WEEK 2: PATHOLOGY PART 2 [ERF] NOT INCLUDED YET

Question 1

3 types of intracranial hemorrhage

Answer 1

epidural
subdural
subarachnoid

Question 2

Bleeding between the inner table of skull and dura

Answer 2

epidural hemorrhage

Question 3

typical cause of epidural hemorrhage

Answer 3

trauma; Due to structural disruption of the dural and skull vessels
commonly associated with calvarial fractures

Question 4

most common etiology of epidural hemorrhage?

Answer 4

Laceration of the middle meningeal artery and its

accompanying dural venous sinuses

Question 5

when does symptoms appear in epidural hemorrhage?

Answer 5

Blood volume reaches 30-50 cc symptoms appear

Question 6

can epidural hemorrhage become asymptomatic?

Answer 6

first 4 to 8 hours

Question 7

cause of subdural hemorrhage?

Answer 7

Trauma to the frontal or occipital regions of the head

Rapid displacement of the cerebral hemispheres against the
inner aspect of the skull

Shearing effect on the bridging veins within the subdural
space

Subdural: Shearing of the Beins

Commonly blood accumulating to a volume of 25-50 cc
results in a tamponade effect on the ruptured bridging veins

Question 8

what hemorrhage is most common in shaken baby syndrome?

Answer 8

subdural hemorrhage

Question 9

most often caused by head injury rapidly changing velocities within the skull may stretch and tear small veins?

Answer 9

subdural hemorrhage

Question 10

most common cause of subarachnoid hemorrhage?

Answer 10

berry (saccular) aneurysm, commonly in the circle of willis.

most common d/t Due to congenital defects of the smooth muscle fibers of
the tunica media

Question 11

MC location of congenital saccular aneurysm in the brain.

Answer 11

branch of the middle cerebral/portion of ICA just before maging MCA siya

but it can occur in any part of the circle of willis

Question 12

Interruption of blood supply commonly due to blockage or rupture
of blood vessel causing sudden death of brain cells

Answer 12

CVA

Question 13

why is MCA one of the most common location of CVA

Answer 13

because it does not form the circle of willis

Question 14

MC of intracerebral hemorrhage?

Answer 14

hypertensive vascular disesase.

Question 15

cause of ischemic stroke?

Answer 15

Caused by thrombotic or embolic occlusion of a cerebral

artery

Question 16

ischemic infarction may lead to what 2 consequences?

Answer 16

cerebral edema; inc ICP

Question 17

most common congenital anomaly that can cause stroke?

Answer 17

arteriovenous malformation

Question 18

where are AVM usually located?

Answer 18

superficial portion of gray matter

Question 19

CNS tumors are how many percent of all tumors?

Answer 19

10%

Question 20

most common solid cancer in children?

Answer 20

CNS Tumor; 2nd siya to leukemia if all malignancies

Question 21

peak of age of CNS tumor?

Answer 21

double peak; 1st and 6th decade

Question 22

location of CNS tumor in adult and children?

Answer 22

adults- 70% supratentorial

children- 70% infratentorial

Question 23

classifications of intracranial tumors?

Answer 23

metastatic (majority)
extrinsic
intrinsic

Question 24

most common extrinsic tumors of brain?

Answer 24

meningioma

Question 25

distribution of metastasis in the brain is most common in what area?

Answer 25

cerebral hemishpere - 80 percent cerebellum - 15 brain stem - 5 percent

Question 26

Many cancer cells that enter the brain are killed by | astrocytes by secreting a protein called

Answer 26

Fas Ligand

Question 27

Is charcot-bouchard microaneurysm a congenital problem?

Answer 27

no. acquired because of continuous trauma and degeneration of the tunica media, wherein the smooth muscle layer is replaced with fibrous tissue.

Question 28

why is the bifurcation of ICA and MCA the most common site of aneurysm?

