Neuro Flashcards
What protrudes during Spina Bifida Meningomyelocele?
menignes and spinal cord
What is the most common cause of Hydrocephalus in infants?
Cerebral Aqueduct Stenosis
What structure connects the lateral ventricles to the 3rd ventricle?
Foramen of Monro
What structure connects the 3rd ventricle to the 4th ventricle?
cerebral aqueduct of sylvius
Which two structures connect the 4th ventricle to the subarachnoid space?
Magenda
Luschka
What structure doesnt develop during a Dandy-Walker Formation?
cerebellar vermis
How does a Dandy-Walker malformation present? (two)
massively dilated 4th ventricle
absence of cerebellum
What is abnormal during an Arnold-Chiari Malformation Type Two?
congenital downward displacement of cerebellar tonsils through foramen magnum
What does an Arnold-Chiari Malformation Type Two often result in?
Hydrocephalus
What two anatomical abnormalities is an Arnold-Chiari Malformation Type Two associated with?
meningomyelocelle
What condition does Arnold-Chiari Type 1 arise with?
Syringomyelia
What vertebral levels does Syringomyelia often occur at?
C8-T1
What two senses are lost during Syringomyelia? What is spared?
pain and temperature
fine touch
Why can Syringomyelia cause muscle weakness?
syrinx expansion can disrupt anterior horn neurons
Syringomyelia can disrupt what tract that leads to Horner Syndrome? What is disrupted? Where?
Hypothalamospinal
disrupted lateral horn
T1
Which cells in the spinal cord are destroyed by polio?
Anterior horn cells
Are destruction of anterior horn cells LMN or UMN?
LMNs
What is Werdnig-Hoffman Disease?
inherited degeneration of anterior horn cells
Which tract is disrupted during ALS?
corticospinal
Destruction of what tract during ALS can lead to UMN signs?
lateral corticospinal
A defect in what enzyme can be associated with ALS?
zinc/copper superoxide dismutase
Does syringomyelia damage LMNs or UMNs?
LMNs
Where does Friedrichs Ataxia have muscle weakness?
lower extremities
What gene is involved in Friedrichs Ataxia?
Frataxin
What is the function of Frataxin?
handles mitochondrial iron regulation
What is the main cause of death in Friedrich Ataxia?
HCOM
What is the trinucleotide repeat of Friedrich Ataxia?
GAA
What compose the leptomeninges?
pia and arachnoid
What bug can cause meningitis in non-immunized infants?
H. influenzae
What immune cells are found and what is the glucose level during viral meningitis?
Lymphocytes
normal glucose
What immune cells are found and what is the glucose level during fungal meningitis?
Lymphocytes
decrease glucose
What causes death during bacterial meningitis? Why?
herniation
edema
What are the sequelae of bacterial meningitis based on?
fibrosis
How long does it take for neurons to begin to die due to ischemia?
3- 5 minutes
What tumor can cause cerebral ischemia?
insulinoma
Which three cells of the brain are most susceptible to ischemia?
cerebral pyramidal neurons
Purkinje neurons of cerebellum
pyramidal neurons of hippocampus
What causes a pale infarct? Where?
thrombotic stroke
periphery of cortex
What vessels do most emboli from the left heart travel in on their way to the brain?
middle cerebral
What part of the brain does an embolic stroke usually effect? What color of infarct?
periphery of cortex
hemorrhagic
What vessels are most commonly effected during a Lacunar Stroke? What is the disease process? Complication of?
lenticulostriate
hyaline arteriolosclerosis
HTN
Involvement of what structure leads to a pure motor stroke ?
internal capsule
Involvement of what structure leads to a pure motor sensory?
thalamus
What type of cell proliferates during Gliosis?
astrocytes
What is the histological sign of infarction at the cellular level in the brain? How long after infarction?
red /eosinophilic neurons
12 hours
What vessels burst during an Intracerebral Hemorrhage? What type of aneurysm? Cause?
