L02 : Neuropatologi

Question 1

What is the pathological basis of headache?

Answer 1

Raised intracranial pressure

Headaches can be caused by various factors including intracranial causes.

Question 2

What causes impaired reflexes?

Answer 2

Corticospinal tract lesion

Exaggerated reflexes can indicate lesions in the corticospinal tract.

Question 3

What is the pathological basis of muscle deficit?

Answer 3

Loss of trophic stimulus from lower motor neurones

Muscle deficits can result from issues in lower motor neurones.

Question 4

What is the cause of neck stiffness?

Answer 4

Irritation or inflammation of meninges

Neck stiffness is often associated with meningitis.

Question 5

What are the types of congenital CNS malformations?

Answer 5

• Neural tube defects
• Forebrain anomalies
• Posterior fossa defects
• Hydromyelia, syringomyelia

Congenital CNS malformations can arise from various developmental issues.

Question 6

What is the most common type of CNS malformation?

Answer 6

Neural tube defects

They have a wide geographic and ethnic variation in frequency.

Question 7

What is the critical period for neural tube development?

Answer 7

22-28 days of gestation

This is when the neural plate transforms into the neural tube.

Question 8

What is anencephaly?

Answer 8

Failure of the neural tube to close resulting in absence of the calvarium and incomplete formation of the brain

Anencephaly often leads to severe developmental issues.

Question 9

What is spina bifida?

Answer 9

Failure of closure of the dorsal aspect of the vertebral column

This condition can range from mild to severe forms.

Question 10

What are the causes of hydrocephalus?

Answer 10

• Increased CSF production
• Obstruction of CSF flow
• Decreased CSF resorption
• Brain atrophy and compensatory ventricular dilatation

Hydrocephalus can arise from congenital or acquired causes.

Question 11

What is a common cause of epidural hematoma?

Answer 11

Arterial laceration, usually middle meningeal artery

Epidural hematomas can lead to rapid accumulation of blood.

Question 12

What characterizes concussion?

Answer 12

Transient alteration of consciousness secondary to brain trauma without structural damage

Concussions often result from blunt force trauma.

Question 13

What is the difference between open and closed head injury?

Answer 13

Open injury involves a break in the skull, while closed injury does not

The classification affects the treatment approach.

Question 14

What is the typical outcome of myelomeningocele?

Answer 14

Herniation of malformed cord and meninges through vertebral defect

Myelomeningocele can be associated with conditions like Arnold-Chiari malformation.

Question 15

What is the role of folate in preventing neural tube defects?

Answer 15

Folate supplementation is effective in preventing neural tube defects

It is recommended to begin folate supplementation prior to pregnancy.

Question 16

What is the significance of traumatic brain injury in terms of mortality?

Answer 16

Leading cause of death in people under 45

Traumatic brain injury represents a major public health concern.

Question 17

Fill in the blank: Hydrocephalus is an accumulation of excessive _______ within the ventricular system of the brain.

Answer 17

cerebrospinal fluid

Hydrocephalus results from various forms of obstruction or increased production.

Question 18

What are the effects of cerebral hemisphere lesions?

Answer 18

Visual field defects or blindness

Such lesions can result from various causes including trauma and vascular accidents.

Question 19

What is a symptom of dementia?

Answer 19

Loss of functioning neurones due to ischaemia, toxic injury or neurodegenerative disease

Dementia encompasses a variety of underlying conditions affecting cognition.

Question 20

What is an epidural hematoma?

Answer 20

Arterial laceration, usually middle meningeal artery, leading to rapid accumulation of blood.

Often associated with temporal trauma and may have a lucid interval.

Question 21

What is a subdural hematoma?

Answer 21

Common cause of death in accidents, caused by bridging vein severance, leading to slow or rapid accumulation of blood.

Can present as acute, subacute, or chronic.

Question 22

What are the symptoms of a subarachnoid hemorrhage?

Answer 22

Symptoms can include severe headache, nausea, photophobia, and altered consciousness.

1/3 caused by accidents, 2/3 by ruptured aneurysms.

Question 23

What is concussion?

Answer 23

Transient loss of consciousness due to trauma, no structural damage.

Often seen in sports like boxing.

Question 24

What is a contusion?

Answer 24

Wedge-shaped lesion associated with edema, hemorrhage, and necrosis resulting from blunt trauma.

Can be coup or contrecoup based on impact.

Question 25

What are the common types of CNS tumors?

Answer 25

Tumors can be classified as: * Gliomas * Neuronal tumors * Poorly differentiated tumors * Meningothelial tumors * Nerve sheath tumors * Adenohypophyseal tumors ## Footnote Gliomas are the most common primary CNS tumors.

Question 26

What are the main types of gliomas?

Answer 26

Includes: * Astrocytomas * Oligodendrogliomas * Ependymomas ## Footnote Astrocytomas include fibrillary and glioblastoma.

Question 27

What is the most common cause of dementia?

Answer 27

Alzheimer disease, accounting for more than half of dementia cases. ## Footnote Vascular disease is the second most common cause.

Question 28

What is the pathology of Alzheimer disease?

