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testing123 > 3. Neuropathology > Flashcards

3. Neuropathology Flashcards

1
Q

Primary brain vesicles

A

Forebrain (prosencephalon) - tele and dien
Midbrain (mesencephalon) - mesen
Hindbrain (rhombencephalon) - meten and myelen

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2
Q

Secondary brain vesicles

A 
Telecephalon
Diencephalon
Mesencephalon
Metencephalon
Myelencephalon
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3
Q

Primary neurulation

A

Formation of neural plate (day 18-19)
Neural folds (20-21)
Closure of neural tube (22)
Rostral then caudal

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4
Q

Secondary neurulation

A

Development of neural tube (day 28)

species specific

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5
Q

What spinal level does spinal cord end during prenatal life at 12 week, 15 week and 24 week?

A

C5, S3, S1

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6
Q

What spinal level does spinal cord end at newborn and adult life?

A

L3, L1-2 (end of dura/arachnoid sac at S2)

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7
Q

Tissue repair in fetus vs adult brain

A

Macrophages cause phagocytosis (without gliosis) -> pseudoprimary malformation
(hydranencephaly or porencephalic cyst before or at early 2nd trimester)

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8
Q

Subependymal germinal matrix hemorrhage occur in which population?

A

Prematurely born (<1500 kg) within 3 days after delivery

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9
Q

Pathogenesis of germinal matrix hemorrhage?

A

Periventricular area with fragile microcirculation stroma

Hypoxic stress -> autoregulation fails and excessive perfusion ruptures GM microcirculation

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10
Q

Grades of GM hemorrhage

A

I confined in GM
II filling lateral ventricles
III with distention
IV parenchyma

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11
Q

Usual location of GM hemorrhage

A

Head of caudate > thalamus > behind foramen of monro

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12
Q

Where do contusions occur most frequently?

A

Frontal and temporal lobes

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13
Q

Traumatic epidural hematoma source of bleeding?

A

Middle meningeal artery

Less common: laceration of venous sinus (transverse sinus from occipital fracture)

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14
Q

Duret hemorrhage?

A

Delayed upper brainstem hemorrhage from rapidly evolving descending transtentorial herniation

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15
Q

Pathophysiology of Duret hemorrhage

A

Stretching/laceration of pontine perforating branches of basilar artery

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16
Q

Diffuse axonal injury?

A

Axonal damage

parasagittal white matter, corpus callosum, internal capsule, cerebellar peduncles

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17
Q

Duret hemorrhage vs brainstem small tissue-tear hemorrhages in DAI?

A

Both in upper brainstem, but Duret is delayed and in paramedian areas, whereas DAI located in dorsolateral brainstem

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18
Q

Microscopic timeline picture of DAI?

A 
2-12h
Axonal swellings (beta-amyloid precursor protein), then axonal disconnection, then microglial clusters around degenerating axons (5-10 days)
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19
Q

Classify DAI

A

I: frontal/temporal, cerebellar and internal capsule
II: corpus callosum (splenium)
III: brainstem/cerebellar peduncles and corticospinal tracts

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20
Q

Biochemical changes in DAI

A 
1h: neurofilament immunoreactivity
4-5: accum of bAPP
6h: ubiquitin
1d-2m: axonal swelling
2m-y: wallerian degeneration/demyelination
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21
Q

Which type of temporal bone fracture results in conductive hearing deficit?

A

Longitudinal temporal bone fracture

Transverse causes more direct nerve damage ith sensorineural hearing deficit (more forceful)

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22
Q

Most striking microscopic finding in lisencephaly type I?

A

Cortex made from 4 layers (molecular - external neuronal - cellular - internal nuronal)

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23
Q

Macroscopic and microscopic picture of mesial temporal lobe (hippocampal sclerosis)

A

Ammon’s horn sclerosis
Macroscopic: hippocampus smaller than other side, enlarged temporal horns

Microscopic: neuronal loss in CA1, gliosis

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24
Q

Rasmussen syndrome

A

Rare disorder in children
Progressive unilateral neurologic deficit + sudden onset epilepsy refractory to medical treatment.
Hemiplegia, hemianopsia, intellectual deterioration

25
Q

Microscopic picture of Rasmussen syndrome

A

Like chronic viral encephalitis - lymphocyte cuffs around blood vessels, microglial nodules

