Pathoma

Question 1

Most common cause of meningitis in neonates

Answer 1

Group B strep
E. coli
Listeria monocytogenes

Question 2

Most common cause of meningitis in nonvaccinated infants?

Answer 2

H. influenza

Question 3

Most common virus causing meningitis?

Answer 3

Coxsackie virus

Question 4

Fungi causes meningitis in the following group of individuals

Answer 4

immunocompromised individuals

Question 5

Most common cause of meningitis in children and teenagers? In adults and the elderly?

Answer 5

N meningitidis; S pneumoniae

Question 6

How much glucose is usu in the CSF?

Answer 6

2/3 of plasma glucose levels (ex: if blood glucose is 100g, glucose in CSF would be ~66)

Question 7

At what level should you put the needle to do a lumbar puncture?

Answer 7

L4/L5 (spinal cord ends at L2)

Question 8

CSF analysis: Neutrophils with low CSF glucose

Answer 8

bacterial meningitis

Question 9

CSF analysis: Lymphocytes with normal CSF glucose

Answer 9

viral meningitis

Question 10

CSF analysis: Lymphocytes with decreased CSF glucose

Answer 10

fungal meningitis

Question 11

What is the difference b/w a meningocele and a meningomyelocele?

Answer 11

meningocele: protrustion of the meninges
meningomyelocele: protrusion of meninges and spinal cord

Question 12

Presents as a dimple or patch of hair overlying the vertebral defect

Answer 12

spina bifida

Question 13

Damage to the anterior motor horn; present with lower motor neuron signs - flaccid paralysis with muscle atrophy, fasciculations, weakness with decreased muscle tone, impaired reflexes, and negative Babinski sign

Answer 13

poliomyelitis

Question 14

Presents as a sudden headache (“worst headache of my life”) with nuchal rigidity; most frequently due to rupture of a berry aneurysm

Answer 14

subarachnoid hemorrhage

Question 15

Collection of blood b/w dura and skull

Answer 15

epidural hematoma

Question 16

Why do you get a lens shaped bleed with epidural hematoma?

Answer 16

because the dura is so tightly adhered to the skull, so it remains attached at the two edges

Question 17

Lucid intervals; “talk and die syndrome”

Answer 17

epidural hematoma

Question 18

What usually causes subdural hematoma? What tears in subdural hematoma?

Answer 18

trauma; bridging veins that lie between the dura and the arachnoid

Question 19

What shape do subdural hematomas take on?

Answer 19

crescent shape

Question 20

Involves displacement of the cerebellar tonsils into the foramen magnum

Answer 20

tonsillar herniation

Question 21

Displacement of the cingulate gyrus under the falx cerebri

Answer 21

subfalcine herniation

Question 22

Displacement of the temporal lobe uncus under the tentorium

Answer 22

uncal herniation

Question 23

What 3 complications are associated with uncal herniation?

Answer 23

1. compression of CN 3 leading to a blown pupil and the eye moving “down and out”
2. compression of posterior cerebral artery leads to infarction of occipital lobe
3. rupture of paramedian artery can lead to Duret (brainstem) hemorrhage

Question 24

Increased CSF resulting in dilated ventricles; presents with a) urinary incontinence, b) gait instability, and c) dementia

Answer 24

hydrocephalus

Question 25

Tumors in adults usu occur (blank) the tentorium, while tumors in kids usu occur (blank) the tentorium

Answer 25

above; below

Question 26

Malignant, high-grade tumor of astrocytes; most common primary malignant CNS tumor in adults; usu in the cerebral hemisphere; crosses the cerebral hemispheres (butterfly lesions)

Answer 26

glioblastoma multiforme

Question 27

What would you see histologically in glioblastoma multiforme?

Answer 27

regions of necrosis surrounded by tumor cells (pseudopalisading) and endothelial cell proliferation

Question 28

Because glioblastomas are tumors of astrocytes, they will be (blank) positive

Answer 28

GFAP

Question 29

Benign tumor of arachnoid cells; most common BENIGN CNS tumor in adults; more commonly seen in women; imaging reveals a round mass attached to the dura

Answer 29

meningioma

Question 30

What would you see histologically in meningiomas?

Answer 30

whorled pattern of growth and psammoma bodies

Question 31

Benign tumor of Schwann cells; involves cranial nerves, most frequently CN 8; tumor cells are S-100 positive; associated with NF2

Answer 31

Schwannomas

Question 32

Malignant tumor of oligodendrocytes; calcified white matter, usu in the frontal lobe

Answer 32

oligodendroglioma

Question 33

What would you see histologically with oligodendroglioma?

Answer 33

fried-egg appearance of cells

Question 34

Benign tumor of astrocytes; most common CNS tumor in kids; usu in the cerebellum

Answer 34

pilocytic astrocytoma

Question 35

Because a pilocytic astrocytoma is a tumor of glial cells it will be (blank) positive

Answer 35

GFAP

Question 36

What would you see on imaging if you had a pilocytic astrocytoma? What about histologically?

Answer 36

cystic lesion with mural nodule (something growing off of the wall of the tumor); Rosenthal fibers

Question 37

Malignant tumor derived from granular cells of the cerebellum; usu arises in children; small, blue round cells; Homer-Wright rosettes

Answer 37

medulloblastoma

Question 38

Malignant tumor of ependymal cells; usu in children; most commonly in 4th ventricle (in kids); pseudorosettes (surrounding vasculature)

Answer 38

ependymoma