM)
Cryptococcosis --> menigitis
46
In utero viral CNS infection leads to microcephaly
Rubella (German measles) and Zika virus
47
Negri bodies associated with which CNS infection?
Rhabdovirus/Rabies
48
Lewy bodies associated with which CNS condition?
Parkinsons
49
Hirano bodies associated with which CNS condition?
alzheimers
50
Frequently seen in patients who are immunosuppressed
fungal CNS infections ( Candidiasis; Aspergillosis. Phycomycoses; Cryptococcosis)
51
A Rapidly progressive dementia in humans known as transmissible subacute spongiform encephalopathies is??
Creutzfeldt-Jakob disease
52
Prominent spongiosis of brain; no inflammation
Creutzfeldt-Jakob disease
53
___ = Devoid of DNA or RNA; resistant to heating
prion
54
This dz is Fatal ; die 7 months after onset of symptoms
Creutzfeldt-Jakob disease
55
PRion Dz with hosts:
Kuru -
Scrapie -
Bovine spongiform encephalopathy (BSE) – known as mad cow disease
Humans
Sheep
Cattle
56
Histology = (PrP) amyloid plaques
| (biopsy tonsils for diagnosis)
Prions
57
______ most important condition where primary damage to CNS myelin occurs with relative preservation of axons
Multiple sclerosis
58
Most common demyelinating disease affecting white matter of brain
Multiple sclerosis
59
Autoimmune disorder causing demylentation of axons
Multiple sclerosis
60
Multiple sclerosis affects the:
Angles of the lateral ventricles
Cerebellar peduncles
Optic nerves
Brain stem
61
Charcot triad of ______may be associated with what symptoms?
MS;
Nystagmus
Intention tremor
Scanning speech
62
Direct injury to axon and have secondary myelin loss Known as Wallerian degeneration occurs in???
peripheral neuropathy
63
Damage to Schwann cells or myelin
| / Abnormal slow nerve conduction velocity happens in
peripheral neuropathy
64
Disorders associated with peripheral neuropathy are? (2)
Diabetes
| GILLAN BARRE’S
65
Autoimmune-mediated demyelination of PERIPHERAL nerves
GILLAN BARRE’S
66
Most common cause of peripheral neuropathy is ?
Diabetic peripheral neuropathy
67
Most common cause of ACUTE INFLAMMATORY PERIPH NEUROPATHY is
GILLAN BARRE’S
68
This autoimmue dz of perioheral nerve typically happens after 2-4weeks after____??
viral illness,
immunization ,
allergic reaction (YA)
69
s/s of GILLAN BARRE’S = ?
Ascending muscle weakness and paralysis
70
In GILLAN BARRE’S Remyelination over a period of ???
3-4 months
71
Most common motor neuron disease
ALS
72
Most common ACUTE INFLAMMATORY PERIPH NEUROPATHY
GILLAN BARRE’S
73
Most common cause of GENERAL peripheral neuropathy
DM
74
Most common demyelinating disease affecting white matter of brain
MS
75
Most important indicator of injury
gliosis
76
Most common neurodegenerative disease
Alzeihmers
77
Most common group of primary brain tumors
gliomas
78
Most common primary intracranial neoplasm
Glioblastoma
79
DEMYELINATING DISEASES
```
MS
peripheral neuropathy ( DM, GB)
```
80
DISORDERS OF NEUROMUSCULAR JUNCTION
Myasthenia gravis
| Lambert-Eaton syndrome
81
MS has demyelination but preserves the axon T or F?
T
82
When autoantibodies directed against acetylcholine receptors you get which dz?