Answer 28

``` The bifurcations produce Eddy currents which causes trauma to the endothelial cells. This in turn causes the entry of triglycerides, setting into motion the development of atherosclerosis. ```

Question 29

A lot of cerebral infarcts, later on, are associated with | hemorrhage. why?

Answer 29

Because when a vessel undergoes infarction, the surrounding blood vessels also die. So then how will the hemorrhage occur? Remember that the unobstructed portion of the other branches are still patent, therefore blood will still drain into the infarcted part of the brain and will cause some degree of hemorrhage

Question 30

Brain tumors have rare extraneural spread. tor f?

Answer 30

T

Question 31

most common causes of brain metastasis in adults?

Answer 31

Lung 50 percent | Breast 15 to 20 percent

Question 32

4 implications (risk factor) on the pathophysiology of brain tumors?

Answer 32

pathogenesis is mostly unknown. but the following have been implicated. Genetic factors chemical and viral factors Radiation Immunosuppression

Question 33

most common tumor in children in cerebellum?

Answer 33

medulloblastoma most common in children in the cerebellum

Question 34

T or F? Behavior of CNS tumors cannot be readily categorized into benign or malignant

Answer 34

T

Question 35

Arise from the coverings of the brain and spinal cord

Answer 35

extrinsic brain tumors

Question 36

most common extrinsic brain tumor?

Answer 36

meningioma, more common in females

Question 37

WHO classification of meningioma: what is grade 1 grade 2 grade 3

Answer 37

benign (90%) atypical (7%) anaplastic/malignant (2%)

Question 38

most common histologic subtype of meningioma?

Answer 38

meningothelial

Question 39

most aggressive histologiuc subtyppe of meningioma?

Answer 39

angioblastic

Question 40

what hormones are risk factors in having meningiomas?

Answer 40

estrogen and progesterone

Question 41

most common site of schwannoma

Answer 41

vestibular branch of the 8th cranial nerve in the region of the cerebello-pontine angle, aka acoustic neuroma.

Question 42

usually arise in the dorsal nerve roots of the spinal cord; most frequently in patients with neurofibromatosis.

Answer 42

neurofibroma

Question 43

infiltrate any portion of the brain; most common type of brain tumor.

Answer 43

Gliomas

Question 44

most common brain tumor, accouning for more than half of all primary CNS malignancies; Most cases occur in the first decade of life -> Peak age at 5-9 years.

Answer 44

astrocytoma

Question 45

Astrocytomas come in four major subtypes:

Answer 45

Juvenile pilocytic astrocytome (grade 1) o Fibrillary/diffuse astrocytoma (grade 2) o Anaplastic astrocytoma (grade 3) o Glioblastoma multiforme (grade 4)

Question 46

type of astrocytoma that has is highly aggressive with short life expectancy

Answer 46

glioblastoma multiforme

Question 47

most common malignant brain tumor in children, accounting for 10-20% of primary CNS neoplasms and approximately 40% of all posterior fossa tumors-- > Highly invasive embryonal neuroepithelial tumor.

Answer 47

medulloblastoma

Question 48

Cerebellar tumor arising predominantly from the _______

Answer 48

cerebllar vermis.

Question 49

Most common neuroblastic tumor in the CNS |  Almost exclusively in the cerebellum arising from the external granular layer of cerebellum.

Answer 49

medulloblastoma

Question 50

you can have a Primary CNS Lymphoma without having Lymphoma elsewhere. T or F

Answer 50

T

Question 51

intrinsic brain tumor most common in adults; usually located in white matter of cerebral hemisphere.

Answer 51

Oligodendroglioma

Question 52

epednymoma is often located in?

Answer 52

4th ventricle

Question 53

intrinsic brain tumor located in the suprasellar region causing pituitary dysfunction and visual disturbance

Answer 53

craniopharyngioma

Question 54

choroid plexus papiloma is common in what ventricle?

Answer 54

lateral ventricles