CNS 2 Flashcards
MS Clinical Symptoms
Relapsing and Remitting Oligiclonal bands and plasma cells in CSF
How prevalent is MS
1 in 1000
Who is affected?
W>M 2:1
Uncommon in kids and adults over 50
What gene is MS linked to
HLA-DR Haplotype
Deep and surface lesions that are glassy and depressed (grey-tan)
What is dementia
Progressive loss of cognitive function idependent of the state of attention
Is dementia age related
no
What is the most common cause of dementia in elderly?
Alzheimer’s
What type of Alzheimer’s present earlier
Familial
What Trisomy is Alzheimer’s linked to
21 Downs
What percent of down syndrome patients have AD by age 45
90%
What gene is linked to AD?
Amyloid Precursor Protein (APP) on chromosome 21.
Downs patients have a third copy, hence the high AD rate
What allele indicates and increased risk of AD
APOE
What is Lewy Body Dementia
In the morning they are fine, by the evening they are demented visual hallucinations (non-threatening)
Spontaneous motor features of parkinson’s
Lewy body
(Lewy-Body and Parkinsons)
Which disease has lewy bodies in the cortex?
Lewy-Body only
What can you treat PD patients with early on
L-Dopa
Huntingdons Disease
Autosomal dominant
Age of HD onset
40 Death by 60
What is the HD gene
Chromosome 4 CAG repeat expansion
You need 37+ repeats to see symptoms
What is anticipation in genetics
If you have 35 repeats you won’t have HD but your kids will have more repeats and get the disease.
Not all disorders have this progression
Where do HD patients lose neurons
caudate nucleus
Astrocytomas
Graded by WHO scheme Grade 2+ is diffuse Grade 1 doesn’t progress
Pilocytic Astrocytoma
WHO 1 Kids get it in posterior region
Grade 1 Astrocytoma
Grade 2 Astrocytoma
Grade 4 Astrocytoma = Glioblastoma
Necrosis
Mitiosis
Blood vessel prolieration
Ringed butterfly on CT
Oligo dendrogliomas
Grade 2 always progresses to 3
posterior fossa or spinal cord (in ventrical)
Medullablastoma
70% under age of 16 Middle cerebellum sheets of cells with little cytoplasm (very blue)
medulloblastoma
meningioma
best tumor to get
dura based
slow growing tumor “just” pushes brain out of way and doesn’t usually cause cognitive deficits
Meningioma
Histo ddx = Somoma bodies
craniopharyngioma
birth to 20 machine oil
Craniophyrngiomas
Under 20
Calcified and Cystic Lesions
Cholesterol Crystals
Machine Oil
metastatic tumors
more common in adults
will look like tissue of origin
breast/lung/colon most likely
hemorrhagic metastasis = RCC
Peripheral Nerve Tumor
Schwannoma Neurofibroma
Schwannoma
Tumor sits on top of nerve and can sometimes be removed
Neurofibroma
Tumor in nerve itself so nerve will always be lost in surgery
Look for “stringy carrots”
GBM
Glioblastoma Multiformis (Grade 4)
