CNS Path Quiz 6 part 3

Question 1

loss of intellectual function to the degree that it interferes with ADL is termed

Answer 1

dementia

short term memory loss alone is not enough to be considered dementia

Question 2

when might dementia be considered reversible? irreversible?

Answer 2

• reversible when caused by: infxn, drugs, alcohol, metabolic imbalances, hormone imbalances, depression
• irreversible when caused by: injury to the brain, disease

Question 3

what is THE most common cause of dementia?

Answer 3

Alzheimer’s

Question 4

most common form of Alzheimer’s disease?

Answer 4

late-onset Alzheimer’s disease

Question 5

Early-onset Alzheimer’s disease associated with mutations in genes located on which chromosomes?

Answer 5

1, 14, and 21

Question 6

Early-onset Alzheimer’s in half of all relatives before the age of 50 is another type of Alzheimer’s disease called?

Answer 6

Familial Alzheimer’s disease

Question 7

what are the characteristic abnormalities found in the brains of individuals with Alzheimer’s disease?

Answer 7

• Amyloid plaques

- Neurofibrillary tangles

Question 8

Neurofibrillary tangles are found inside of neurons and consist of insoluble twisted fibers made of what?

Answer 8

tau protein

Question 9

macroscopic brain findings of a patient with Alzheimer’s disease

Answer 9

deepened sulci
diminished width of gyri
overall loss of mass

Question 10

what type of dementia is characterized by micro-infarctions and areas of low blood flow causing damage to the brain?

Answer 10

vascular dementia (multi-infarct dementia)

Question 11

macroscopic brain findings of a patient with multi-infarct dementia (vascular dementia)

Answer 11

multiple cystic infarcts in various locations

Question 12

Cerebral atrophy seen in Pick’s disease (clinically similar to AD) occurs where?

Answer 12

frontal and temporal lobes

“knife-like” in appearance

Question 13

Parkinson’s disease primarily affects which parts of the brain?

Answer 13

the pigmented neuronal groups (substantia nigra and locus ceruleus)

Question 14

macroscopic brain findings of a patient with Parkinson’s disease

Answer 14

pale substantia nigra

Question 15

Some patients with Parkinson’s disease also have dementia. What is this dementia called?

Answer 15

-Lewy body dementia

Question 16

what’s the most common demyelinating disease?

Answer 16

Multiple sclerosis

Question 17

pathophysiology of MS

Answer 17

• loss of myelin slows down nerve messaging

- plaques form over the affected area, further disrupting nerve communication

Question 18

while there are no definitive diagnostic test for MS. what tests can be done and what are their findings?

Answer 18

• MRI w/ Gadolinium enhancement (can distinguish between old and new plaques)
• Lumbar puncture (elevated immune proteins)

Question 19

Progressive multifocal leukoencephalopathy (PML) is due to infection by

Answer 19

the JC virus

it’s a demyelination disease

Question 20

a brain bx of a patient with Progressive multifocal leukoencephalopathy (PML) reveals

Answer 20

enlarged astrocytes

Question 21

Central pontine myelinolysis caused by

Answer 21

overly rapid correction for hyponatremia

Question 22

In children, majority of tumors are found where?

Answer 22

below the tentorium (in the posterior fossa)

Question 23

In adults, majority of tumors are found where?

Answer 23

above the tentorium

Question 24

most common brain tumor in children is

Answer 24

astrocytic tumors such as glioblastomas

Question 25

most common brain tumor in adults is

Answer 25

metastatic tumors

Question 26

meningiomas are

Answer 26

• benign adult tumors

- arise in the arachnoid

Question 27

gliomas are

Answer 27

• malignant tumors of glial cells
• occur in the cerebral hemisphere of adults
• occur in brain stem and cerebellum of kids

Question 28

Astrocytoma appears how microscopically?

Answer 28

They can be stellate, spindle-shaped with fiber like processes, or plump with a large eosinophilic cytoplasmic mass

Question 29

the most malignant form of astrocytoma? occurs?

Answer 29

• Glioblastoma multiforme (GBM)

- occurs in the frontal and temporal lobes

Question 30

microscopic appearance of glioblastoma multiforme

Answer 30

high cellularity, cellular

anaplasia and nuclear anaplasia

Question 31

Bifrontal butterfly S-shaped

lesion consistent with

Answer 31

glioblastoma multiforme

Question 32

A butterfly lesion is a lesion which

Answer 32

infiltrates across the corpus callosum (allowing pathological process to spread from one hemisphere to another)

Question 33

In cases of ependymomas found in the posterior fossa near the 4th ventricle, the development of what is common?

Answer 33

hydrocephalus

Question 34

a ganglioma consists of

Answer 34

mature neurons

Question 35

more often a neuronal tumor consists of mature neurons and glial cells called

Answer 35

ganglioglioma

Question 36

The most common of the poorly differentiated brain tumors is the

Answer 36

medulloblastoma

Question 37

microscopic appearance of medulloblastoma

Answer 37

individual tumor cells are small, ovoid or slightly elongated with high nuclear/cytoplasmic ratio

Question 38

on MRI, a mass in the cerebellar is consistent with which neuronal tumor?

Answer 38

medulloblastoma