Neuro Flashcards
1
Q
neural tube defects
A
- arise from incomplete closure of neural tube
- from low folate
2
Q
how to detect neural tube defects
A
elevated AFP in amniotic fluid and maternal blood
3
Q
anencephaly
A
- absence of skull and brain
- frog like appearance
- maternal polyhydramnios (no swallowing)
4
Q
spina bifida
A
failure of posterior vertebral arch to close
5
Q
spina bifida occulta
A
- leads to dimple or patch of hair overy lying the vertebral defect
6
Q
meningocele
A
only meninges out
7
Q
menignomyeleocele
A
meninges plus spinal cord out
8
Q
cerebral aqueduct stenosis
A
- stenosis of channel draining 3/4 ventricles
- accumulation of CSF in ventricles
- leads to enlarged head
9
Q
Dandy Walker syndrome
A
- no cerebellar vermis
- massively dilated 4 ventricle with absent cerebellum
- hydorcephalus
10
Q
Arnold-Chiari malformation
A
- cerebellar tonsils through foramen magnum
- poor draining leads to hydrocephalus
- may occur with meningomyelocele and syringomyelia
11
Q
syringomyelia
A
- cystic degeneration of spinal cord
- caused by trauma or Arnold-Chiari malformation
- C8-T1
- loss of pain and temp in upper limbs
- destruction of anterior commisure
12
Q
results of expansion of syrinx
A
- muscle atrophy and weakness
- horner syndrome (lateral horn)
13
Q
poliomyelitis
A
- damage to anterior motor horn
- viral infection
- flaccid paralysis
14
Q
Werdnig-Hoffmann disease
A
- degeneration of anterior motor horn
- floppy baby
- not compatible with life
15
Q
ALS
A
- degeneration of upper and lower motor neurons
- anterior motor horn leads to LMN signs
- lateral corticospinal tract leads to UMN signs
16
Q
how to differentiate ALS from syringomyelia
A
no sensory involvement in ALS
17
Q
familial ALS
A
zinc-copper dismutase mutation
- increased in free radical damage
18
Q
Friedreich Ataxia
A
- degeneration of cerebellum and spinal cord tracts
- ataxia with loss of vibratory sense and proprioception
- muscle weakness
- GAA repeat in frataxin gene
- associated with hypertrophic cardiomyopathy
19
Q
meningitis in neonate
A
GBS, e coli and listeria
20
Q
meningitis in children and teens
A
neisseria meningitidis
21
Q
meningitis in adults and elderly
A
strep pneumo
22
Q
meningitis in non vaccinated infants
A
H flu
23
Q
meningitis in immunocomprimised
A
fungi
24
Q
meningitis (viral)
A
coxsackie
25
LP findings
```
bacterial = neutrophils and low glucose
viral = lymphocytes with normal glucose
fungal = lymphocytes with low glucose
```
- hint = living things consume glucose
26
highly vulnerable regions in moderate global ischemia
- layers 3, 5 and 6 of cortex (cortical laminar necrosis)
- hippocampus
- purkinje layer of cerebellum
27
three ways to get ischemic stroke
1. thrombus (pale)
2. embolus (hemorrhagic - blood comes back)
3. lacunar stroke (hyaline arteriolosclerosis)
28
lacunar strokes occur in....
lenticular striate vessels
29
early findings in ischemic stroke
- red neurons**
- then neutrophils, microglial cells and granulation tissue
- fluid filled space surrounded by gliosis
30
first sight of neuron death
red neurons
31
most common cause of intracerebral hemorrhage
rupture of Charcot-Bouchard microaneurysms
32
common site of intracerebral hemorrhage
basal ganglia
33
complication of intracerebral hemorrhage
HTN
34
LP shows........in subarachnoid hemorrhage
xanthochromia (yellow tinge to blood breakdown)
35
most common berry aneurysm location
anterior circle of Willis at anterior branch points
36
common association with berry aneurysms
Marfans and ADPKD
37
layer of vessel lacking in berry aneurysms
media
38
epidural hemotoma
- rupture of middle meningeal artery
- lens shaped lesion
- blood between dura and skull
- herniation is lethal
39
subdural hematoma
- blood in arachnoid
- problem in vein
- from trauma
- herniation is lethal
40
tonsillar herniation
cerebellum compresses brainstem
41
study other herniations
do it
42
oligodendrocytes
produce myelin in CNS
43
leukodystrophy
- mutations in enzymes for production of myelin
| - white matter
44
metachromatic leukodystrophy
- deficiency of arylsulfatase
- most common
- myelin cannot be degraded and accumulates in lysosomes
45
Krabbe disease
- deficiency of galactocerebroside beta-galactosidase
| - galactocerebroside accumulates in macrophages
46
adrenoleukodystrophy
- impaired addition of coA to long chain fatty acids
| - FAs accumulate damaging adrenal gland and white matter
