Introduction to Neuropathology (Martin) Flashcards by Billy Harrah

Acute insult to neurons leads to what distinct characteristic feature?

This occurs about how long after irreversible hypoxic/ischemic insult?

1) Red Neurons

2) 12-24 hours

How well did you know this?

Not at all

Perfectly

What morphologic change causes injured neurons to turn red?

Intense eosinophilia

How well did you know this?

Not at all

Perfectly

What does subacute and chronic neuron injury lead to?

What is the hallmark?

1) Degeneration

2) Reactive gliosis (Proliferation of astrocytes in response to brain injury)

How well did you know this?

Not at all

Perfectly

In relation to axonal reaction due to injury, what is central chromatolysis?

Nissl removed from center of cell to periphery

How well did you know this?

Not at all

Perfectly

Negri Bodies are intracytoplasmic inclusions seen in?

Neurofibrillary tangles are seen in?

Lewy bodies are seen in?

Vacuolization of perikaryon and neuronal processes is seen in?

1) Rabies
2) Alzheimer’s
3) Parkinson’s
4) Creutzfeldt-Jakob

How well did you know this?

Not at all

Perfectly

Cowdry bodies are intranuclear inclusions seen in?

Owl’s eye nuclear inclusion bodies are seen in?

1) Herpes

2) Cytomegalovirus

How well did you know this?

Not at all

Perfectly

What is the most important histopathologic indicator of CNS injury?

What is this characterized by?

1) Gliosis (Astrogliosis)

2) Both hypertrophy and hyperplasia of astrocytes

How well did you know this?

Not at all

Perfectly

What are the injured astrocytes called when the cytoplasm expands and becomes bright pink?

Gemistocytes

How well did you know this?

Not at all

Perfectly

What are thick, elongated, brightly eosinophilic, irregular structures that occur within astrocytic processes?

They are found in regions of?

They are characteristic of what a low grade, non infiltrating neoplasm in children?

1) Rosenthal fibers
2) Long standing gliosis
2) Pilocytic astrocytoma

How well did you know this?

Not at all

Perfectly

What are round, faintly basophilic, periodic acid Schiff (PAS) positive, concentrically lamellated structures found wherever there are astrocytic end processes?

Corpora amylacea

How well did you know this?

Not at all

Perfectly

What are the mesoderm derived phagocytic cells that serve as resident macrophages of the CNS?

What surface marker is more commonly seen with it?

1) Microglia

2) CD68

How well did you know this?

Not at all

Perfectly

Microglia that develop elongated nuclei (rod cells) are associated with?

Neurosyphilis

How well did you know this?

Not at all

Perfectly

Microglia aggregating around a small foci of necrosis is known as?

Microglia congregating around cell bodies of dying neurons is known as?

1) Microglial nodules

2) Neuronophagia

How well did you know this?

Not at all

Perfectly

Injury or apoptosis of oligodendrocytes is a feature of?

Acquired demyelinating diseases and leukodystrophies

How well did you know this?

Not at all

Perfectly

What conditions are oligodendrocytes associated with?

1) PML

2) Multiple system atrophy (MAS)

How well did you know this?

Not at all

Perfectly

What may produce severe ependymal injury with viral inclusions in ependymal cells?

CMV

How well did you know this?

Not at all

Perfectly

Which cerebral edema is characterized by an increase in extracellular fluid?

Which is characterized by an increase in intracellular fluid?

1) Vasogenic edema

2) Cytotoxic edema

How well did you know this?

Not at all

Perfectly

What is Vasogenic edema the result of?

What is Cytotoxic edema the result of?

1) Disruption in the BBB

2) Na+/K+ ATPase is compromised leading to retention of Na and water

How well did you know this?

Not at all

Perfectly

Cytotoxic edema can lead to?

Herniation

How well did you know this?

Not at all

Perfectly

Which cerebral edema can be secondary to a neoplasm?

Vasogenic edema

How well did you know this?

Not at all

Perfectly

What can be caused by hydrocephalus due to an increase in intracranial pressure?

Papilledema

How well did you know this?

Not at all

Perfectly

What is the most common cause of noncommunicating hydrocephalus in the neonate/infant?

Aqueductal stenosis

How well did you know this?

Not at all

Perfectly

What is obstructed in noncommunicating hydrocephalus causing it to not communicate with the subarachnoid space?

Ventricular system

Communicating hydrocephalus occurs when CSF is not absorbed properly at the dural sinus level, thus the ventricles tend to be?

Symmetrically dilated

Hydrocephalus ex vacuo refers to a compensatory increase in ventricular volume secondary to? How is the CSF pressure?

