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NMSP > Intro to Neuropath > Flashcards

Intro to Neuropath Flashcards

1
Q

GFAP stains what cells

A

astrocytes

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2
Q

selective vulnerability

A

set of neurons with shared properties in response to insult

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3
Q

when do you see red neurons

A

12-24 hrs after acute insult; earliest indicator

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4
Q

what is the primary indicator of an axonal reaction

A
  • central chromatolysis (nissl at periphery)

- peripheral displacement of nucleus

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5
Q

what is the intracytoplasmic neuronal inclusion

A

lipofuscin

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6
Q

when is lipofuscin present

A
  • rabies: negri bodies [esosinophilic]
  • AD: neurofibrillary tangles
  • parkinson: lewy bodies
  • CJD
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7
Q

what are the intranuclear neuronal inclusions

A
  • herpes: cowdry type A bodies [acidophilic]

- CMV (has intranuclear and cytoplasmic) [basophilic]

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8
Q

hypertrophy and hyperplasia of astrocytes; most important indicator of CNS injury

A

gliosis

astrocytes are metabolic buffers and detoxifiers of brain; foot processes contribute to BBB

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9
Q

describe the appearance of a gemistocyte

A

large nucleus that is eccentrically located, bright pink cytoplasm

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10
Q

what three diseases have ALZ type 2 astrocyte

A

hyperammononemia, wilson, hereditary metabolic disorder of the urea cycle

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11
Q

HSP alpha-B crystalline and HSP27

A

seen in rosenthal fibers

  • thick, elongated, brightly eosinophilic
  • occur within astrocyte processes
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12
Q

what are the two histo elements of pilocytic astrocytoma

note: both are slow processes

A
  1. rosenthal fibers - beaded sausage / corkscrew hyaline bodies; bright pink
  2. eosinophilic granular bodies - protein droplets, PAS+ ; seen in gangliolioma and pleomorphic xanthoastrocytoma
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13
Q

this leukodystrophy has periventricular, perivascular, and subpial rosenthal fibers

A

alexander disease

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14
Q

indigestible remnants of astrocyte metabolism, commonly seen in aged brains

PAS+

A

corpora amylacea

round, faintly basophilic and laminated; subpial and perivascular

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15
Q

corpora amylacea and EGB are both…

A

PAS+

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16
Q

microglia are derived from

A

mesoderm

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17
Q

CR3 and CD68 +

A

microglia

*CD68 stains brown

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18
Q

miroglial response to injury

A
  1. microglial nodules : surround small foci of necrosis
  2. neuronophagia : surround dying neuron
  3. rod cell w/ elongated nuclei (neurosyhpillis)
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19
Q

what cells are responsible for PML and MSA in response to injury

A

oligodendrocytes

  • progressive multifocal leukoencephalopathy
  • multiple system atrophy
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20
Q

PML has…

A

intranuclear inclusions

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21
Q

MSA has…

A

alpha-synuclein, a glial cytoplasmic inclusion

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22
Q

what virus damages ependymal cells?

A

CMV; viral inclusions

disruption of ependymal lining can lead to ependymal granulations

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23
Q

increased EC fluid d/t BBB disruption and increased vascular permeability

A

vasogenic edema

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24
Q

describe the fluid shift in vasogenic edema

A

intravascular to intercellular

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25
Q

what impairs resorption of excess extracellular fluid in vasogenic edema?

A

paucity of lymphatics

26
Q

vasogenic edema often follows…

A

ischemic injury

27
Q

increased intracellular fluid d/t neuronal, glial or endothelial cell membrane injury

A

cytotoxic edema

28
Q

cytotoxic edema follows…

A

generalized hypoxic/ischemic insult or metabolic derangement

29
Q

gyri flattened, sulci narrowed and ventricles compressed is ecidence of […] which can lead to…

A
  1. cerebral edema

2. herniation

30
Q

results in an increased production of CSF

A

choroid plexus papilloma

31
Q

pyogenic meningitis results in suppurative exudate covering the brainstem and cerebellum, resulting in thickened leptomeninges

what is a consequence of this

A

obstructive hydrocephalus

32
Q

what two pathogens have a predilection for the base of the brain

A

TB and neurosyphillis

33
Q

hypervitaminosis A can lead to…

A

acquired hydrocephalus

  • cranial bones softened; bulging fontanelles, increased ICP, blurred vision
34
Q

what kind of hydrocephalus does neurosyphillis cause?