47
multiple sclerosis
- autoimmune destruction of CNS myelin and oligodendrocytes
- HLA-DR2
- not seen near equator
- scanning speech
48
MLF
crossover from sixth nerve to third nerve for lateral gaze
| - sometimes damaged in MS (internuclear ophthalmoplegia)
49
diagnosis of MS
- MRI plaques
| - LP shows lymphocytes, increased Ig with *oligoclonal IgG bands* and myelin basic protein
50
subacute sclerosing panencephalitis
- slowly progressing persistent infection of brain by measles
- inclusions in grey and white matter
51
progressive multifocal leukoencephalopathy
- **JC virus
- immunosuppression leads to activation
- rapidly progressing neurological signs leading to death
52
central pontine myelinolysis
- focal demyelination of pons
- rapid IV correction of hyponatremia
- occurs in malnourished patients
- locked in syndrome
53
alzheimer diease
- degeneration of cortex
- beta amyloid can't be broken down
- most sporadic
- risk increased in epsilon 4 of APOE
54
APO E risk in alzheimers
E4 is greater risk, E2 is protective
55
early onset alzheimer's associations
- presenilin 1 mutation
| - down syndrome
56
APP chromosome
on chromosome 21, worse in down syndrome
57
pathologic features of alzheimers
- diffuse cerebral atrophy
- narrowing of gyri
- widening of sulci
- hydrocephalus ex vacuo due to atrophy
58
neuritic plaque
- Abeta amyloid
| - and entrapped neurotic processes
59
neurofibrillary tangles
- in cytoplasm of cell
| - has tau (hyperphosphorylated)
60
vascular dementia
- multifocal infarction
- due to HTN, vasculitis, atherosclerosis
- 2nd most common cause of dementia (damage to hippocampus)
61
Pick disease
- picks frontal and temporal cortex
- behavior and language problems
- round aggregates of tau protein (not NF tangles)
62
Parkinsons disease
- loss of dopaminergic neurons in substantia nigra pars compacta in basal ganglia
63
clinical features of parkinsons
- pill rolling tremor
- rigidity
- akinesia/bradykinesia
- postural instability and shuffling gait
64
histologic findings in parkinsons
lewy bodys with alpha synuclein
65
early onset dementia with parkinsons
- Lewy body dementia
- dementia, hallucinations and Parkinson's features
- cortical Lewy bodies
66
Huntington's disease
- loss of GABA neurons of caudate nucleus in basal ganglia (can't inhibit movement)
- ventricle opens up due to degeneration of caudate
- CAG repeats of huntingtin gene
- expansion occurs during spermatogenesis
67
clinical features of Huntington's
- athetosis
- chorea
- dementia
- depression
- death
68
normal pressure hydrocephalus
- increased CSF, dilated ventricles
- stretching of nerve fibers (corona radiata)
- LP improves
- requires shunt
69
triad of normal pressure hydrocephalus
wet - urinary incontinence
wacky - dementia
wobbly - gait instability
70
spongiform encephalopathy
- degeneration due to prion
- alpha to beta pleated conversion
- cant be degraded
- intracellular vacuoles
- spongy holes in brain matter
71
astrocytes
form BBB
72
oligodendrocytes
produce myelin in brain
73
tumor in adults vs kids
```
adults = above tentorium
kids = below tentorium
```
74
glioblastoma multiforme
- malignant, high grade tumor of astrocytes
- most common in adults
- crosses corpus callosum**
- necrosis with edge (pseudopalisading)
75
GFAP
intermediate filament of glial cells
76
meningioma
- benign tumor of arachnoid cell
- usually female
- presents with seizures
- round mass attached to dura
- whorled appearance with somomma bodies
77
schwannoma
- benign tumor of schwann cells
- 8th nerve involvement at CPA
- S100
- bilateral in NF2
78
olidgodendrogliomas
- malignant
- calcified in *white matter*
- frontal lobe
- seizures
- fried egg appearance
79
pilocytic astrocytoma
- benign astrocytes
- most common CNS tumor in kids
- in cerebellum
- cystic lesion with mural nodules
- rosenthal fibers
- GFAP positive
80
medulloblastoma
- malignant tumor from granular cells of cerebellum (neuroectodermal tissue)
- usually kids
- small round blue cells
- Homer-Wright rosettes
- rapidly spreads via CSF
81
edendymoma
- malignant tumor of ependymal cells (line ventricular space
- in kids
- in fourth ventricle with hydrocephalus
- perivascular psuedorosettes
82
craniopharyngioma
- arises from epithelial remnants of Rathke's pouch
- supratentorial mass in child
- optic chiasm compression leads to bitemporal hemianopsia
- calcifications
- benign but recurs
