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COM II- Neuro Robbins > Chap 28 Morphology 3 > Flashcards

Chap 28 Morphology 3 Flashcards

1
Q

Microscopic examination of Acute Disseminated Encephalomyelitis

A
  • Myelin loss with preservation of axons in white matter
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2
Q

What is found in the lesions of the early stage of Acute Disseminated Encephalomyelitis?

A
  • Neutrophils
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3
Q

What is found in the lesions of the later stage of Acute Disseminated Encephalomyelitis?

A
  • Mononuclear infiltrates
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4
Q

What is the histologic similarities between Acute Necrotizing Encephalomyelitis and Acute Disseminated Encephalomyelitis?

A
  • Perivenular distribution of demyelination throughout CNS
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5
Q

What are the histologic differences between Acute Necrotizing Encephalomyelitis and Acute Disseminated Encephalomyelitis?

A
  • Acute Necrotizing damage is more severe
  • Acute Necrotizing causes destruction of small blood vessels, disseminated necrosis of white and gray matter
  • Acute Nec has fibrin deposition and many neutrophils
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6
Q

What is the gross cortical atrophy of the brain involved in AD?

A
  • Widening of cerebral sulci in frontal, parietal, and temporal lobes
  • Significant atrophy can cause compensatory ventricular enlargement
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7
Q

What structures are the first to atrophy in the early course of AD?

A

Hippocampus and amygdala

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8
Q

What is the major microscopic abnormality seen in AD?

A

Neuritic (senile) plaques and neurofibrillary tangles

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9
Q

What are neuritic plaques?

A

Collections of dilated neuritic processes around a central amyloid core surrounded by a clear halo

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10
Q

What is the dominant component of an amyloid plaque?

A

Ab peptide derived from APP protein

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11
Q

What are diffuse plaques?

A

Deposition of Ab peptides with the absence of neuritic processes
*Found in early stage of plaque development in AD

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12
Q

What are neurofibrillary tangles?

A

Tau-containing bundles of filaments in the cytoplasm of the neurons that displace or encircle the nucleus

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13
Q

What do neurofilbrillary tangles look like?

A

In pyramid cells- “flame” shapes

In rounder cells- basket weave of fibers

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14
Q

T/F Tangles are specific to AD

A

F- tangles are not specific to AD and can be found in other diseases as well

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15
Q

What is cerebral amyloid angiopathy?

A

An invariable accompaniment of AD

- When vascular amyloid Ab40 is present

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16
Q

What is the appearance of the atrophic regions of the cortex in FTLD-tau?

A

Neuronal loss, gliosis, and presence of tau-containing neurofibrillary tangles

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17
Q

What occurs in Pick Disease?

A

Brain shows pronounced asymmetric atrophy of the frontal and temporal lobes with sparing of the posterior 2/3s of superior temporal gyrus

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18
Q

What is the appearance of the gyri in Pick disease?

A

Wafer-thin gyri: “Knife-edge” appearance

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19
Q

Where is neuronal loss most severe in Pick Disease?

A

Outer three layers of the cortex

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20
Q

What is the appearance of the surviving neurons of Pick Disease?

A

Pick cells- swelling of neurons

Pick bodies- cytoplasmic filamentous inclusions that stain well with silver methods

21
Q

What is the gross appearance of FTLD-TDP?

A
  • Atrophy of frontal and temporal lobes

- Neuronal loss and gliosis

22
Q

What is found in the inclusions in FTLD-TDP?

A
  • TDP-43 is phosphorylated and ubiquitinated
23
Q

Why does pallor of the substantia nigra occur in PD?

A

Loss of pigmented, catecholaminergic neurons

24
Q

What are Lewy bodies?

A
  • Single of multiple cytoplasmic, eosinophilic inclusions

- Have a dense core surrounded by a pale halo

25
Q

What are the components of Lewy bodies?

A

Filaments and alpha-synuclein

26
Q

What are Lew neurites?