A

communicating

b/c involves leptomeninges, not a single point of obstruction

35
Q

most common parasitic nervous system disease worldwide, causes 50% of acquired epilepsy cases in developing countries

A

neurocysticercosis, caused by Taenia solium tapeworm

36
Q

hydrocephalus ex-vacuo

where do you see atrophy?
what is the CSF pressure?

A

frontal atrophy, normal CSF

37
Q

symmetric type of hydrocephalus; develops slowly; dementia-like manifestations

A

normal pressure hydrocephalus

wacky, wet, wobbly
it is reversible

38
Q

increased ICP is generally due to

A
  • generalized brain edema
  • expanding mass lesion (tumor, abscess, hemorrhage)
  • increased CSF volume (rare)
39
Q
  1. dilated pupil and impaired eye movement
  2. CL homonomyous hemianopia
  3. duret hemorrhage
  4. IL paralysis
A

uncal herniation (transtentorial)

  1. CN3
  2. PCA
  3. rupture of paramedian artery; hemorrhagic lesions visible in midbrain and pons
  4. compression of CL cerebral peduncle

1 + 4 = kernohans phenomenon

40
Q

respiratory and cardiac compression

A

tonsillar herniation; cerebellar tonsils displaced through foramen magnum

41
Q

subfalcine (cingulate) herniation may lead to hydrocephalus due to obstruction of

A

foramen of monro

42
Q

signs and symptoms of ICP

A
  • HA, N, V, lethargy, change in behavior
  • change in pupil reaction, impaired upward gaze
  • false localizing signs (6th nerve palsy; ie kernohan/uncal)
  • seizures
  • decreased coordination, ataxia
  • papilledema
43
Q

what nerve is affected in kernohans phenomenon

A

CNVI

44
Q

what portions of the brain are most sensitive to hypoxia?

A
  1. purkinje of cerebellum

2. pyramidal cells of sommer’s sector (CA1 and CA2 of hippocampus)

45
Q

encephalocele is a diverticulum of disorganized brain tissue extending through a defect in the cranium, most often in the

A

posterior fossa

46
Q

name the three consequences of a myelomeningocele

A
  1. motor and sensory deficits of LE
  2. bowel and bladder control dysfxn
  3. infections
47
Q

what are the three main causes of microcephaly

A
  1. FAS
  2. HIV-1 acquired in utero
  3. zika
48
Q

decreased amount of gyri; smooth or cobblestone surface

A

lissenencephaly

agyria = no gyri

49
Q

neronal heterotopias are commonly associated with

A

epilepsy

  • collections of neurons in inappropriate places (ventricular surface)
50
Q

filamin A protein + DCX (double cortin protein) on X chromosome lead to

A

males: lissencephaly
females: subcortical band heterotopias

51
Q

trisomy 13, SHH leads to

A

holoprosencephaly

  • incomplete separation of cerebral hemispheres across midline
  • cyclopia, arrhinenceophaly
52
Q

agenesis of the corpus callosum leads to

A

mental retardation or normal mentation

batwing lateral bentricles

fairly common

53
Q

which forebrain anomaly has entrapment of meningeal tissue?

A

polymicrogyria

genetic is symmetric and BL; could be d/t local tissue injury at end of migration

<4 layers of gray matter

54
Q

downward extension of the cerebellar vermis into the foramen magnum

A

Chiari II malformation

55
Q

Chiari II malformation is usually associated with

A

hydrocephalus

myelomeningocele

56
Q

low-lying cerebellar tonsils extend down vertebral canal

A

Chiari I

symptomatic if impaired CSF flow

57
Q

enlarged posterior fossa with expanded, roofless fourth ventricle

absent cerebellar vermis replaced by cyst with ependymal lining, which is contagious to leptomeninges

A

dandy-walker malformation

58
Q

hypoplasia of vermis, elongation of cerebellar peduncles and altered brainstem shape

molar tooth sign

A

joubert syndrome

59
Q

fluid-filled cleft-like cavity in the inner portion of the spinal cord

isolated loss of pain and temperature sensation of the UE

A

syringomyelia (syrinx)

affects the anterior white commissure

60
Q

expansion of ependymal-lined central canal of the cord

A

hydromyelia

61
Q

hemorrhage seen in the germinal matrix of premature infants

A

intraparenchymal hemorrhage

62
Q

where does an intraparenchymal hemorrhage occur?

A

between thalamus and caudate nucleus

can lead to SAH; hem. is BL and when large enough, ruptures into 3rd and 4th ventricles

NMSP (2 decks)

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