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18. Nervous System > 11. Neuropathology > Flashcards

11. Neuropathology Flashcards

1
Q

What are the three routes microorganisms can gain entry to the CNS via?

A

Direct spread, blood-borne, iatrogenic.

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2
Q

What is meningitis?

A

The inflammation of the leptomeninges - pia and arachnoid, with or without septicaemia.

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3
Q

What are the likely causative organisms of meningitis in neonates?

A

E. coli, L. monocytogenes.

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4
Q

What are the likely causative organisms of meningitis in 2-5 year olds?

A

H. influenzae type B.

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5
Q

What are the likely causative organisms of meningitis in 5-30 year olds?

A

N. meningitides.

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6
Q

What are the likely causative organisms of meningitis in people over 30 years old?

A

S. pneumoniae.

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7
Q

What is chronic meningitis cause by?

A

M. tuberculosis.

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8
Q

What is chronic meningitis?

A

Chronic clinical course with granulomatous inflammation, fibrosis of meninges, and nerve entrapment.

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9
Q

What are the local complications of meningitis?

A

Death from RICP due to swelling, cerebral infarction causing neurological deficit, cerebral abscess, subdural empyema, epilepsy.

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10
Q

What is encephalitis?

A

A viral infection of the parenchyma which causes neuronal cell death.

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11
Q

What is the result of encephalitis considering the temporal lobe, spinal cord motor neurones, brain stem, and lymphocytic inflammatory reaction?

A

Temp - epilepsy. Spinal cord - MN signs. Brain stem - quick fatality. Lymph - swollen brain so RICP and death.

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12
Q

What causes encephalitis of the: temporal lobe, spinal cord motor neurones, and brain stem?

A

Temp - herpes virus, SC - polio, brain stem - rabies.

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13
Q

What is the histological presentation of cytomegalovirus?

A

Owl’s eyes.

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14
Q

Which patients suffer from CMV?

A

HIV and AIDS immunocompromised patients.

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15
Q

What are prions?

A

Proteins that are part of the normal constituent of synapses.

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16
Q

How can prion proteins become mutated?

A

Sporadic, familial or ingested.

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17
Q

What is the pathophysiology of prions disease?

A

Prion proteins aggregate and cause neuronal death so holes form in grey matter.

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18
Q

What is variable Creutzfeld-Jacob disease an example of?

A

A spongiform encephalopathy.

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19
Q

What is dementia?

A

Acquired global impairment of intellect, reason, and personality without impairment of consciousness.

20
Q

What are the types of dementia?

A

Alzheimers, vascular, Lewy body, and Picks disease.

21
Q

What are the features of Alzheimer’s disease?

A

Loss of cortical neurones (decreased brain weight, cortical atrophy) due to increased neuronal damage.

22
Q

What can neuronal damage be due to in Alzheimer’s disease?

A

Neurofibrillary tangles and senile plaques.

23
Q

What are neurofibrillary tangles?

A

Intracellular twisted filaments of Tau protein. Tau is hyperphosphorylated.

24
Q

What are senile plaques?

A

Foci of enlarged axons, synaptic terminals and dendrites with amyloid deposits in vessels in the centre of plaques.

25
Q

Which mutations of chromosome 21 cause early onset AD with Down’s syndrome?

A

Amyloid precursor protein gene, presenilin genes 1 and 2 code for components of secretase enzymes, lead to incomplete breakdown of APP and amyloid is deposited.

26
Q

What is normal intracranial pressure?

A

0-10mmHg.

27
Q

What are the compensation mechanisms involved in maintaining normal intracranial pressure?

A

Reduced blood volume, reduced CSF volume, spatial-brain atrophy.

28
Q

What are the consequences of expanding lesions in the cranium?

A

Deformation or destruction of the brain around the lesion, displacement of midlines structures, brain shift can cause internal herniation.

29
Q

What is a subfalcine herniation?

A

On same side as mass, cingulate gyrus is pushed under the free edge of the falx cerebri.

30
Q

How can subfalcine hernias cause infarction?

A

Ischaemia of medial parts of the frontal and parietal lobe and corpus callosum due to compression of anterior cerebral artery -> infarction.

31
Q

What is a tentorial herniation?

A

Uncus/medial part of parahippocampal gyrus herniates through tentorial notch.

32
Q

How do tentorial hernias cause dilated pupils?

A

Damages oculomotor nerve on the same side.

33
Q

How are tentorial hernias frequently fatal?

A

Secondary haemorrhage into brainstem -> duret haemorrhage.

34
Q

How can tentoral hernias cause infarction?

A

Occludes blood flow in posterior cerebral and superior cerebellar arteries.

35
Q

What is a tonsilar herniation?

A

Cerebellar tonsils are pushed into foramen magnum, compressing the brainstem.

36
Q

What is a benign tumour of the brain?

A

Meningioma.

37
Q

What is a malignant brain tumour?

A

Astrocytoma.

38
Q

Name a tumour of the brain from non-CNS tissues.

A

Lymphoma, metastasis.

39
Q

What is a stroke?

A

Sudden event producing a disturbance of CNS function due to vascular disease.

40
Q

What are the two categories of stroke?

A

Cerebral infarction (85%) and cerebral haemorrhage (15%).

41
Q

What is the pathogenesis of strokes?

A

Embolism or thrombosis.

42
Q

What are the types of cerebral infarct?

A

Regional and lacuna.

43
Q

What are the two common haemorrhages in cerebral haemorrhage strokes?

A

Intracerebral and subarachnoid.

44
Q

What is intracerebral haemorrhage associated with?

A

Hypertensive vessel damage, Charcot-Bouchard aneurysms, deposition of amyloid around cerebral vessels in the elderly.

45
Q

What causes subarachnoid haemorrhages?

A

Rupture of berry aneurysms.

46
Q

Where are berry aneurysms found?

A

Circle of Willis.

47
Q

What is the presentation of subarachoid haemorrhages?

A

Sudden severe headache (thunderclap), sentinel headache (build up from small bleeds), loss of consciousness. Instantly fatal.

18. Nervous System (17 decks)

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