1) Loss of brain parenchyma | 2) Normal

Normal pressure hydrocephalus is a symmetric type of hydrocephalus that usually occurs in older adults that may exhibit a classic triad of clinical findings of?

Wet, Wobbly, Wacky: 1) Urinary incontinence 2) Gait disturbance 3) Dementia

Increased intracranial pressure is generally due to?

1) Generalized brain edema | 2) Expanding mass lesion

Subfalcine herniation is characterized by?

Cingulate gyrus displaced under the falx

Transtentorial herniation is the herniation of the medial temporal lobe which leads to?

Compression of the oculomotor nerve (CN III) leading to "down and out" eye

Tonsillar herniation is characterized by cerebellar tonsils being displaced through? This can be life threatening due to?

1) Foramen magnum | 2) Respiratory and cardiac center compression

Kernohan's notch is a result of the compression of what structure against the tentorium cerebelli due to transtentorial herniation? What CNs does it involve? What does this cause?

1) Cerebral peduncle 2) CN 3 and 6 3) Ipsilateral hemiparesis and diplopia

What are secondary hemorrhagic lesions in the midbrain and pons that often accompany transtentorial herniation?

Duret hemorrhages

Hypoxic changes are seen most commonly where?

1) Purkinjie of the cerebellum | 2) Pyramidal cells of Sommer's sector (CA1 and CA2)

What does CNS infarct result in?

Liquefactive necrosis

What accounts for most CNS malformations?

Neural Tube defects

Neural Tube defects is most commonly due to?

Folate deficiency

What neural tube defect is characterized by extension of CNS tissue through a defect in vertebral column? What area is most common?

1) Myelomeningocele | 2) Lumbosacral

Encephaloceles most often occurs in what location?

Posterior fossa

Which forebrain anomaly that deals with volume of the brain is more common, microcephaly or megalencephaly?

Microencephaly

Lissencephaly is a forebrain anomaly characterized by?

1) Reduction in the number of gyri | 2) Smooth surface

Neural heterotopias are commonly associated with? They are defined by? It is associated with mutation in what gene?

1) Epilepsy 2) Collections of neurons in inappropriate locations 3) Filamin A gene

Holoprosencephaly can cause what midline facial abnormalites?

1) Cyclopia | 2) Arrhinencephaly (No olfactory structures)

Arnold-Chiari malformation leads to misshapen midline cerebellum with downward extension of vermis though? It has what effect on the posterior fossa? It is often associated with?

1) Foramen magnum 2) Small posterior fossa 3) Myelomeningocele

Dandy-Walker malformation is characterized by? It has what effect on the posterior fossa?

1) Expanded roofless fourth ventricle | 2) Enlarged posterior fossa

What does Joubert syndrome give rise to on imaging?

Molar tooth sign

What is characterized by a fluid filled cleft like cavity in the inner portion of the spinal cord? This leads to what classic symptoms?

1) Syringomyelia (syrinx) | 2) Bilateral loss of pain and temp sensation of upper extremities

What is the most common cause of intraventricular hemorrhage in premature infants? What can it cause?

1) Parenchymal hemorrhage (germinal matrix hemorrhage) | 2) Subarachnoid hemorrhage

A fracture in which bone shifts into the cranial cavity more than the thickness of the bone itself is termed? Fractures that cross sutures of the skull is termed? Fractures that have the presence of orbital or mastoid hematomas along with CSF discharge from nose or ears is termed?

1) Displaced skull fractures 2) Diastatic fractures 3) Basal skull fracture

How is CTE diagnosed during autopsy?

Progressive loss of normal brain matter and an abnormal buildup of a tau protein

Brain contusion typically forms what characteristic pattern?

Wedge shaped

Diffuse axonal injury is characterized by?

Widespread asymmetric axonal swellings

Diffuse axonal injury is best demonstrated with?

1) Silver stain OR 2) Amyloid precursor protein immunostain

What is looked for when diagnosing shaken impact syndrome? With what?

1) Microscopic iron | 2) Prussian blue stain

Vascular abnormalities in what space causes a thunderclap headache?

Subarachnoid Space

What happens to the dura with an epidural hematoma? It is most commonly due to? What vasculature is ruptured?

1) Peeled off skull 2) Skull fracture 3) Middle Meningeal artery

What happens to the dura with an subdural hematoma? What vasculature is ruptured? What population is most at risk?

1) Still attached to skull 2) Bridging veins 3) Elderly

50% of individuals that develop coma, even without cerebral contusions, have?

Diffuse axonal injury