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NS Pathology > اول ٦ صفحات > Flashcards

اول ٦ صفحات Flashcards

1
Q

Acute injury of Neurons

A

Necrosis:
• 12-24hrs Ischemia/hypoxia (very susceptible)

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2
Q

neurons that have lost their
nucleus, intensely eosinophilic

A

Red Neurons

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3
Q

axonal swelling

A

SPHEROIDS

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4
Q

Apoptosis

A

aging

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5
Q

Chronic or subacute injury example

A

Parkinson Disease, Alzheimer disease

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6
Q

Neuronal processes in Chronic or subacute injury

A

thickened & tortuous (Dystrophic Neurites)

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7
Q

Neuronal loss & replacement by gliosis in progressive diseases

A

Chronic or subacute injury

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8
Q

Axonal injury leads to

A

Central Chromatolysis

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9
Q

progressive depletion of
dopaminergic neurons in the basal ganglia,
particularly the substantia nigra.

A

Parkinson disease

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10
Q

Inclusions

A

viral infections

Nuclear or cytoplasmic

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11
Q

Gliosis

A

↑number & size of Astrocytes

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12
Q

Swollen reactive astrocytes with acidophilic cytoplasm (↑GFAP)

A

Gemistocytes

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13
Q

Aggregates of thick eosinophilic astrocytic fibers, in old gliosis or some tumors

A

Rosenthal fibers

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14
Q

Synthesis & maintenance of myelin// inclusion in specific viral infection (JC virus)

A

Oligodendrocytes

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15
Q

Inclusions characteristic of CMV

A

Ependymal cells

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16
Q

lines the ventricles and the spinal canal

A

Ependymal cells

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17
Q

Macrophages in infarction

A

Gitter cells

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18
Q

Elongated cells in syphilis

A

Rod cells

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19
Q

Aggregates of microglia around injured cells

A

Microglial nodules

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20
Q

Aggregate around dead neurons

A

Neuronophagia

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21
Q

Increased Intracranial Pressure

A

↑ in CSF pressure > 15 mm

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22
Q

Increased Intracranial Pressure PATHOPHYSIOLOGY

A

Inside the skull: Brain 70%, CSF 15% , Blood 15%

Expansion in any component is first compensated by ↓ in the rest i.e. ↓ CSF, ↓ blood, ↓ ventricular size

If P. ↑ >15-20mm.Hg , compensation fails

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23
Q

Herniation of Cingulate gyrus under
falx cerebri into the subfalcine space

A

SUBFALCINE HERNIATION

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24
Q

Pressure on Anterior Cerebral Artery →
Cerebral infarction

A

SUBFALCINE HERNIATION

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25
Q

herniation of medial temporal lobe(insula) through
tentorium cerebelli

A

TRANSTENTORIAL HERNATION

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26
Q

TRANSTENTORIAL HERNATION manifestation

A

Occipital infarction

3rd.& 6th. Cranial Nerves. → ipsilateral dilated pupil &impaired eye movement

Cerebral peduncle compression to opposite side → ipsilateral
hemiparesis

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27
Q

Herniation of cerebellar tonsil and medulla through foramen magnum

A

TONSILLAR HERNIATION

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28
Q

BRAIN STEM: Pressure on respiratory & cardiac centers

Associated with which type of herniation

A

TONSILLAR HERNIATION

29
Q

Cardiorespiratory failure & death

A

TONSILLAR HERNIATION

30
Q

Dry Flat Gyri

A

Cerebral Edema

31
Q

Cerebral Edema types

A

Vasogenic Edema

Cytotoxic edema

32
Q

Vasogenic Edema

A

due to↑ permeability with dysfunction of blood brain barrier

Intercellular

white matter

Infarcts, contusions, tumors, abscesses

33
Q

Cytotoxic Edema

A

• due to neuronal & glial injury
• Intracellular
• More in grey matter
• More in toxic & metabolic causes

34
Q

CAUSES OF INCREASED ICP

A
  1. Cerebral Edema: Dry Flat Gyri
  2. Infarction & Hemorrhage
  3. Infections - Abscesses & meningitis
  4. Tumors - Primary & Secondary
  5. Trauma - especially in diffuse brain damage
  6. Hydrocephalus
35
Q

