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Pathoma > Neuro > Flashcards

Neuro Flashcards

1
Q

neural tube defects

A
  • arise from incomplete closure of neural tube

- from low folate

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2
Q

how to detect neural tube defects

A

elevated AFP in amniotic fluid and maternal blood

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3
Q

anencephaly

A
  • absence of skull and brain
  • frog like appearance
  • maternal polyhydramnios (no swallowing)
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4
Q

spina bifida

A

failure of posterior vertebral arch to close

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5
Q

spina bifida occulta

A
  • leads to dimple or patch of hair overy lying the vertebral defect
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6
Q

meningocele

A

only meninges out

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7
Q

menignomyeleocele

A

meninges plus spinal cord out

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8
Q

cerebral aqueduct stenosis

A
  • stenosis of channel draining 3/4 ventricles
  • accumulation of CSF in ventricles
  • leads to enlarged head
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9
Q

Dandy Walker syndrome

A
  • no cerebellar vermis
  • massively dilated 4 ventricle with absent cerebellum
  • hydorcephalus
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10
Q

Arnold-Chiari malformation

A
  • cerebellar tonsils through foramen magnum
  • poor draining leads to hydrocephalus
  • may occur with meningomyelocele and syringomyelia
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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
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12
Q

results of expansion of syrinx

A
  • muscle atrophy and weakness

- horner syndrome (lateral horn)

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13
Q

poliomyelitis

A
  • damage to anterior motor horn
  • viral infection
  • flaccid paralysis
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14
Q

Werdnig-Hoffmann disease

A
  • degeneration of anterior motor horn
  • floppy baby
  • not compatible with life
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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
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16
Q

how to differentiate ALS from syringomyelia

A

no sensory involvement in ALS

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17
Q

familial ALS

A

zinc-copper dismutase mutation

- increased in free radical damage

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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
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19
Q

meningitis in neonate

A

GBS, e coli and listeria

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20
Q

meningitis in children and teens

A

neisseria meningitidis

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21
Q

meningitis in adults and elderly

A

strep pneumo

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22
Q

meningitis in non vaccinated infants

A

H flu

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23
Q

meningitis in immunocomprimised

A

fungi

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24
Q

meningitis (viral)

A

coxsackie

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25
Q

LP findings

A 
bacterial = neutrophils and low glucose
viral = lymphocytes with normal glucose
fungal = lymphocytes with low glucose
  • hint = living things consume glucose
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26
Q

highly vulnerable regions in moderate global ischemia

A
  • layers 3, 5 and 6 of cortex (cortical laminar necrosis)
  • hippocampus
  • purkinje layer of cerebellum
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27
Q

three ways to get ischemic stroke

A
  1. thrombus (pale)
  2. embolus (hemorrhagic - blood comes back)
  3. lacunar stroke (hyaline arteriolosclerosis)
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28
Q

lacunar strokes occur in….

A

lenticular striate vessels

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29
Q

early findings in ischemic stroke

A
  • red neurons**
  • then neutrophils, microglial cells and granulation tissue
  • fluid filled space surrounded by gliosis
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30
Q

first sight of neuron death

A

red neurons

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31
Q

most common cause of intracerebral hemorrhage

A

rupture of Charcot-Bouchard microaneurysms

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32
Q

common site of intracerebral hemorrhage

A

basal ganglia

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33
Q

complication of intracerebral hemorrhage

A

HTN

34
Q

LP shows……..in subarachnoid hemorrhage

A

xanthochromia (yellow tinge to blood breakdown)

35
Q

most common berry aneurysm location

A

anterior circle of Willis at anterior branch points

36
Q

common association with berry aneurysms

A

Marfans and ADPKD

37
Q

layer of vessel lacking in berry aneurysms

A

media

38
Q

epidural hemotoma

A
  • rupture of middle meningeal artery
  • lens shaped lesion
  • blood between dura and skull
  • herniation is lethal
39
Q

subdural hematoma

A
  • blood in arachnoid
  • problem in vein
  • from trauma
  • herniation is lethal
40
Q

tonsillar herniation

A

cerebellum compresses brainstem

41
Q

study other herniations

A

do it

42
Q

oligodendrocytes

A

produce myelin in CNS

43
Q

leukodystrophy

A
  • mutations in enzymes for production of myelin

- white matter

44
Q

metachromatic leukodystrophy

A
  • deficiency of arylsulfatase
  • most common
  • myelin cannot be degraded and accumulates in lysosomes
45
Q

Krabbe disease

A
  • deficiency of galactocerebroside beta-galactosidase

- galactocerebroside accumulates in macrophages

46
Q

adrenoleukodystrophy

A
  • impaired addition of coA to long chain fatty acids

- FAs accumulate damaging adrenal gland and white matter

47
Q

multiple sclerosis

A
  • autoimmune destruction of CNS myelin and oligodendrocytes
  • HLA-DR2
  • not seen near equator
  • scanning speech
48
Q