Lenticulostriate
Charcot-Bouchard
HTN
What is the most commonly affected brain structure during an intracerebral hemorrhage?
basal ganglia
Which type of hemorrhage is WHOL?
subarachnoid
Which type of hemorrhage produces xanthochromia? Why?
subarachnoid
bilirubin
What is the most common cause of an Intracerebral Hemorrhage? Where?
berry aneurysm
anterior communicating artery branch points
Other than berry aneurysm, what are the two other causes of an intracerebral hemorrhage?
AV malformation
anti-coagulated state
What two conditions can give rise to berry aneurysms?
Marfans and ADPKD
What vessel causes an epidural hematoma?
middle meningeal
What vessel causes an subdural hematoma?
bridging veins
Which type of cerebral hemorrhage is usually caused by a trauma?
subdural
Which type of cerebral hemorrhage is most often present in the elderly? Why?
subdural
cerebral atrophy
What is a subfalcine herniation?
cingulate gyrus under falx cerebri
Which vessel is compressed during a subfalcine herniation?
anterior cerebral
What in an Uncal Herniation?
herniation of uncus of temporal lobe under tentorium cerebelli
What does compression of posterior cerebral artery cause?
contralateral homonymous hemianopsia
What three structures get compressed with an Uncal Herniation?
cranial nerve three
posterior cerebral artery
Paramedian artery
What cell is preferentially affected by Metachromatic Leukodystrophy? What happens?
oligodendrocytes
myelin builds up b/c it cant be broken down
What enzyme is deficient during Krabbe Disease? Which cell type is affected?
Galactocerebrosidase
macrophages
What is impaired during Adrenoleukodystrophy? Two affected areas?
impaired addition of CoA to long chain fatty acids
adrenal gland and white matter
What is the haplotype of Multiple Sclerosis?
HLA-DR2
What cell accumulates in the CSF during Multiple Sclerosis?
Lymphocytes
What protein accumulates in the CSF during Multiple Sclerosis?
Myelin Basic Protein
What are the two treatments for MS?
high dose steroids
IFN-beta
What virus causes Subacute Sclerosing Panencephalitis?
Measles
What is seen on histology during Subacute Sclerosing Panencephalitis?
inclusions in neurons and oligodendrocytes
What two populations are at an increased risk of Central Pontine Myelinosis?
alcoholics
liver disease
When gene is implicated in Alzheimers?
ApoE
Which allele of ApoE is associated with higher risk? Lower risk?
epsilon-4 = higher
epsilon-2 = lower
Why can Down Syndrome present with early onset Alzheimers?
amyloid-precursor-protein on chromosome 21
Familial Early-Onset Alzheimers are associated with what gene? Which form?
Presenelin
one
What form of amyloid deposits in Alzheimers?
Amyloid-Beta
Why can Alzheimers increase the risk of stroke?
Amyloid-beta can deposit around and weaken vessels
Where does tau accumulate? What form?
intracellular
hyperphosphorylated
What type of protein is tau?
microtubule associated
What specific part of the brain are cholinergic neurons lost during Alzheimers?
nucleus basilis of meynert
What two lobes are primarily effected during Pick Disease?
frontal and temporal
What is Pick Disease characterized by histologically?
round aggregates of tau
What layer of the brain does Pick Disease effect?
cortex
What do the effects in the frontal Lobe manifest as regarding Picks Disease?
behavioral issues
What do the effects in the temporal Lobe manifest as regarding Picks Disease?
language issues
What protein accumulates in the neurons during Parkinsons Disease? Called?
α-Synuclein
Lewy Bodies
What is Lewy Body Dementia? Where do these Lewy Bodies accumulate?
early onset dementia
CORTEX
What are the three main symptoms of Lewy Body Dementia?
Dementia
hallucinations
parkinsonian features
Where are the Lewy Bodies found during Lewy body dementia?
cortex
What is the trinucleotide repeat for Huntingtons?
