CNS Pathology Flashcards

1
Q

Leptomeningitis

A

an inflammatory process that is localized to the interfacing surfaces of the pia mater and arachnoid mater, where CSF flows

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2
Q

Pachymeningitis

A

inflammation of the dura due to chronic sinus infection or mastoiditis. The dura serves as a barrier and inflammation is restricted to the outer surface

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3
Q

What organisms cause meningitis in neonates

A

E. coli

Group B Strep

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4
Q

What organisms cause meningitis in infants 3mo to 3yrs

A

H. influenzae

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5
Q

What organisms cause meningitis in adults

A

Strep pneumo

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6
Q

What causes meningitis in military barracks

A

Neisseria meningitidis

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7
Q

What is the definitive dx of meningitis

A

neutrophils in CSF

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8
Q

Which cell type dominates in a viral meningitis

A

lymphocytes

Ex causes TB, fungal

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9
Q

What are gross characteristics if bacterial meningitis

A

Opacification of arachnoid- creamy white exudate made of PMNs and fibrin
-will travel along the spinal cord as well because it is connected to the brain

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10
Q

What are the classic signs of meningeal infection

A
  • nuchal rigidity
  • head retraction
  • spontaneous flexion of the knees and hips when the neck is flexed-Brudzinski sign
  • Kernig’s sign
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11
Q

What is Parkinson’s disease

A

loss of neurons in the substantia nigra

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12
Q

Clinical manifestation of Parkinson’s disease

A

pill-rolling tremors, muscle rigidity. emotionless face, and emotional lability

  • drooling
  • most cases are idiopathic
  • increased incidence of dementia and depression
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13
Q

What are some causes for Parkinson’s disease

A
  • Viral Encephalitis
  • most cases are idiopathic
  • ingestion of MPTP chemical
  • old age
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14
Q

What are gross examination characteristics of Parkinson’s disease?

A
  • loss of pigmentation of substantia nigra
  • atrophic nerve cells have lewy bodies
  • microscopically: pigmented neuron scarce
  • extracellular deposits of melanin from necrosis of neurons
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15
Q

What are some physical features of Parkinson’s disease

A
  • eyes unblinking, staring
  • drooling, mouth open
  • stooped posture,
  • cog-wheel rigidity
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16
Q

What other things cause Parkinson’s like syndrome?

A
  • manganese poisoning
  • hydrocephalus
  • tumors near basal ganglia
  • drugs: phenothiazine, haldol
  • infarcts of basal ganglia
17
Q

What is Alzheimer’s disease?

A

-progressive insidious disease that impairs cognitive function, loss of memory and leads to dementia

18
Q

What is the pathology behind Alzheimer’s disease?

A

beta-protein amyloid deposition in senile plaques

-they are found in cerebral cortex in the intelligence zone and the in the cerebral blood vessels

19
Q

What are gross examination characteristics of Alzheimer’s disease?

A
  • narrowing of gyri
  • widening of sulcus
  • loss of 200 grams of brain mass in 3 to 8 yrs
20
Q

What are the microscopic findings in Alzheimer’s disease

A
  • senile neuritic plaques silver staining neuritic process around a beta core in hippocampus and amygdala
  • neurofibrillary tangles /flame cells
  • amyloid angiopathy
21
Q

What is the clinical presentation of Alzheimer’s disease

A
  • loss of memory
  • difficulty with language
  • patients become mute incontinent and bedridden
  • terminal bronchopneumonia is usually the cause of death
22
Q

WHat is multiple sclerosis

A

chronic demyelinating disease of CNS with both motor and sensory sections affected

23
Q

What are risk factors for MS

A
  • women
  • mean age at 30 yrs of age
  • genetic: twins and increased risk in 2 and 3rd degree relatives
  • immune: perivascular lesions with a lot of Cd4 and CD8 cells
  • infectious JC virus, Mumps, Rubella, Herpes, Measles
24
Q

What is the hallmark of MS?

A

-white matter plaques

25
Q

What is a berry aneurysm?

A

arterial defect during embryonic development

  • point of congenital muscle weakness
  • occur in circle of willis
26
Q

What is HTN associated aneurysms/Charcot-Bouchard?

A

-lipohyalinosis deposits in the cerebral arterioles causes them to weaken an rupture

27
Q

What are the sites of Hypertensive Intracerebral Hemorrhage from most common to least?

A

-basal ganglia-thalamus-75%
-pons-15%
cerebellum-10%

28
Q

What is an intraventricular hemorrhage?

A
  • small vessels ruptures in the ventricle and distend it with blood causing death
  • compression of the vital centers in the medulla
29
Q

Cerebral hemorrhage vs cerebral infarct

A

cerebral infarct: emboli causes ischemia and the infarction

cerebral hemorrhage: hematoma ruptures and then bleeds into the cerebellum