MLF

A

crossover from sixth nerve to third nerve for lateral gaze

- sometimes damaged in MS (internuclear ophthalmoplegia)

49
Q

diagnosis of MS

A
  • MRI plaques

- LP shows lymphocytes, increased Ig with oligoclonal IgG bands and myelin basic protein

50
Q

subacute sclerosing panencephalitis

A
  • slowly progressing persistent infection of brain by measles
  • inclusions in grey and white matter
51
Q

progressive multifocal leukoencephalopathy

A
  • **JC virus
  • immunosuppression leads to activation
  • rapidly progressing neurological signs leading to death
52
Q

central pontine myelinolysis

A
  • focal demyelination of pons
  • rapid IV correction of hyponatremia
  • occurs in malnourished patients
  • locked in syndrome
53
Q

alzheimer diease

A
  • degeneration of cortex
  • beta amyloid can’t be broken down
  • most sporadic
  • risk increased in epsilon 4 of APOE
54
Q

APO E risk in alzheimers

A

E4 is greater risk, E2 is protective

55
Q

early onset alzheimer’s associations

A
  • presenilin 1 mutation

- down syndrome

56
Q

APP chromosome

A

on chromosome 21, worse in down syndrome

57
Q

pathologic features of alzheimers

A
  • diffuse cerebral atrophy
  • narrowing of gyri
  • widening of sulci
  • hydrocephalus ex vacuo due to atrophy
58
Q

neuritic plaque

A
  • Abeta amyloid

- and entrapped neurotic processes

59
Q

neurofibrillary tangles

A
  • in cytoplasm of cell

- has tau (hyperphosphorylated)

60
Q

vascular dementia

A
  • multifocal infarction
  • due to HTN, vasculitis, atherosclerosis
  • 2nd most common cause of dementia (damage to hippocampus)
61
Q

Pick disease

A
  • picks frontal and temporal cortex
  • behavior and language problems
  • round aggregates of tau protein (not NF tangles)
62
Q

Parkinsons disease

A
  • loss of dopaminergic neurons in substantia nigra pars compacta in basal ganglia
63
Q

clinical features of parkinsons

A
  • pill rolling tremor
  • rigidity
  • akinesia/bradykinesia
  • postural instability and shuffling gait
64
Q

histologic findings in parkinsons

A

lewy bodys with alpha synuclein

65
Q

early onset dementia with parkinsons

A
  • Lewy body dementia
  • dementia, hallucinations and Parkinson’s features
  • cortical Lewy bodies
66
Q

Huntington’s disease

A
  • 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
Q

clinical features of Huntington’s

A
  • athetosis
  • chorea
  • dementia
  • depression
  • death
68
Q

normal pressure hydrocephalus

A
  • increased CSF, dilated ventricles
  • stretching of nerve fibers (corona radiata)
  • LP improves
  • requires shunt
69
Q

triad of normal pressure hydrocephalus

A

wet - urinary incontinence
wacky - dementia
wobbly - gait instability

70
Q

spongiform encephalopathy

A
  • degeneration due to prion
  • alpha to beta pleated conversion
  • cant be degraded
  • intracellular vacuoles
  • spongy holes in brain matter
71
Q

astrocytes

A

form BBB

72
Q

oligodendrocytes

A

produce myelin in brain

73
Q

tumor in adults vs kids

A 
adults = above tentorium
kids = below tentorium
74
Q

glioblastoma multiforme

A
  • malignant, high grade tumor of astrocytes
  • most common in adults
  • crosses corpus callosum**
  • necrosis with edge (pseudopalisading)
75
Q

GFAP

A

intermediate filament of glial cells

76
Q

meningioma

A
  • benign tumor of arachnoid cell
  • usually female
  • presents with seizures
  • round mass attached to dura
  • whorled appearance with somomma bodies
77
Q

schwannoma

A
  • benign tumor of schwann cells
  • 8th nerve involvement at CPA
  • S100
  • bilateral in NF2
78
Q

olidgodendrogliomas

A
  • malignant
  • calcified in white matter
  • frontal lobe
  • seizures
  • fried egg appearance
79
Q

pilocytic astrocytoma

A
  • benign astrocytes
  • most common CNS tumor in kids
  • in cerebellum
  • cystic lesion with mural nodules
  • rosenthal fibers
  • GFAP positive
80
Q

medulloblastoma

A
  • malignant tumor from granular cells of cerebellum (neuroectodermal tissue)
  • usually kids
  • small round blue cells
  • Homer-Wright rosettes
  • rapidly spreads via CSF
81
Q

edendymoma

A
  • malignant tumor of ependymal cells (line ventricular space
  • in kids
  • in fourth ventricle with hydrocephalus
  • perivascular psuedorosettes
82
Q

craniopharyngioma

A
  • arises from epithelial remnants of Rathke’s pouch
  • supratentorial mass in child
  • optic chiasm compression leads to bitemporal hemianopsia
  • calcifications
  • benign but recurs

Pathoma (11 decks)

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