Excess CSF in ventricular system with enlarged ventricles, caused by

A

I. ↓ resorption in inflammation & obstruction
II. Overproduction of CSF in some tumors

36
Q

Chronic HYDROCEPHALUS with compensation

A

children → Large head, thin skull, open fontanel

37
Q

Some viruses have selective sites

A

• CMV - Ventricles

• HSV - Temporal lobe & orbital frontal area

• Polio - Anterior horn cells of spinal cord

• Herpes Zoster - Thoracic dorsal root ganglia

38
Q

Thoracic dorsal root ganglia infected by

A

Herpes Zoster

39
Q

Anterior horn cells of spinal cord infected by

A

Polio

40
Q

Temporal lobe & orbital frontal area infected by

A

HSV

41
Q

Ventricles

A

CMV

42
Q

HSV-2 in adults may cause

A

meningitis

43
Q

Acute Bacterial Meningitis of Neonates

A

Streptococci & E.coli

44
Q

Acute Bacterial Meningitis>6m

A

H. influenza, S. pneumoniae

45
Q

Acute Bacterial Meningitis in Shunt operations

A

Staphylococci

46
Q

Acute Bacterial Meningitis Elderly

A

S. pneumonia & L. monocytogenes

47
Q

Acute Bacterial Meningitis in Adolescents & young adults

A

N. meningitidis

48
Q

Waterhouse-
Friderichsen Syndrome

A

N. meningitidis

49
Q

C.S.F. findings (lumbar puncture):

A

• ↑Pressure, ↑Protein, ↓sugar, numerous neutrophils, demonstrable bacteria

50
Q

COMPLICATIONS OF BACTERIAL MENINGITIS

مهم تعرف الفرق عن تبع الفيروس

A
  1. Obstructive hydrocephalus
  2. Cerebral infarction
  3. Cerebral abscess
  4. Epilepsy
  5. Cranial nerve palsy
  6. Deafness (8th cranial nerve)
51
Q

MORPHOLOGY in Acute Bacterial Meningitis:

A

Exudate in subarachnoid space, especially around base, full of neutrophils & organisms

52
Q

ACUTE ASEPTIC MENINGITIS (VIRAL MENINGITIS) by which microorganisms

A

Enterovirus, echovirus, coxackie v., mumps v., EBV, HIV قراءة مش بصم

53
Q

ACUTE ASEPTIC MENINGITIS (VIRAL MENINGITIS(

A

➢ Hematogenous spread.
➢ Mild self-limiting often seasonal

54
Q

ACUTE ASEPTIC MENINGITIS (VIRAL MENINGITIS)

A

CSF is clear, slight ↑ protein, normal sugar, ↑↑ lymphocytes

مهم شو نوع الخلايا +++ انه السكر طبيعي

55
Q

BRAIN ABSCESS

A

➢ CSF: ↑protein, ↑cells, normal sugar.

56
Q

BRAIN ABSCESS morphology

A

• Localized suppuration surrounded by granulation tissue, reactive astrocytes & severe edema leading to ↑ ICP.
• Later gliosis & collagen formation

57
Q

BRAIN ABSCESS how you will be infected

A

➢ Direct infection from paranasal sinuses, mastoiditis & middle ear → Frontal or temporal lobes , mostly single

➢ Hematogenous route,
• More in parietal lobe
• May be multiple

58
Q

HUMAN IMMUNODEFICIENCY VIRUS (HIV)

A

At least 60% of AIDS pts. develop CNS dis

59
Q

HIV

A

aseptic viral meningitis in 10%

60
Q

Commonest cause of dementia in the young

A

Chronic HIV: Meningoencephalitis

61
Q

Pathology of HIV

A

.white matter, basal ganglia & spinal cord.
• Demyelination, microglial nodules with multinucleated giant cells»
• Brain atrophy

62
Q

CYTOMEGALO VIRUS (CMV) in aids patients

A

subacute encephalitis any region & any cell

mainly ependymal & subependymal cells.

hemorrhagic necrosis

large cytoplasmic & intranuclear inclusions

brain destruction, microencephaly & calcification

63
Q

Rare cases develop paralysis of respiratory muscles

Virus??

A

POLIOVIRUS

64
Q

Atrophy of the anterior (motor) spinal roots, and neurogenic
atrophy of denervated muscle in case of

A

Chronic POLIOVIRUS

65
Q

Acute POLIOVIRUS affects which region

A

Affect anterior horn motor neurons of the spinal cord

66
Q

RABIES degeneration and inflammatory reaction, most severe in

A

midbrain, & floor of 4th. Ventricle

67
Q

Negri bodie

A

RABIES

68
Q

Negri bodies

A

:cytoplasmic eosinophilic inclusions in pyramidal neurons of the hippocampus & Purkinje cells
of cerebellum

69
Q

مهم مهم بصم

A

➢ All common features of viral encephalitis seen with intranuclear viral inclusions in neurons & glial cells.(cowdry type A )

NS Pathology (3 decks)

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