L2

Question 1

Superficial vessels are most occluded by

Answer 1

emboli

Question 2

Deep penetrating vessels are most affected by

Answer 2

hypertension

Question 3

TIA:

Answer 3

focal brain ischemia (few minutes to 24 hrs) without acute infarction & without loss of consciousness

Question 4

.GLOBAL HYPOXIA:

Answer 4

Failure of auto-regulatory mechanisms in the brain when systolic. B.P. drops < 50 mmHg

Question 5

Causes of previous note global hypoxia

Answer 5

Cardiac arrest & Ineffective cardiopulmonary resuscitation

Question 6

microscopic signs

Answer 6

A) Red neurons : acute phase(pyknotic nucleus)
B)tissue necrosis, macrophages (sub-acute) .
C)irregular neuronal loss, gliosis & brain atrophy(Repair) of global hypoxia

Question 7

Morphology

Answer 7

A. PseudoLaminar necrosis: hippocampus & Purkinje cells,

B. Watershed’ infarcts: Bilateral symmetric wedge-shaped discolored areas

Question 8

Focal Ischemia:

Answer 8

Focal brain necrosis , (+ family history)

Question 9

Thrombotic occlusion

Answer 9

Ischemic/ pale(Soft swollen) /// Embolic occlusion: hemorrhagic/ red(WEDGE SHAPED)

Question 10

Embolism is more common than thrombosis & may lead to multiple small infarcts

Answer 10

Trueeee “)

Question 11

After 10 days-3 weeks:

Answer 11

liquefaction, Cavity within 1- 6 months

Question 12

Histopathologic progression of CNS infarct:

Answer 12

Edema, Red neurons, PMNs, Macrophages, Gliosis(i**)

Question 13

complication of old infarct:

Answer 13

Wallerian degeneration(axonal degeneration+myelin disintegration)

Question 14

Venous infarction is

Answer 14

very hemorrhagic

Question 15

Most common cause of primary intracerebral hemorrhage is

Answer 15

HTN

Question 16

C.N.S. lesions in HTN:

Answer 16

Lobar+Slit H , Charcot Bouchard Microaneurysms*** , Lacunar Infarcts

Question 17

Duret hemorrhage :

Answer 17

Usually with massive displacements & herniations *

Question 18

Saccular (Berry) aneurysm:

Answer 18

Commonest cause of spontaneous subarachnoid hemorrhage, F > M

Question 19

projection not present at birth in Saccular (Berry) aneurysm

Answer 19

True

Question 20

In 1/3 of cases rupture is initiated by

Answer 20

acute increase in iICP

Question 21

Conditions of Berry aneurysm

Answer 21

Polycystic kidney disease (AD) +Marfan Sy++Coarctation of aorta

Question 22

Rupture results in:

Answer 22

Subarachnoid hemorrhage, Parenchymal ± ventricular hemorrhage, Bloody CSF (Xanthochromia)

Question 23

Arteriovenous malformation (AVM)

Answer 23

most likely to cause significant hemorrhage

Question 24

Concussion

Answer 24

Immediate and temporary disturbance + No demonstrable lesion

Question 25

Cerebral Edema:

Answer 25

Occurs with and without an obvious structural lesion

Question 26

Diffuse Axonal Injury:

Answer 26

Acceleration / Deceleration injury,+asymmetric axonal swelling (Retraction Balls)