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Patho II 22 > CNS > Flashcards

CNS Flashcards

1
Q

Consequence of cerebral autoregulation failure

A

failure at mean arterial pressure of around 180 mmHg -> cerebral edema and increased ICP

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2
Q

Etiology of vasogenic edema

A

BBB breakdown

increased vascular permeability

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3
Q

etiology of cytotoxic edema

A

increase in intracellular fluid because of neuronal, glial or endothelial cell membrane injury

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4
Q

Global symptoms of elevated ICP

A

Headache
Decreased consciousness
Vomiting

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5
Q

3 common clinical settings associated with

herniation (a focal symptoms of elevated ICP)

A

cerebral edema
increased CSF volume (hydrocephalus)
mass lesions

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6
Q

pathophysiology of NPH

A

Cerebrovascular disease
Hypertension
Congenital
Decreased CSF absorption

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7
Q

Clinical triad of NPH

A

Gait difficulty

Cognitive deficits

Psychomotor slowing

Decreased attention and concentration

Impaired executive function

Urinary incontinence

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8
Q

Causes of hypoxic-ischemic brain injury

A

Causes of hypoxic-ischemic brain injury

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9
Q

etiology of SDH

A

tearing of the

bridging veins

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10
Q

TBI Glasgow Coma Scale (GCS) score

A

13 to 15  mild traumatic brain injury

9 to 12  moderate

8 or less  severe

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11
Q

TBI Primary brain Injury

A

diffuse axonal injury
focal cerebral contusions
Hematomas

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12
Q

TBI secondary brain Injury

A

inflammatory responses
apoptosis
ischemias

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13
Q

CTE and its pathophys

A

develops after repeated concussion

tau-immuno-reactive degenerative

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14
Q

pathophys of myelomeningocele

A

Chiari II malformation
Brain stem dysfunction
Hydrocephalus

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15
Q

CP pathophys

A

Periventricular leukomalacia (PVL)

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16
Q

pathophys of meningitis

A

Cytokines
increased BBB permeability
increased ROS
increased ICP

17
Q

etiology of fever in meningitis

A

reset the hypothalamic thermal set point by pyrogens

18
Q

etiology of headache in meningitis

A

↑ ICP stimulate nociceptors

19
Q

etiology of changed mental status in meningitis

A

↑ICP → brain herniation → damage to ARAS

20
Q

PD pathophys

A

Dopamine depletion in basal ganglia

Disruptions in the connections to the thalamus and motor cortex

21
Q

Compensatory mechanisms in PD

A

Increasing dopamine synthesis
Increasing dopaminergic neurons
Increasing the proliferation of dopamine receptors

22
Q

Clinical features of PD

A

Tremor
Bradykinesia
Rigidity
Postural instability

23
Q

pathophys of vascular dementia

A

brain ischemia or loss of vascular integrity with hemorrhage disrupts normal brain function and causes cognitive impairment

24
Q

mechanism for HAND

A

HIV-1, through infected monocytes, can cross the BBB -> neuroinflammation
-> cytokines release

HIV+patients have high cortisol levels indicative of HPA axis deregulation

etiology of Alzheimer’s Disease is linked to HAND

HIV-1 induces synaptic deficits and neurodegeneration

25
Q

MS pathophys

A

begins as an inflammatory immune-mediated disorder

microglia form a complex with the activated T cells
-> destruction of the myelin and oligodendrocytes

26
Q

Clinically isolated syndromes (CIS) pattern of MS

A

first attack of a disease with inflammatory demyelination but has yet to fulfill MS diagnostic criteria

27
Q

MS Relapsing-remitting (RR)

A

clearly defined relapses/exacerbation with partial or full recovery

28
Q

MS Secondary progressive (SP)

A

initial RR disease course followed by gradual worsening

29
Q

MS Primary progressive (PP)

A

steady progression from onset

30
Q

etiology and pathophys of ALS

A

Excessive glutamate resulting in death of motor neurons (excitotoxicity)
Inflammatory responses

motor neuron degeneration and death
Spinal cord becomes atrophic

31
Q

Clinical features of ALS

A

upper: weakness with slowness, hyperreflexia and spasticity
lower: weakness, atrophy and fasciculations

32
Q

pathophys of GBM

A

mutation in isocitrate dehydrogenase (IDH)  accumulation of the onco-metabolite 2-hydroxyglutarate (2-HG)

33
Q

clinical symptoms of GBM

A 
headache
increased ICP
nausea and vomiting
cognitive impairment
Seizures
34
Q

etiology and clinical features of meningiomas

A

abnormal chromosome 22

headache and weakness in an arm or leg are the most common symptoms

35
Q

most common tumor that metastasizes to the brain

A

lung

Patho II 22 (4 decks)

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