CIS III Flashcards
_______ deficiency can cause peripheral neuropathy
B12
______ must be measured to ensure patients on warfarin.
INR (normal 2.5-3.5)
PTT
3 cardiac tests for post-stroke patients presenting w/neurocognitive deficits
- echo
- carotid US
- EKG
meningioma
meningiomas arise from ______ cells
meningothelial cells of the arachnoid layers (aka arachnoid cells)
patients w/ _____ have an increased risk of meningiomas
neurofibromatosis type 2
merlin is a cytoskeleton protein that appears to regulate _______,
membrane receptor signaling
NF2 gene encodes _____
merlin
(contact inhibition of tumor growth)
Meningiomas grade ______ have a lower risk of regrowth after treatment
WHO grad 1-2
syncytial meningioma: note psammoma body (yellow) and oval nuclei w/central clearing
(WHO grade I)
- Yellow arrow: psammoma body
- Black arrow: oval nuclei w/central clearing
Fibroblastic meningioma
(note: collagen deposition & growth pattern)
meningiomas that invade the brain are grade ______
2
(grade 3 can invade also)
WHO grade 2 meningiomas have ______ (3 characteristics)
- increased cellularity foci of necrosis
- grow in sheets
- increased N/C ratio
Malignant meningiomas (grade 3) have _______ (2 characteristics)
- sarcomatous histology
- >20 mitoses per 10 hpf
malignant meningiomas (grade 3) can metastasis to _____
anywhere inside or outside CNS
(bones, lymph nodes, abdomen, etch)
Most meningiomas are attached to the ______.
underlying dura (WHO grade 1 won’t invade the meningioma; majority of cases)
Fibroblastic meningiomas are grade ______ .
1
(fibroblasts, collagen present on histology)
WHO grade 2 meningioma shows _______-like (2) growth with increased cellularity
- sheet-like
- pattern-less
chordoid meningioma; grade 2
(loose & empty stroma, chords & nests of tumor cells w/epithelioid appearance w/mucopolysaccarides)
Meningioma type? Grade?
- Atypical meningioma; clear cell
- WHO grade 2
(tumor cells w/abundant clear cytoplasm)
Meningioma type?
Grade?
- papillary meningioma
- WHO grade 3
_____ and _____ meningiomas appear similarly on histology.
- rhabdoid
- papillary
wait and see approach for meningiomas that have _____ (2)
- no edema
- no invasion
large, infiltrating meningiomas treatment recommendations
resection/surgery
(before radiation)
atypical meningioma treatment (2)
- rersection w/histopathology confirmation
- then radiation to prevent recurrence
The primary event in the pathogenesis of ADis the generation of _____- in the CNS neurons
AB (amyloid beta peptides)
amyloid precursor protein
APP
Majory secondary event in AD is the aggregation of _______ in the CNS neurons
hyperphosphorylated tau
2 major histo findings in AD
- neurofibrillary tangles
- neuritic plaques
Neurofibrillary tangles are aggregation of _______; neuritic plaques are an aggregation of _______.
- hyperphosphorylated tau
- aB peptides
Black arrows?
severely atrophic hippocampus
Dx?
alzheimer disease : enlarged lateral ventricles (temporal horns) and third ventricles
_______ lobe is particularly affected by AD
medial portion of the temporal
enlarged ventricles in AD is secondary to _______.
brain parenchyma attrophy (hydrocephalus ex vacuo)
neurofibrillary tangle: contains aggregated hyperphosphorylated tau
neurofibrillary tangle in AD are ______ shaped
flame: contains hyperphosphorylated tau
neurofibrillary tangles are composed of _________
hyperphosphorylated 3R & 4R tau
silver stain of neurofibrillary tangle: hyperphosphorylated tau
neuritic/senile plaque: neuronal processes/neuritic/dystrophic neurons
(aB peptide aggregation. Remnants of the dendrites of the neuron)
psammomatous meningioma: note numerous psammoma bodies (laminated calcified concretions)
Type of meningioma? Grade?
- atypical meningioma
- WHO grade 2
(NOTE: solid sheet of tumor w/increased cellularity, hyperchromatic nuclei and ⇡ N/C ratio)
Grade?
WHO Grade 2
(clear cell meningioma; note: polygonal tumor cells w/clear cytoplasm & oval nuclei; separated by prominent bands of collagen)
Meningioma type? Grade?
- atypical meningioma/malignant
- WHO Grade 2
(note the invasion into brain parenchyma)
meningioma type? grade?
- Papillary
- grade 3/malignant
meningioma type? Grade?
- Rhabdoid meningioma
- WHO Grade 3/malignant
(note eccentric hyperchromatic nuclei; eosinophilic)
2 major types of FTLD
- FTLD-Tau
- FTLD-TDP
_______ protein aggregates in FTLD-TDP
TDP-43
Some patients w/FTLD also have ______.
amyotrophic lateral sclerosis
Prototypical FTLD is ______ disease
Pick
Pick Disease: atrophy of the frontal loabe and gyri
Pick disease
(note: frontal & temporal lobes show sulcal widening and knife-edge gyral atrophy w/hydrocephalus ex vacuo)
Pick bodies: oval intracytoplasmic filamentous inclusions
(aggregated hyperphosphorylated 3R tau)
Pick body
TDP-43 positive neurons: pick disease
TDP-43 positive motor neurons & glial cells
(Pick disease)
TDP-43 positive, but there is less of it → ALS