26
Q

What are rosenthal fibers

A

Eosinophilic bodies
See in neoplasms (juvenile pilocytic astrocytomas), around craniopharyngiomas, multiple sclerosis plaques, Alexander disease

27
Q

Classifications of astrocytomas

A 
Grade 1 (juvenile pilocytic): GFAP staining, rosenthal fibers
Grade 1 (subependymal giant cell): assoc. with tuberous sclerosis
Grade 2 (diffuse): nuclear atypia but no mitosis, moderately increased cellularity
Grade 2 (pleomorphic xanthoastrocytoma): pleomorphic lipidized cells in bg of reticulin network)
Grade 3 (Anaplastic): nuclear atypia and mitosis
Grade 4 (GM): nuclear atypia, mitosis, microvascular proliferation and necrosis
Grade 4 (Gliomatosis cerebri): extensively diffuse at least 3 lobes, superficial and/or deep gray matter
28
Q

Primary vs secondary glioblastoma

A

Primary (age>55, males) - EGFR overexpression, PTEN

Secondary (younger, women) - 2/3 TP53 mutations and no EGFR amplifications

29
Q

Colloid cysts

A

Usually anterior 3rd ventricles
Glistening cysts with mucin - outer fibrous connective tissue capsule lined by ciliated pseudostratified epithelium, PAS+ mucin

30
Q

Craniopharyngioma histology

A

Squamous epithelium, keratin

31
Q

Schwannoma histology

A

Verocay body (Antoni A -dense and B - loose patterns) - palisading nuclei

32
Q

What are verocay bodies?

A

Densely packed whorled arrangements in palisaded cells of Antoni A areas of schwannomas

33
Q

Which tumors show dual histologic patterns?

A

Schwannomas

Pilocytic astrocytoma

34
Q

Stains for schwannoma

A

S100, Leu7, laminin, vimentin, collagen IV

35
Q

Central neurocytoma histology

A

Neuroepithelial tumor with uniform round cells with nucleus-free areas of neuropil.
Synaptophysin positive

36
Q

Which bone tumors have giant cells?

A

Giant cell tumor

Aneurysmal bone cyst

37
Q

S100 + stains which tumors (7)?

A 
Schwannoma
Eosinophilic granuloma
Paraganglioma
Hemangioblastoma
Chordoma
Esthesioneuroblastoma
Meningioma (20%)
38
Q

Specific stains for melanoma

A

MART-1 and HMB-45

39
Q

Subtypes of meningiomas that are PAS+?

A

Secretory meningioma

40
Q

Secretory meningiomas stain what +?

A

PAS
Cytokeratin
CEA

41
Q

2 common + stains for meningiomas

A

EMA and vimentin

42
Q

Hemangiopericytoma stains

A

Reticulin, vimentin, vWF

43
Q

EMA stains distinguish which tumors?

A

Hemangiopericytoma (-) vs meningioma (+)

44
Q

Stains for germinoma

A

PLAP (placental alk phos), c-kit

45
Q

Blepharoplasts

A

Intracytoplasmic basal bodies

Ependymoma

46
Q

Which chromosomes are assoc. with meningioma progression?

A

Chromosome 1 alteration and chr22 deletion

47
Q

Derivative of schwann cells

A

neural crest cells

48
Q

Mode of inheritance of neurofibromatosis type 1

A

Chr 17, autosomal dominant

49
Q

Fried egg appearance on H&E tumor?

A

Oligodendroglioma

50
Q

Reed-sternberg binucleated cells tumor?

A

Hodgkin

51
Q

Flexner-Wintersteiner rosettes tumor?

A

Retinoblastomas

52
Q

Small, round blue cell tumors of childhood?

A 
Neuroblastoma
Chondrosarcoma
Rhabdomyosarcoma
Lymphoma
Ewing sarcoma
53
Q

Classification of human prion dx?

A
  1. Idiopathic (CJD, sporadic fatal insomnia)
  2. Familial
  3. Acquired (kuru, CJD)
54
Q

CJD on histology

A

Spongiform appearance (vacuoles)

55
Q

Alzheimers on histology

A

Senile plaques and neurofibrillary tangles, neuronal loss

56
Q

What are senile plaques?

A

Deposits of Abeta peptides

57
Q

What are neurofibrillary tangles?

A

Intracellular inclusion bodies (tau proteins)

58
Q

Alzheimer macroscopically?

A

Cerebral atrophy in mesial temporal structures

testing123 (11 decks)

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