Myasthenia Gravis
83
Alterations in morphology of POSTSYNAPTIC membranes & depletion of ACH receptors
MG
84
This dz May be associated with thymoma or thymic hyperplasia
MG
85
Repetitive use or electrophysiologic stimulation of muscles makes condition worse
MG
86
Autoantibodies inhibit PRESYNAPTION function of calcium channels
Lambert-Eaton
87
Antibodies block release of acetylcholine
LE
88
Weakness improved with repetitive stimulation; associated with small cell lung carcinoma
LE
89
MG vs LE
MG – POST SYNAP ; thymic hyperplasia ; stimulation worsens
LE – PRESYNAP ; stimulation improves
BOTH – Autoimmune ; muscle weakness
90
NEURODEGENERATIVE DISEASES
Degeneration of specific groups of neurons
91
TYPES OF NEURODEGENERATIVE DISEASES
```
AMYOTROPHIC LATERAL SCLEROSIS (ALS/LOU GEHRIG DISEASE)
PARKINSON DISEASE
HUNTINGTON DISEASE
ALZHEIMER DISEASE
(APHA)
```
92
PROTEINS ASSOCIATED WITH ALZHEIMER DISEASE
Aβ & Tau
93
PROTEINS ASSOCIATED WITH PARKINSON DISEASE
α-synuclein
94
PROTEINS ASSOCIATED WITH HUNTINGTON DISEASE
HUNTINGTON protein
95
What typically occurs in NEURODEGENERATIVE DISEASES?
Progressive loss of motor neurons from cortex, brain stem and spinal cord in older individuals
AND
Gliosis and secondary degeneration of motor tracts
96
Most common motor neuron disease
ALS
97
EARLY s/s = weakness of hands,
dropping objects
LATE s/s = lung infections; denervation atrophy
ALS
98
Death in 1-6 years usually respiratory
ALS
99
ALS Lower motor neuron signs
| ALS Upper motor neuron signs
Fasciculation
| Hyperreflexia
100
Loss of dopamine and associated with protein α-synuclein
Parkinson's
101
Triad of symptoms of Parkinson's
-Tremor
-Rigidity
-Bradykinesia
(Others Masked face Shuffling gait)
102
Negri bodies =
Lewy bodies =
Hairano bodies =
rabies virus
Parkinsons
Alzheimers
103
Fatal, progressive degeneration and atrophy of the striatum
Huntington's
104
Huntington's affects the :
1.
2.
3.
1. caudate nucleus
2. putamen
3. rontal cortex (with neuronal depletion and gliosis)
105
Eitology for huntingtons?
HD gene on short arm of chromosome 4
Huntington protein produced
Accumulates inside neuronal nuclei
106
s/s of huntingtons
Choreiform movements and dementia
Early - athetoid-slow, writhing, involuntary
Later- progressive cognitive decline, incontinence, anorexia/weight loss, dementia
107
pt with Huntingtons are at a risk of ?
suicide
108
Most common neurodegenerative disease & Most important cause of progressive dementia in older adults
Alzheimer disease
109
suspected etiology of ___ = amyloid gene expression (chromosome 21)
Alzheimer disease
110
Pneumonia is usual cause of death
Alzheimer disease
111
signs and symptoms of alzhhmrs
-Progressive failure of memory
Degeneration of temporal and parietal cortex
112
```
Histopathology of Alzheimer disease contains: (5)
S
H
A
N
G
```
```
Senile (neuritic) plaques ( Aß protein)
Hirano bodies
Amyloid angiopathy
Neurofibrillary tangles and neuropil thread
Granulovacuolar degeneration
```
113
In children, majority of intracranial tumors are in the _____?
posterior fossa
114
In adults, majority of intracranial tumors are ________?
supratentorial
115
Main primary sites of metastasis to brain from?
Breast,
GI
Lung
skin
116
Main primary sites of metastasis to spinal cord are?
Prostate, kidney, breast, lung carcinomas
117
Most common group of primary brain tumors
Gliomas
118
Most common primary intracranial neoplasm
Glioblastoma (Glioblastoma multiforme)
119
Meningioma
Benign ; Infiltration of skull ; Histopathology
| Whorled pattern tx: Surgery
120
Negri bodies –
Lewy Bodies –
Hirano bodies –
Psammoma bodies -
rabdovirus
parkinson
alzheimers
menuguoma
121
These s/s associated with ???
Headache
Hemiparesis
Personality change
Glioblastoma (Glioblastoma multiforme)
