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Neurology Week 4 2018/19 > 2: Neuropathology 1 > Flashcards

2: Neuropathology 1 Flashcards

1
Q

What germ cell layer do neurons and glial cells come from?

A

Ectoderm

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2
Q

Which germ cell layer do microglia come from?

A

Mesoderm

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3
Q

Necrosis is ___ death of brain cells and occurs in which brain disease?

A

rapid

sudden failure e.g stroke

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4
Q

Atrophy is a ___ reduction in brain size.

Is it normal?

A

slow

Depends - occurs with age, but is accelerated in diseases such as Alzheimer’s

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5
Q

What happens to neurons histologically in acute injury?

A

Nuclei shrink and angulate

Nucleolus is lost

Cytoplasm turns red

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6
Q

___ neurons are indicative of acute neuronal injury.

A

Red

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7
Q

Which types of acute injury cause red neuronal death?

A

Hypoxia

Infarction

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8
Q

What is the role of astrocytes in the CNS?

A

Support cells

Maintain homeostasis, maintain BBB, role in repair

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9
Q

What is reactive gliosis?

Which cells undergo it?

What does it look like?

A

Non-specific reaction to CNS injury by glial cells

Glial cells (astrocytes, microglia, ependymal cells, oligodendrocytes)

Hypertrophy and hyperplasia, nucleus enlarges

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10
Q

In demyelinating diseases (e.g MS), the conduction velocity of neurons (increases / decreases).

A

decreases

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11
Q

What process do astrocytes undergo in response to injury?

A

Reactive gliosis

like all glial cells

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12
Q

What happens to astrocytes in gliosis?

A

Hypertrophy

Hyperplasia

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13
Q

Which important processes do

a) neurons
b) glial cells

undergo in response to injury?

A

a) “Red neuron” reaction

b) Reactive gliosis

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14
Q

What are the role of microglia in the CNS?

A

Immune surveillance

Phagocytosis

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15
Q

Which immune cell are microglia very similar to?

A

Macrophages

do the same job i.e phagocytosis, just in the brain

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16
Q

Which state causes acute brain injury and occurs in stroke, trauma and cardiac arrest?

A

Hypoxia

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17
Q

Which percentage of inhaled oxygen is used by the brain?

A

20%

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18
Q

Why do neurons depolarise after extended hypoxia?

Which neurotransmitter is released in response to this abnormal depolarisation?

Which ion then enters the neuron

A

Na/K ATPase stops working - so Na accumulates inside the cell, causing a depolarisation

Glutamate (excitatory)

Ca2+

19
Q

What is excitotoxicity?

What triggers it?

A

Process by which neurons are killed by excessive glutamate > Ca2+ release

Extended hypoxia - Na/KATPase fails - Depolarisation - Glutamate release - Ca2+ influx - Release of endotoxins

20
Q

Various types of swelling, or ___, occur in response to brain injury.

A

oedema

21
Q

What is vasogenic oedema?

A

Breakdown of the BBB in infarcted areas of the brain allows water, ions and protein to filter out, causing swelling

22
Q

What is cytotoxic oedema?

A

Hypoxic cells lose function of their sodium-potassium pump

Sodium accumulates in the cell

So water and chloride ions follow down the osmotic gradient

Causing the cell to swell

Protein can also get in through the wrecked cell membrane

23
Q

Oedema causes ___ of brain tissue.

A

compression

24
Q

What can happen to the brain if intracranial pressure increases too much?

A

Herniation

which tends to be fatal

25
Q

What is haemorrhagic conversion?

A

Blood vessels weakened by an ischaemic stroke rupture, causing bleeding

26
Q

Which three processes cause compression, contributing to complications following a brain injury?

A

Cytotoxic oedema

Vasogenic oedema

Haemorrhagic conversion

27
Q

The area of brain affected by a stroke depends on the ___ which are affected.

A

arteries

28
Q

What is the average BP of the brain circulation?

A

20 mmHg

29
Q

What pathologies of blood vessels cause stroke?

A

Infarction

Haemorrhage

AVM

Aneurysm

Dissection

30
Q

What is a cardio risk factor for stroke?

A

Hypertension

31
Q

What is

a) global
b) focal

hypoxic ischaemic injury?

A

a) Widespread brain deperfusion due to shock, hypotension, cardiac arrest, trauma…
b) Damage to one specific area of the brain due to blockage of a specific artery

32
Q

What MAP is required to perfuse the brain?

A

60 mmHg and above

33
Q

What are risk factors for ischaemic stroke?

A

Hypertension

All the CVD risk factors for atherosclerosis - smoking, diet, HT, age, male diabetes

Congenital heart disease

34
Q

What colour do neurons turn in acute damage secondary to ischaemic stroke?

A

Red

35
Q

Microglia hoover up dead cell debris by ___.

A

phagocytosis

36
Q

If an ischaemic stroke turns into a bleed, what is that process called?

Which structure is damaged to cause this?

A

Haemorrhagic conversion

Blood brain barrier

37
Q

Which cardio risk factor is a big predictor of stroke?

A

Hypertension

38
Q

Which type of infarct affects the basal ganglia?

A

Lacunar infarction

39
Q

Haemorrhage

bleeding tissue is damaged by hypoxia

surrounding tissue is damaged by oedema and compression

A
40
Q

Which notable type of vascular disease causes subarachnoid haemorrhage?

A

Berry aneurysm

41
Q

What are some rarer causes of haemorrhagic stroke?

A

Amyloid angiopathy

ARTERIOVENOUS malformation

42
Q

Which circulation is damaged to cause a Berry aneurysm?

A

Circle of Willis

43
Q

Which renal disease is associated with Berry aneurysm?

A

Polycystic kidney disease

44
Q

Why may haemorrhages secondary to Berry aneurysms cause hydrocephalus?

A

Blood stops CSF reabsorption in subarachnoid granulations

Neurology Week 4 2018/19 (12 decks)

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