CAG
Further expansion of trinucleotide repeats occurs where during Huntingtons?
spermatogenesis
What improves a normal pressure hydrocephalus?
lumbar puncture
What is the treatment for a normal pressure hydrocephalus?
ventriculo-peritoneal shunt
What is the NORMAL secondary structure of prions?
α-helical
What is the mutated secondary structure of prions?
β-pleated
What is the key histological feature of Spongiform Encephalopathy?
intracellular vacuoles
What are the two characteristics seen on physical exam during Creutzfeldt-Jakob Disease? How quickly does this develop?
dementia and ataxia
rapidly
What is seen on the EEG during Creutzfeldt-Jakob Disease?
sharp/spike waves
How long does it take for Creutzfeldt-Jakob Disease to become fatal?
less than one year
Where do most Metastatic Tumors appear in the brain?
Grey-White junction
Where are adults primary brain tumors usually located?
supra-tentorial
Where are childrens primary brain tumors usually located?
infra-tentorial
What are the three most common brain tumors in adults?
glioblastoma multiforme
meningioma
schwannoma
What are the three most common brain tumors in children?
medullablastoma
pilocytic astrocytoma
ependyoma
What cells is malignant during Glioblastoma Multiforme?
astrocytes
Where in the brain does Glioblastoma Multiforme usually arise?
cerebral hemisphere
Which brain tumor can cross the corpus callosum?
Glioblastoma Multiforme
What are two key histology buzz phrases for Glioblastoma Multiforme?
Necrotic
Pseudo-palisading
What specific cells proliferate during glioblastoma multiforme?
endothelial
What is the IHC stain for Glioblastoma Multiforme?
GFAP
Which two brain tumors shows Psamomma Bodies?
ependyoma and meningioma
Where in the brain does a Schwanoma most commonly occur?
cerebello-pontine angle
Which brain tumors are S100 positive?
Schwannoma
In what lobe does an oligodendroglioma usually arise?
frontal
Which tumor ‘calcifies in the white matter’?
Oligodendroglioma
What CNS tumor has a fried egg appearance on histology?
Oligodendroglioma
Is a Pilocytic Astrocytoma benign or malignant?
Benign
Where does a Pilocytic Astrocytoma arise?
cerebellum
How does Pilocytic Astrocytoma appear on imaging?
cystic lesion with a mural nodule
Rosenthal fibers are associated with what CNS tumor? Stain?
Pilocytic astrocytoma
eosinophilic
What are Rosenthal Fibers?
eosinophilic processes of astrocytes
What is the stain for Pilocytic Astrocytoma?
GFAP
What cells is a medulloblastoma derived from? What part of the brain?
granular
cerebellum
What embryonic layer is a medullablastoma derived from?
Neuroectoderm
Where can a Medulloblastoma metastisize? Called?
Cauda Equina
Drop Metastasis
What layer of tissue gives rise to a craniopharyngioma?
Epithelial
What can be seen on biopsy during Craniopharyngioma? Resembling?
calcifications
tooth-like appendages
When does a woman need folate to prevent neural tube defects?
prior to conception
Where two locations is high α-FP found?
maternal blood
amniotic fluid
What is the mode of inheritance for Friedrich Ataxia?
Autosomal Recessive
How does N. meningitis get into the blood?
through the nasopharynx
What virus is the most common viral cause of meningitis?
Coxsackie
Is photophobia more common with viral or bacterial meningitis?
viral
How long does a Transient Ischemic Attack last?
less than 24 hours
How long does a stroke last?
greater than 24 hours
What structure is the end result of an ischemic stroke?
fluid-filled cyst surrounded by gliosis
Why are Berry Aneuryms weak?
lack tunica media
A period of lucidity can be present in what type of hematoma?
Epidural
What causes death in an Epidural hematoma?
herniation
Which bone is classically fractured during an Epidural Hematoma?
temporal
Between what two structures do the bridging veins lie?
dura and arachnoid
Atrophy of the brain could cause what type of hematoma?