A

Dystrophic processes that contain aggregated alpha-synuclein

27
Q

What is found in the affected regions of progressive supranuclear palsy?

A

Globose fibrillary tangles in the neurons and glia

28
Q

What is the appearance of the affected regions of corticobasal degeneration?

A

Loss of neurons, gliosis, and “ballooned” neurons

29
Q

What is the most specific pathologic finding for CBD?

A

Clusters of tau-positive processes around astrocytes and the presence of tau-positive threads in gray and white matter

30
Q

What is the appearance of the substantia nigra in CBD?

A

Loss of pigmented neurons, neuronal achromasia and tangles

31
Q

Where does atrophy occur in the cerebellar form of multiple system atrophy?

A

Cerebellar peduncles, pons, medulla

32
Q

Where does atrophy occur in the parkinsonian form of multiple system atrophy?

A

Substantia nigra and the striatum

33
Q

What is the diagnostic element in multiple system atrophy?

A

Glia cytoplasmic inclusions that contain alpha-synuclein and ubiquitin

34
Q

What is the appearance of the brain in Huntington Disease?

A

Brain is small and atrophy of the caudate nucleus and frontal lobe

35
Q

What is seen microscopically with Huntington Disease?

A

Loss of striatal neurons and changes in the caudate nucleus

36
Q

What structures are spared in the brain of a person with Huntington Disease?

A
  • Diaphorase-positive neurons

- Large cholinesterase-positive neurons

37
Q

What is the appearance of the spinal cord in Friedreich Ataxia?

A
  • Loss of axons and gliosis in posterior columns, the corticospinal tract, and spinocerebellar tracts
  • Degeneration of neurons in spinal cord, brainstem, cerebellum, and motor cortex
38
Q

What is the appearance of the heart in Friedreich Ataxia?

A
  • Enlarged with pericardial adhesions

- In autopsy, multifocal destruction of myocardial fibers with inflammation and fibrosis

39
Q

Where are the abnormalities usually in Ataxia-Telangiectasia?

A

Cerebellum

40
Q

What occurs in Ataxia-Telangiectasia?

A
  • Loss of Purkinje and granule cells

- Degeneration of doral columns, spinocerebellar tracts, and anterior horn, and peripheral neuropathy

41
Q

Where are telangiectatic lesions found in Ataxia-Telangiectasia?

A
  • CNS, conjunctiva, and skin of the face neck and arms
42
Q

What are amphicytes and when are they seen?

A
  • Enlargement of the nucleus to 2-5 times normal size

- Seen in ataxia-telangiectasia

43
Q

What structures are hypoplastic in ataxia-telangiectasia?

A

Lymph nodes, thymus, and gonads

44
Q

What is the appearance of the anterior roots in ALS?

A
  • Thin due to loss of LMN fibers and precentral motor in the cortex is atrophic
  • Reduced number of anterior-horn neurons associated with reactive gliosis
45
Q

What are Bunina bodies and when are the seen?

A
  • Remnants of autophagic vacuoles
46
Q

What occurs in the LMNs and UMNs in ALS?

A

LMN loss- skeletal muscles get degraded and show atrophy

UMN loss- degeneration of corticospinal tract causing volume loss and absence of myelinated fibers

47
Q

What is the characteristic appearance of Wernicke encephalopathy?

A

Foci of hemorrhage and necrosis in mamillary bodies and walls of 3rd and 4th ventricle

48
Q

What is the difference between early lesions and later lesions of Wernicke encephalopathy?

A

Early lesions- dilated capillaries with prominent endothelial cells
Later lesions- macrophages and cystic space with hemosiderin-laden macrophages

49
Q

What lesions predominate in Korsakoff syndrome?

A

The later lesions of Wernicke encephalopathy (lesions infiltrated with macrophages and cystic space with hemosiderin-laden macrophages)

COM II- Neuro Robbins (8 decks)

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