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Pathology Lab > 10 Central and Peripheral Nervous Systems > Flashcards

10 Central and Peripheral Nervous Systems Flashcards

1
Q

Intracerebral hemorrhage is often associated with _____

A

Stroke

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2
Q

Hemorrhage in the basal ganglia and thalamus

A

Ganglionic hemorrhage

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3
Q

Ganglionic hemorrhage is commonly caused by

A

Hypertension

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4
Q

Hemorrhage in the lobes of the cerebral hemisphere

A

Lobar hemorrhage

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5
Q

Lobar hemorrhage is commonly caused by

A

Cerebral amyloid angiopathy

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6
Q

Risk factor most commonly associated with deep brain parenchymal hemorrhages

A

Hypertension

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7
Q

Minute aneurysms

A

Charcot-Bouchard aneurysms

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8
Q

Differentiate intracerebral hemorrhage from subarachnoid hermorrahge based on their different etiologies and common locations

A

Etiology:
I - hypertension, cerebral amyloid anagiopathy; S - saccular aneurysm, traumatic hematoma
Location:
I - basal ganglia and thalamus, cerebral hemisphere; S - subarachnoid space

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9
Q

Differentiate Charcot-Bouchard aneurysm from saccular aneurysm

A

C - vessels less than 300 um (within basal ganglia), associated with chronic HPN
S - larger intracranial vessels in subarachnoid space, intracranial aneurysm

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10
Q

State the four types of vascular malformation and differentiate each

A

AVM - enlarged blood vessels separated by gliotic tissue; shunting
Cavernous malformation - low flow channels, cerebellum, pons, subcortical regions
Capillary telangiectasia - foci of dilated, thin-walled vascular channels
Venous angioma - ectatic venous channels

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11
Q

Classified as acute pyogenic meningitis

A

Suppurative meningitis

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12
Q

Histopathology of suppurative meningitis

A

Intense inflammatory infiltrate
Congestive vessels
Langhans multinucleated cell

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13
Q

Most common pattern of tuberculous involvement

A

Diffuse meningoencephalitis

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14
Q

Differentiate suppurative meningitis from TB meningitis

A

S - acute pyogenic meningitis, CSF: mostly PMNs, elevated protein, dec. glucose
T - chronic bacterial menigoencephalitis, CSF: moderate pleocytosis, high protein, dec/N glucose levels

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15
Q

Causative organisms of acute bacterial meningitis with their corresponding age predilection

A

Neonates - E. coli, Group B strep
Adolescents - N. meningitidis
Adults - S. pneumoniae, L. monocytogenes

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16
Q

Enumerate common complications of acute pyogenic menigitis and TB meningitis

A

A - Waterhouse-Friderichsen syndrome (hemorrhagic infarction of the adrenal glands and petechiae); hydrocephalus; chornic adhesive arachnoiditis
T - hydrocephalus (arachnoid fibrosis); arterial occlusion and infarction (obliterative endarteritis)

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17
Q

Enumerate major forms of neurosyphilis

A 
Meningovascular NS (base of the brain and the cerebral convexities)
Paretic NS - invasion of T. pallidum
Tabes dorsalis - damage to sensory axons in the dorsal roots
18
Q

How do the two lesions compare histologically? (A and T)

A

A - exudate, meningeal vessels are engorged

T - gelatinous or fibrinous exudate, granulomas

19
Q

Primary brain tumor
Benign tumor of adults
Rounded mass with a well-define dural base that compresses the underlying brain

A

Meningioma

20
Q

Meningioma arises from

A

Meningothelial cells of the arachnoid

21
Q

Cytogenic abnormalities in meningioma

A

Loss of chromosome 22

22
Q

Forms uniform cells that appear in a characteristic whorled appearance

A

Meningioma

23
Q

Microscopic collections of calcium found in many types of tumor
Circular, acellular, basophilic

A

Psammoma bodies

24
Q

What are the usual sites of meningioma

A

Usually attached to the dura, along any external surface of the brain

25
Q

What are the clinical features of this tumor?

A

Slow-growing lesion
Vague nonlocalizing features or focal finding referable to compression of underlying brain
Multiple lesions = NF2 mutations
Express progesterone receptors grow rapidly during pregnancy

26
Q

Most common malignant neoplasm of the central nervous system

A

Medulloblastoma

27
Q

Medullablastoma originates from

A

Nueroectoderm

28
Q

Medullablastoma is most commonly seen in ___

A

Cerebellum

29
Q

Molecular alteration in medulloblastoma

A

Loss of material from 17p with the WNT

30
Q

Medulloblastoma commonly affects

A

Children, in the midline of cerebellum

31
Q

Tumor tissue contains nodules of differentiated neurocytic cells that express neuronal proteins

A

Desmplastic nodular medulloblastoma

32
Q

Nodular regions are more abundant and often filled with streaming cells along a fibrillary background

A

Medulloblastoma with extensive nodularity

33
Q

Characterized by marked nuclear pleomorphism, cell wrapping, high mitotic count, abundant apoptotic bodies

A

Anaplastic medulloblastoma

34
Q

Individual tumor cells are small with scant cytoplasm and hyperchromatic nuclei that are frequently elongated or crescent shaped

A

Salt and pepper (MB)

35
Q

List the most common causes of intra-cerebral hemorrhage in the elderly and in infants/newborns

A

I - intraventricular hemorrhage (IHV)
N - hemorrhagic infarction
E - hypertension&raquo_space; intracranial hemorrhage

36
Q

Explain the pathogenesis of pupillary dilatation, vomiting and sensorial changes in increased ICP

A

Inc ICP&raquo_space; herniation and impingement

  • Pupillary dilation (transtentorial herniation)
  • Vomiting (infratentorial herniation)
  • Sensorial changes (transtentorial herniation)
37
Q

Sunny-side up or fried egg appearance

A

Oligodendroglioma

38
Q

Well circumscribed, gelatinous, gray masses, often with cysts, focal hemorrhage and calcification
Clear cytoplasm forming a halo

A

Oligodendroglioma

39
Q

Increased cell density, nuclear anaplasia, mitotic activity and necrosis

A

Anaplastic oligodendrogliomas

40
Q

Blood vessels within the membrane (oligodendrogliomas)

A

Chicken-wire appearance

41
Q

Differentiate oligodendroglioma from medullobrlastoma based on their location, age predilection, molecular alterations

A 
Location:
O - cerebral hemisphere, M - cerebellum
Age: 
O - 4th and 5th decades, M - children
MA:
O - isocitrate dehydrogenase, deletions of chromosome 1p and 19q, M - WNT type, SHH type, Group 3 (MYC), Group 4 (i17q)
42
Q

State the overall prognosis (M vs O)

A

M - 5-year survival rate, 75%

O - 5-10, better prognosis

Pathology Lab (4 decks)

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