Subdural
What cant get degraded during Metachromatic Leukodystrophy?
myelin
What two things get destroyed during Multiple Sclerosis?
myelin and Oligodendrocytes
What does the ‘Pan’ of Subacute Sclerosing Panencephalitis mean?
effects gray and white matter of brain
What specific cell is affected during PML?
Oligodendrocytes
What is a common cause of death in Alzheimers?
infection
What protein is derived from APP?
Aβ Amyloid
What happens to the ventricles during Alzheimers? Why?
dilation of ventricles
atrophy of brain
Is Aβ Amyloid extracellular or intracellular?
always extracellular
What is the function of Tau?
microtubule associating protein
Is Tau intracellular or extracellular?
intra
What causes Tau to no longer be able to assemble microtubules?
Hyper-phosphorylation
What specific part of the Basal Ganglia looses dopaminergic neurons in Alzheimers?
substantia nigra pars compacta
What specific part of the basal ganglia is affected during Huntingtons?
caudate
What becomes larger during Huntingtons?
lateral ventricles
What gets stretched during a Normal Pressure Hydrocephalus?
Corona Radiata
What causes a Normal Pressure Hydrocephalus?
decreased absorption of CSF in ARACHNOID granulations
What are the three most common sources of mets to brain?
lung
breast
kidney
What type of filament is a Glioblastoma Multiforme derived from?
intermediate filament
What type of cell is neoplastic in a meningioma?
Arachnoid
What brain tumor can present with a whorled pattern?
Meningioma
Homer-Wright Rosettes are present in what brain tumor?
Medulloblastoma
Which ventricle do Ependyomas most often arise?
4th ventricle
Which brain tumor can present with a Perivascular Rosette? What do these structures surround?
Ependyoma
blood vessels
What is the only brain tumor in kids that may present as supratentorial?
Craniopharyngioma
What does the wall of the neural tube form?
CNS
What does the hollow lumen of the neural tubes form?
ventricles
What part of the body experiences weakness early on during ALS?
hands
What two parts of the CNS are defective during Friedrich Ataxia?
cerebellum
spinal cord
What causes a thrombotic stroke?
rupture of atherosclerotic plaque
What color of infarct is a thrombotic stroke?
pale
Which hematoma is crescent shaped?
Subdural
By what mechanism could a tonsillar herniation result in death?
cardiopulmonary arrest
What two parts of the brainstem are affected during a Duret Hemorrhage?
Midbrain and upper pons
What produces β-Amyloid from APP?
β-cleavage
Which arch doesnt close during Spina Bifida?
posterior vertebral arch
Does Dandy-Walker present with hydrocephalus?
yes
What is the mode of inheritance of Friedrich Ataxia?
autosomal recessive
What heart condition does Friedrich Ataxia lead to?
Hypertrophic Cardiomyopathy
From outer to inner, what are the three levels of the meninges?
dura
arachnoid
pia
What causes Charcot-Bouchard aneurysms?
hyaline arteriosclerosis
Viral inclusions within the gray and white matter are indicative of what disease?
SSPE
What is the most common cause of death in Alzheimers?
infection
Are amyloid plaques intra or extracellular?
extra
Which brain tumor displays a ‘whorled’ pattern?
meningioma
What forms if there is a neural tube defect at the cranial end of the neural tube?
anencephaly
What is the mode of inheritance of Werdnig Hoffman Disease?
autosomal recessive
Does an embolic stroke cause an ischemic infarct or hemorrhagic infarct?
hemorrhagic
What is the mode of inheritance of adrenoleukodystrophy?
X-linked
What does scaning speech resemble?
drunk speech
Which protein composes neuritic plaques?
beta-amyloid
Are neuritic plaques intra or extracellular?
extra
Which protein composes neurofibrillary tangles?
hyperphosphorylated tau
Are neurofibrillary tangles intra or extracellular?
intra
Startle Myoclonus is indicative of what brain disease?
CJD
Do brain tumors metastisize?
no
What does pseudopalasading mean in regards to GBM?
healthy cells surround necrotic area
Which brain tumor expresses estrogen receptor?
Meningioma