Answer 28

Characterized by Aβ-containing senile plaques and neurofibrillary tangles formed by tau filaments. ## Footnote Also shows cortical atrophy primarily in frontal, temporal, and parietal lobes.

Question 29

What are the risk factors for Alzheimer disease?

Answer 29

Risk factors include: * Aging * Head trauma * Menopause * Low educational level ## Footnote Protective factors include anti-inflammatory drugs and high educational level.

Question 30

What is Pick disease?

Answer 30

Lobar sclerosis leading to loss of executive function followed by dementia, indistinguishable from Alzheimer disease. ## Footnote It is a type of frontotemporal dementia.

Question 31

True or False: Primary CNS tumors rarely metastasize outside the CNS.

Answer 31

True ## Footnote Approximately 25% of cancer patients develop CNS metastasis.

Question 32

Fill in the blank: The WHO system assigns histological grades to primary CNS neoplasms ranging from grade I to _____, with grade IV being the most malignant.

Answer 32

IV ## Footnote Higher grades indicate more aggressive tumors.

Question 33

What are the common symptoms of CNS tumors?

Answer 33

Symptoms include: * Sensory/motoric changes * Seizures * Increased intracranial pressure ## Footnote These symptoms depend on the tumor's location.

Question 34

What are neurodegenerative disorders characterized by?

Answer 34

Progressive dysfunction and death of neurons, affecting specific groups while leaving others intact. ## Footnote Common in the elderly and increasingly significant in aging populations.

Question 35

What types of neurodegenerative disorders affect cognition?

Answer 35

Includes: * Alzheimer's disease * Pick disease ## Footnote These involve degeneration in the cerebral cortex.

Question 36

What is the most common primary CNS tumor?

Answer 36

Astrocytomas ## Footnote They account for a significant percentage of CNS tumors.

Question 37

What is a common complication of subdural hematoma?

Answer 37

Complications can include seizures, hydrocephalus, and dementia. ## Footnote These can occur if the victim survives the initial injury.

Question 38

What is the typical site of metastasis for CNS tumors?

Answer 38

Gray/white matter junction ## Footnote This is the most common site for metastatic CNS tumors.

Question 39

What is a neurofibrillary tangle?

Answer 39

An intracellular structure illustrated by a silver stain.

Question 40

What is Pick disease characterized by?

Answer 40

Loss of executive function followed by dementia indistinguishable from Alzheimer's disease.

Question 41

What is the typical progression of sporadic Pick disease?

Answer 41

Becomes symptomatic in mid-adult life and progresses relentlessly to death over 3 to 10 years.

Question 42

What areas of the brain are severely atrophied in Pick disease?

Answer 42

Frontal lobe and superior temporal lobe gyrus.

Question 43

What are the main symptoms of Parkinsonism?

Answer 43

Muscular rigidity, bradykinesia, resting tremor, expressionless countenance, emotional lability, cognitive impairments including dementia.

Question 44

What is the most common cause of Parkinsonism?

Answer 44

Idiopathic Parkinson’s disease (IPD).

Question 45

At what age does idiopathic Parkinson’s disease typically onset?

Answer 45

6th to 8th decades of life.

Question 46

What is the worldwide incidence of idiopathic Parkinson’s disease in people over age 50?

Answer 46

1 in 100 people.

Question 47

What are the key pathology findings in Parkinson's disease?

Answer 47

* Loss of neurons in the substantia nigra * Accumulation of Lewy bodies formed by filamentous α-synuclein aggregates.

Question 48

What are Lewy bodies involved in?

Answer 48

Removal of damaged cytoskeletal proteins and contain proteins like alpha synuclein and ubiquitin.

Question 49

What are the two main categories of diseases of myelin?

Answer 49

* Associated with abnormal myelin metabolism: Leukodystrophies * Associated with loss of normal myelin: Demyelinating diseases.

Question 50

What is the typical onset age for leukodystrophies?

Answer 50

Infancy to adolescence.

Question 51

What is the typical onset age for multiple sclerosis?

Answer 51

20s and 30s.

Question 52

What characterizes the course of multiple sclerosis?

Answer 52

Multiple demyelinating foci at different times during the disease course, with waxing and waning.

Question 53

What is the classic pathology of multiple sclerosis?

Answer 53

Multiple patches of demyelination throughout white matter.

Question 54

What are common symptoms of multiple sclerosis?

Answer 54

* Motoric: impaired vision, motor weakness * Sensory: paresthesias, ataxia.

Question 55

What is a shadow plaque in multiple sclerosis?

Answer 55

Only partial loss of myelin.

Question 56

What are the two types of toxic CNS effects of chronic alcoholism?

Answer 56

* Direct effects of ethanol * Secondary nutritional effects (e.g. thiamine deficiency).

Question 57

What is a consequence of cerebellar degeneration due to chronic alcoholism?

Answer 57

Cerebellar dysfunction leading to truncal ataxia, unsteady gait, and nystagmus.

Question 58

What is Wernicke syndrome associated with?

Answer 58

Chronic alcoholism and thiamine deficiency.

Question 59

What is central pontine myelinolysis?

Answer 59

A neurological condition associated with rapid correction of hyponatremia.