Gianani Final CIS Flashcards

1
Q

What is diffuse axonal injury?

a type of traumatic brain injury
a complication of herpes virus encephalitis
a symptom of parkinson disease
synonymous with  MS
The first sign of ALS
A

A type of traumatic brain injury. Seen when neurons are stretched from rapid acceleration/ deceleration.

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2
Q

What do we see in Herpves virus

A
  • you will see Cowdry inclusions.
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3
Q

Progressive Multifocal Leukoencephalopathy

A

Jc and Bk virus –>

lesion of oligodendrocytes –> demyelination

Affects immunocompromised

inclusions are in the nucleus

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4
Q

Tau deposition is related to

  • ALS
  • Traumatic encephalopathy
  • Parkinson disease
  • Cerebral Amyloid Angiopathy
  • Gillan- Barre syndrome
A

Traumatic encephalopathy

repetitive mild head injury with tautopathy (deposition of tau protein)

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5
Q

Guillan Barre syndrome

A

progressive demyelination of peripheral nerves

CSF protein content is high. Other disease with high protein in the CSF: meningitis

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6
Q

Cerebral Amyloid Angiopathy

A
  • degenerative disease
  • amyloid
  • in a clinical vignette, an elderly person but without HTN might be a good candidate
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7
Q

protein involved in Parkinson’s disease

A

synuclein, which is also involved in Lewy Body Dementia

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8
Q

ALS

A

a neuropathy of the upper and lower neurons

You would see a secondary change in the muscles

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9
Q

Beta-2-transferrin testing is used in the evaluation of

  • Basilar skull fracture
  • Meningitis
  • Hypoxic ischemic encephalopathy
  • Oligodendroglioma
  • Meningioma
A

Beta-2-transferrin is a protein present in the CSF but not in the serum

used to diagnose Basilar skull fracture

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10
Q

Oligodendroglioma genetics

A

19q (long arm)

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11
Q

worst location for meningitis

A

basilar meningitis is associated with tuberculous

CN that can be involved: VI

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12
Q

issues that –> elevated protein level in CSF

A

neoplasms
bacterial meningitis
MS (oligoclonal)

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13
Q

Guillan-Barre syndrom

A

viral or low-grade bacterial agent (like campylobacter)

immune response that attacks the nerve cells of the PNS and their support structures–> Guillain Barre

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14
Q

vitamin deficiency in the differential dx for peripheral neuropathy

A

Vitamin B12

also can be related to dementia

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15
Q

Is the ApoE genetic locus associated with AD?

A

yes

in familial forms we see AD earlier
also in trisomy 21

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16
Q

most frequent site of the neurofibrillary tangles of tau are found in AD

A

medial temporal cortex

17
Q

alpha-secretase activity in AD

A

may prevent accumulation of Abeta protein

18
Q

difference between demyelinating disease and MS?

A

MS is a subset of it.

Others: Neuromyelitis Optica- Auto Abs against aquaporin-4, a water channel of astrocytes

Progressive Multifocal Leukoencephalopathy

Guillain-Barre syndrome

19
Q

intranuclear inclusion plus demyelination =

A

PML. You will see demyelination of the cerebellum and pons.

20
Q

The pathology of ALS involves

  • degenerative disorder of upper and motor neurons
  • Loss of substantia nigra
  • autoimmunity
  • necrosis of muscular tissue
  • peripheral neuropathy
A

degenerative disorder of upper and motor neurons

dementia appears at the onset or develops later in a significant proportion of ALS patients

relentlessly progressive. Majority of patients die, usually from respiratory paralysis, within 2-3 years of onset.

21
Q

pilocytic astrocytoma

A

children
cerebellum/ optic nerve
good prognosis

22
Q

glioblastoma multiforme

A

grade four astrocytoma

23
Q

ependymoma

A

ependymal cells line the CSF

–> hydrocephalus

24
Q

vasculor pseudo-rosette + hydrocephalus, code word for

A

ependymoma

25
Virkow-Robbins spaces are
associated with the subarachnoid space
26
sites of CSF foration
1. choroid plexus of the vevntricle cavities, mostly is formed in the lateral ventricles 2. some originates from the ependymal cells lining the ventricles 3. Some from the brain substances through perivascular spaces
27
Movement of the CSF inside the ventricle is controlled by the
1. Pulsation of the artery in the choroid plexus | 2. by the aid of the cilia and microvilli of the epenymal cells
28
xanthochromia of the CSF?
yellow discoloration of the CSF due to oxyhemoglobin which appears in 4-6 hours and bilirubin which appears in 2 days. eliotropism is the same thing
29
blood in the CSF
if it's only in the first tube, it was traumatic lumbar puncture if it's in subsequent ones, subarachnoid hemorrhage
30
first step with lady who has bad headaches?
rule out migraines
31
ring-enhancing lesion?
glioblastoma multiforme, e.g.
32
serpentine palisading necrosis, cellular proliferation and endothelial proliferation
buzzwords for glioblastoma
33
Neurocysticercosis
commonest global parasitic infection of the CNS and leading cause of epilepsy worldwide cystercercus cellusosae, Taenia solium larvae Pork meat --> patients become definite host Cysticercosis as intermediate host- muscle, other organs Variable manifestation, some asymptomatic There is an inflammatory reaction following the parasite's death eventual calcification
34
CNS involvement in AIDS
direct: HIV encephalitis indirect- infectious- toxoplasmosis, cryptococcus, PML - neoplastic: lymphoma
35
cells that PML affects?
oligodendrocytes
36
Cerebral lymphoma
PCNSL is typically a diffuse large B-cell lymphoa (DLBCL) the tumors that arise in immunocompromised patients are EBV-positive