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Patho > CNS > Flashcards

CNS Flashcards

1
Q

define leptomeningitis

A

an inflammatory process that is localized to the interfacing surfaces of the PIA & ARACHNOID where CSF flows

-most common and related to bacteria

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2
Q

pachymeningitis (elephant- strong)

A

inflammation of the DURA usually a consequence of contagious infection (sinusitis or mastoiditis)

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3
Q

Whats the difference between septic vs a septic meningitis?

A

septic- bacterial

aseptic- viral

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4
Q

What is the most common bacterial meningitis in neonates?

A

E. Coli & Group B strep, Listeria

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5
Q

What is the most common bacterial meningitis in an infant?

A

H. influenza

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6
Q

What is the most common bacterial meningitis for adults?

A

Strept. pneumococcus

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7
Q

What is the most common bacterial meningitis in military barracks/dorms?

A

N. meningitidis (harbored in peoples sinuses)

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8
Q

What is a definitive dx tool to dx bacterial meningitis?

A

PMN’s in CSF

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9
Q

What is the hallmark indicator of TB, viral meningitides, chronic fungal infections?

A

lymphocytes

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10
Q

in bacterial meningitis the brain discloses an exudate of __________ & __________. This opacifies the arachnoid giving a _______ or ______ appearance over the _______ and ________ of the brain

A

fibrin and PMN’s

creamy gray or white

convexities and base

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11
Q

intracranial and intraspinal subarachnoid space are _________ so the exudate passes _______ between the compartments

A

connected

freely

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12
Q

What type of exudate does H. Influenza elicit?

What is the result of this?

A

dense leukocytic exudate that is rich in fibrin over the convexities

As a result, exudate becomes loculated making a barrier to abx

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13
Q

What are common sxs in a peds pt for bacterial meningitis?

A

HA, vomiting, fever, convulsions.

-note: if untx= coma & death

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14
Q

What are the classical signs of meningeal infection?

A

cervical rigidity, head retraction, Kernig sign (pain in knee when hip flexed) & Brudzinski sign ( flex of knees & hip when flex neck)

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15
Q

Define Parkinson’s disease?

A

a neuo d/o characterized by loss of neurons in the Substantia Nigra (in midbrain)

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16
Q

What are signs & sxs of Parkinson’s disease?

A
  • tremors @ rest
  • pill rolling (tremors in the distal extremities that is present at rest & stop with voluntary movement)
  • muscular rigidity/ hypertonia (cog wheel rigidity)
  • mask face (mouth open, fixed expression, eyes not blinking)
  • emotional lability (depression, dementia)
  • slowness of voluntary movements
  • reduced rate of swallowing
  • diminished spontaneous movement (akinesia)
  • posture is char. stooped
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17
Q

Genetic mutation of what chromosome can cause an early onset of parkinsons?

A

Chromosome 4

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18
Q

What causes Parkinsons?

A

NOTHING IT IS TYPICALLY IDIOPATHIC!!!

Also noted after pt has h/o VIRAL ENCEPHALITIS or intake of toxic chemical

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19
Q

What does the Substantia Nigra so ?

A

relays info to basal ganglia through dopaminergic synapses

20
Q

What does the SN and Locus Cerules of the brain look like in Parkinsons?

A

it has a loss of pigmentation (melanin)

21
Q

What are Lewy Bodies?

A

atrophic nerve cells that contain spherical granular eosinophilic cytoplasmic inclusions

22
Q

What is used for substitution therapy during early Parkinsons?

A

Levodopa

23
Q

What are other causes of Parkinson-like sxs?

A
  • Drugs: Phenothiazine, Haldol
  • CO or Mag posioning
  • Bilat infarct of basal ganglia
  • hydrocephalus
  • Tumors near basal ganglia -Cerebral trauma
24
Q

Define Alzheimer’s Dz

A

insidious and progressive neuro d/o characterized by:

  • memory loss
  • cognitive impairment
  • eventual dementia
25
Q

women are twice affected compared to men in what dz?

A

MS and alzheimers

26
Q

What is the cause of Alzheimers?

A

not fully been found. but relates to beta protein amyloid deposition in senile plaques in the cerebral cortex and are linked to intellectual funx

27
Q

Where are beta protein amyloid also found?

A

cerebral blood vessels

28
Q

What are neurofibrillary tangles?

A

paired helical filaments that consists of abnl form of normally occurring microtubule associated protein

29
Q

What does the neurofibrillary tangles cause?

A

destabilizes microtubules causing axonal degeneration and the paired helical filaments which occupy the cytoplasm of pyramidal cells in AD

30
Q

What does a brain with AD look like?

A

narrow gyri, sulci widen, bilat cortical atrophy is apprent in frontal, temporal, parietal & hippocampal cortices

31
Q

What are microscopic characteristics of AD?

A
  1. Senile plaques
  2. Neurofibrillary tangles
  3. Amyloid angiopathy
32
Q

Define senile plaques

A

discrete spherical masses of silver staining neuritic processes surrounding a central amyloid core

-found in hippocampus, amygdala, cortex

33
Q

Where are amyloid angiopathy found?

A

found in cerebral blood vessels seen with congo red stains

34
Q

What is the usual cause of death in AD pts?

A

bronchopneumonia

35
Q

Define multiple sclerosis

A

chronic, demyelinating dz of CNS in which a number of patches are demyelinated in white matter

36
Q

What functions does MS affect?

A

sensory and motor functions

-note: at beginning there are long remissions and short exacerbation.

as progresses it is opposite

37
Q

What age is MS aquired? at what age is it rare?

A

30’s

rare before 14 and after 60

38
Q

What is the etiology of MS?

A

unknown.

studies show possibly:

  • genetic: 2nd and 3rd degree relatives, monozygotic twins
  • immune: perivascular lymphocytes & macroph. with CD4 & CD8 T cells
  • infectious etiology
39
Q

What are the hallmarks of MS?

A

plaques with smooth rounded contour in white matter (occasionally gray white junction). preference for optic chiasm and periventricular white matter

40
Q

What are the histological steps of MS

A
  1. loss of myelin in region of axonal perservation
  2. perivascular inflammation of lymphocytes and macrophages with focal edema
  3. plaques age and edema regresses
  4. astrocytes traverse aging plaque and tissue becomes dense with glial processes
41
Q

What are sxs of MS?

A

lesions of optic n. :
- blurred vision, loss of vision in one eye

lesion of brainstem:

  • double vision
  • vertigo

plaques in spinal chord:

  • weakness in extremities
  • numbness in lower extremities

Other sxs:
-paralysis, dysarthria, severe visual defects, incontinence, dementia

42
Q

How do pt’s with MS usually die?

A

respiratory paralysis or UTI’s in terminal coma

43
Q

How long do pt’s survive after onset of sxs?

A

20-30 yrs

44
Q

What causes berry aneurysms?

A

arterial defects that originate during embryonic development when bifurcation of an artery creates a Y-shape configuration because when the parent vessel splits the muscular layer doesnt integrate with the branches causing a weakness

45
Q

What are the 3 rules about CNS tumors?

A
  1. CNS is susceptible to tumors (melanoma, breast, lung)
  2. Primary tumors in adults are frontal. Kids are pons and cerebellum
  3. benign or malignant tumors increase intracranial pressure and can cause seizures
46
Q

What do malignant tumors do to the brain?

A

it destroys the tissue resulting in rapid growth => fatal

Patho (6 decks)

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