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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
what impairs resorption of excess extracellular fluid in vasogenic edema?
paucity of lymphatics
26
vasogenic edema often follows...
ischemic injury
27
increased intracellular fluid d/t neuronal, glial or endothelial cell membrane injury
cytotoxic edema
28
cytotoxic edema follows...
generalized hypoxic/ischemic insult or metabolic derangement
29
gyri flattened, sulci narrowed and ventricles compressed is ecidence of [...] which can lead to...
1. cerebral edema | 2. herniation
30
results in an increased production of CSF
choroid plexus papilloma
31
pyogenic meningitis results in suppurative exudate covering the brainstem and cerebellum, resulting in thickened leptomeninges what is a consequence of this
obstructive hydrocephalus
32
what two pathogens have a predilection for the base of the brain
TB and neurosyphillis
33
hypervitaminosis A can lead to...
acquired hydrocephalus - cranial bones softened; bulging fontanelles, increased ICP, blurred vision
34
what kind of hydrocephalus does neurosyphillis cause?
communicating b/c involves leptomeninges, not a single point of obstruction
35
most common parasitic nervous system disease worldwide, causes 50% of acquired epilepsy cases in developing countries
neurocysticercosis, caused by Taenia solium tapeworm
36
hydrocephalus ex-vacuo where do you see atrophy? what is the CSF pressure?
frontal atrophy, normal CSF
37
symmetric type of hydrocephalus; develops slowly; dementia-like manifestations
normal pressure hydrocephalus wacky, wet, wobbly it is reversible
38
increased ICP is generally due to
- generalized brain edema - expanding mass lesion (tumor, abscess, hemorrhage) - increased CSF volume (rare)
39
1. dilated pupil and impaired eye movement 2. CL homonomyous hemianopia 3. duret hemorrhage 4. IL paralysis
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
respiratory and cardiac compression
tonsillar herniation; cerebellar tonsils displaced through foramen magnum
41
subfalcine (cingulate) herniation may lead to hydrocephalus due to obstruction of
foramen of monro
42
signs and symptoms of ICP
- 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
what nerve is affected in kernohans phenomenon
CNVI
44
what portions of the brain are most sensitive to hypoxia?
1. purkinje of cerebellum | 2. pyramidal cells of sommer's sector (CA1 and CA2 of hippocampus)
45
encephalocele is a diverticulum of disorganized brain tissue extending through a defect in the cranium, most often in the
posterior fossa
46
name the three consequences of a myelomeningocele
1. motor and sensory deficits of LE 2. bowel and bladder control dysfxn 3. infections
47
what are the three main causes of microcephaly
1. FAS 2. HIV-1 acquired in utero 3. zika
48
decreased amount of gyri; smooth or cobblestone surface
lissenencephaly agyria = no gyri
49
neronal heterotopias are commonly associated with
epilepsy - collections of neurons in inappropriate places (ventricular surface)
50
filamin A protein + DCX (double cortin protein) on X chromosome lead to
males: lissencephaly females: subcortical band heterotopias
51
trisomy 13, SHH leads to
holoprosencephaly - incomplete separation of cerebral hemispheres across midline - cyclopia, arrhinenceophaly
52
agenesis of the corpus callosum leads to
mental retardation or normal mentation batwing lateral bentricles fairly common
53
which forebrain anomaly has entrapment of meningeal tissue?
polymicrogyria genetic is symmetric and BL; could be d/t local tissue injury at end of migration <4 layers of gray matter
54
downward extension of the cerebellar vermis into the foramen magnum
Chiari II malformation
55
Chiari II malformation is usually associated with
hydrocephalus myelomeningocele
56
low-lying cerebellar tonsils extend down vertebral canal
Chiari I symptomatic if impaired CSF flow
57
enlarged posterior fossa with expanded, roofless fourth ventricle absent cerebellar vermis replaced by cyst with ependymal lining, which is contagious to leptomeninges
dandy-walker malformation
58
hypoplasia of vermis, elongation of cerebellar peduncles and altered brainstem shape molar tooth sign
joubert syndrome
59
fluid-filled cleft-like cavity in the inner portion of the spinal cord isolated loss of pain and temperature sensation of the UE
syringomyelia (syrinx) affects the anterior white commissure
60
expansion of ependymal-lined central canal of the cord
hydromyelia
61
hemorrhage seen in the germinal matrix of premature infants
intraparenchymal hemorrhage
62
where does an intraparenchymal hemorrhage occur?
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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