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Year 5 Histopath > Cerebral > Flashcards

Cerebral Flashcards

1
Q

Define infarction

A

An area of tissue death due to lack of oxygen. Accounts for 70-80% of strokes

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2
Q

What is the most common cause of infarction

A

Cerebral atheroclerosis Can also be caused by embolism from intra/extra cranial plaques

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3
Q

What are importnt predictors of stroke?

A

TIAs. 15% of 1st strokes are preceded by a TIA

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4
Q

Risk factors for stroke or TIAs are:

A

Smoking, DM, HTN, FH , past TIAs, OCP, PVD, Alcohol excess, Hyperviscosity e.g. Sickle cell, polycythaemia vera

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5
Q

Signs/Symptoms of a stroke are:

A

Sudden onset, FAST, Numbness, Loss of vision, Dysphagia

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6
Q

Signs/Symptoms of a TIAs are:

A

Symptoms last less than 24 hours, Amaurosis fugax (painless loss of vision in one eye that is not permanent), Carotid bruit

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7
Q

Vascular territories commonly affected in strokes are:

A

Anterior vs Posterior territory , Most common is MCA

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8
Q

What areas are affected in TIAs?

A

Any, Characteristally embolic atherogenic debris from the carotid artery travels to the opthalmic branch of the internal carotid

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9
Q

Investigations of stroke are:

A

CT/MRI (infarct vs haemorrhage), Ix for vascular risk: BP, FBC, ESR, U&E, glucose, lipids, CXR, ECG, carotid doppler

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10
Q

Investigations for TIA:

A

Carotid US, Ix for vascular risk: BP, FBC, ESR, U&E, glucose, lipids, CXR, ECG, carotid doppler

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11
Q

Management of a stroke is:

A

Aspirin +/- dipyridamole, Thrombolytics if less than 3 hours after event, +/- carotid endartectomy, Long term: treat HTN, decrease lipids, anticoagulate

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12
Q

Management of a TIA is:

A

Aspirin +/- dipyridamole, +/- carotid endartectomy, Long term: treat HTN, decrease lipids, anticoagulate

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13
Q

What are the 2 main subtypes of Haemorrhage

A

Non Traumatic, Traumatic

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14
Q

Name 2 causes of Non Traumatic haemorrhage

A

Intraparenchymal haemorrhage, Subarachnoid haemorrhage

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15
Q

Describe intraparenchymal haemorrhage

A

50% due to HTN, onset is abrupt, can cause charcot-bouchard microaneurysms (likely to rupture), Common site is the basal ganglia

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16
Q

Describe Subarachnoid haemorrhage

A

85% from ruptured berry aneurysms, most at internal bifurication, F>M, usually under 50 years of age, thunderclap headache, vomiting and LoC, Increased in PKD, Ehler’s Danlos and Aortic coarctation, Associated with vascular abnormalities including AV malformations, capillary telangiectasias, venous and cavernous angiomas, Ehlers Danlos

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17
Q

Name 2 Traumatic haemorrhages

A

Extradural Haemorrhage, Subdural Haemorrhage

18
Q

Describe extradural haemorrhage

A

Skull Fracture, Ruptured middle meningeal artery –> rapid arterial bleed, Lucid interval –> LoC

19
Q

Describe subdural haemorrhage

A

Prev history of minor traume –> damaged bridging veins with slow venous bleed, Often elderly/alcoholic, Associated with brain atrophy, Fluctuating consciousness

20
Q

Whate are the 6 types of increased ICP?

A

Uncal, Central (transtentorial), Cingulate (subfalcine), Transcalvarial, Upward, Tonsillar

21
Q

What can cause raised ICP?

A

Oedema, space occupying lesion (e.g. tumour, abscess) –> brain herniation

22
Q

What are the signs/symptoms of meningism?

A

Headache, Stiff neck, Photophobia, +ve Kernig’s sign

23
Q

What is Kernig’s sign

A

having the person lie flat on the back, flex the thigh so that it is at a right angle to the trunk, and completely extend the leg at the knee joint. If the leg cannot be completely extended due to pain, this is Kernig sign.

24
Q

What are the signs/symptoms of viral meningitis?

A

Mild systemic symptoms, Not unwell, Rash is unusual

25
Q

What are the signs/symptoms of bacterial meningitis?

A

Marked systemic symptoms, Unwell, Rash, Drowsy, Coma, septic shock

26
Q

If you suspect bacterial meningitis, what should you do?

A

Immediately treat with IV Abx, Then conform with lumbar puncture and blood culture

27
Q

How does the CSF look in pyogenic, TB and viral cerebral infection

A

Pyogenic: - often turbid (cloudy), TB: - fibrin web, Viral: - usually clear

28
Q

Cerebral infection in a neonate is most likely caused by:

A

Bacterial: GBS, E.coli, Listeria, Viral: Echovirus, Coxsackie’s, Mumps, HIV

29
Q

Cerebral infection in a 1 month - 6 year old is most likely caused by:

A

Bacterial: Strep pneumoniae, Haemophilus influenza

30
Q

Cerebral infection in a young adult/adolescent is most likely caused by:

A

Bacterial: N. meningitidis, Strep. Pneumoniae

31
Q

Cerebral infection in the elderly is most likely caused by:

A

Gram -ve bacilli e.g. E.coli, Strep. Pneumoniae

32
Q

Define viral encephalitis

A

inflammation of the brain caused by a virus.

33
Q

Describe viral encephalitis

A

May be localised e.g. temporal or frontal lobes OR general, May involve the meninges –> meningoencephalitis

34
Q

Symptoms of viral encephalitis are:

A

Drowsiness, Seizures, Behavioural changes, Headache, Fever

35
Q

Causes of viral encephalitis are:

A

Herpes simplex 1, Rabies

36
Q

Where are the most common primaries for secondary brain tumours?

A

Lung, Breast, Malignant melanoma, They are well demarcated, solitary or multiple with surrounding oedema

37
Q

What are the commenest group of primary brain tumours?

A

Astrocytomas, Primary tumours originate in the brain, spinal cord or meninges and rarely metastasise outside CNS

38
Q

Buzzwords for a oligodendroma are:

A

Soft, Gelatinous, calcified

39
Q

Buzzwords for a pilocytic astrocytoma are:

A

Indolent, Childhood

40
Q

Buzzwords for a Ependymoma are:

A

Ventricular tumour, Hydrocephalus

41
Q

Buzzwords for a Meningioma are:

A

NF2 (neurofibromatosis type II

Year 5 Histopath (17 decks)

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