Exam 2

Question 1

Neuron injury

intraneuronal inclusions

Answer 1

result from viral encephalidities (CMV,rabies)

Question 2

fibrillary astrocytes

Answer 2

In white matter; prone to neoplastic transformation/gliomas

Question 3

protoplasmic astrocytes

Answer 3

In gray matter

Question 4

Epidural hematoma

Answer 4

• arterial bleed bt skull and dura mater
• due to trauma-result of temporal bone fracture
• progressive
• collapses venous sinuses
• ventricles shift from midline

Question 5

Subdural hematoma

Answer 5

• venous bleed in subdural space
• due to trauma
• shift of ventricles
• contralateral weakness
• seizures/cognitive impairment

Question 6

Subarachnoid hemorrhage

Answer 6

-bleed in subarachnoid space
-due to arterial aneurysm
severe headache

Question 7

Cerebral contusion

Answer 7

-bruise of the cortical surface of the brain
-secondary to trauma
mild trauma may be limited to gray cortex
-hemorrhage/edema may lead to transtentorial herniation

Question 8

Vascular malformation

Answer 8

arteriovenous malformation: arteries shunting into the veins; lack of blood supply to brain

• SA or Intracerebral hemorrhages
• most common congenital vascular malformation
• detected with angiography

Question 9

Aneurysms

Answer 9

localized blood filled bulge in wall of blood vessel

• Berry aneurysm: bifurcation of vessels in carotid
• rupture produces SA hemorrhage

Question 10

Hypertensive cerebral hemorrhage

Answer 10

• at basal ganglia/thalamus level
• hypertension weakens arterioles
• abrupt symptoms of weakness

Question 11

Intraventricular hemorrhage

Answer 11

bleeding into ventricles

-death bc distended 4th ventricle + compression of medulla

Question 12

Pontine hemorrhage

Answer 12

loss of consciousness-damage to reticular formation

-rare to survive

Question 13

Non-hypertensive causes of cerebral hemorrhage

Answer 13

-A/V malformation leak
-neoplastic vessel erosion
endothelial damage by microorganism
-embolic infarction w/ hemorrhage into necrotic area

Question 14

Ischemia + Infarction

Answer 14

Global ischemia: general decrease in cerebral blood flow

• from near drowning, carbon monoxide, smoke inhalation
  
  • vessels have overlapping circulation
  • rapid decline in flow = watershed infarct
  • vascular obstruction (emboli)
  • regional ischemia & local infarct
  • caused by atherosclerosis

Question 15

Hydrocephalus

Answer 15

-congenital or acquired
-Cause: excessive CSF
-requires shunts
-Infant symptoms: convulsion, blindness, weakness
Adult: headache, tremors, gait, vomiting, papilledema

Question 16

Meningitis

Answer 16

headache+fever+stiff neck

• Bacterial:most serious
• Viral:most common, not as aggressive

Question 17

Cerebral Abscess

Answer 17

• microorganisms lodged in rich capillary bed of cerebral cortex and adjacent white matter
• cause inflammation
• formation of abscess
• abscess may expand and create toxic products (fatal)
• sinus infections, ear infections

Question 18

poliomyelitis

Answer 18

enterovirus affecting motor neurons (respiratory)

Question 19

rabies

Answer 19

virus affecting brainstem

-painful throat spasms, difficulty swallowing, aspiration

Question 20

Herpes Simplex-1

Answer 20

cold sores
-virus stored in gasserial ganglia
(headache, altered mental status, seizures)

Question 21

Herpes Simplex 2

Answer 21

vulvar/penile lesions

-stored in pelvic ganglia

Question 22

Arbovirus

Answer 22

arthropods infect

-identified where noted

Question 23

subacute sclerosing panencephalitis

Answer 23

Cause: measles virus
SS: mental change, motor/sensory deficits, death

Question 24

progressive multifocal leukoencephalopathy (pml)

Answer 24

Cause: JC virus found in CSF of brain (immunosuppressed pts)

• destruction of white matter
• progressive, can be fatal
• headaches/seizures

Question 25

Multiple sclerosis

Answer 25

most common CNS disease

• females; 30 y.o
• Affect sensory and motor function
• Exacerbations/remissions
• genetic/immune factors
• demyelination causes plaques in white matter of brain/sc- hallmark of MS