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Neuro - Path Flashcards

1
Q

What causes communicating hydrocephalus?

A

Decreased CSF absorption by arachnoid granulations

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2
Q

TIA defined how?

A

Regional ischemia < 24 hours

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3
Q

Sudden, brief, uncontrolled, muscle contraction?

A

Myoclonus

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4
Q

Alzheimer’s familial case assoc w/what mutation?

What other syndrome assoc w/it?

A

Presenilin 1 and 2

Down syndrome by age 40

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5
Q

Pilocytic astrocytoma Mal/B9?

Arises where?

Imaging shows what?

A

B9 tumor of children (most common)

Cerebellum

Cystic lesion w/mural nodule

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6
Q

Tension HA: U/l or b/l? FM or M?

Duration?
Tx?

Describe

A

B/l, Females

> 30 min, usually 4-6 hour
NSAID, amitriptyline for chronic pain

Steady pain, no photo/phonophobia

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7
Q

Describe the following type of seizures: tonic-clonic

Tonic

Atonic

A

Grand mal - alternating stiffening and movement

Stiffening

Drop seizure

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8
Q

What is characterized by regions of necrosis surrounded by tumor cells (pseudopalisading)?

(+) for what?

A

Glioblastoma

GFP

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9
Q

What histology shows small, round blue cells? What may be present?

A

Medulloblastoma

Homer-Wright rosettes

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10
Q

Pick disease presents w/what anatomically?

Find what structures?

A

Frontotemporal lobe degen

Ubq TDP-43

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11
Q

Multifocal infarction due to HTN, atherosclerosis or vasculitis causes what?

A

2 cause

Vascular dementia

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12
Q

Friedreich ataxia is what?

Mutation?

Assoc with what?

A

Degen of cerebellum and spinal cord, Loss of DTRs, muscle weakness

AR, trinucleotide repeat of GAA

Hypertrophic cardiomyopathy

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13
Q

Poliomyelitis is damage to what?

A

AH –> LMN

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14
Q

MMA is a branch off what?

A

Maxillary artery

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15
Q

What histology shows loss of pigmented neurons in SN?

A

PD

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16
Q

Embolic stroke most common source is what?
Involves what?

Results in what?

A

Left side heart (AFib)
MCA

Hemorrhagic infarct at the periphery of cortex

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17
Q

What is a herniation of the cingulate gyrus under the falx cerebri called?

What is compressed?

A

Subfalcine herniation

ACA

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18
Q

What causes a crescent shaped hemorrhage?

May cause what?

A

Subdural hematoma

Midline shift

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19
Q

Degen disease of frontal and temporal cortex w/round aggregates of Tau proteins is what?

Progresses to what?

A

Pick disease

Dementia

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20
Q

Describe the following type of seizures: absence

Myoclonic

A

Petit mal - no postictal confusion, blank stare

Quick, repetitive jerks

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21
Q

What adult tumor presents as a calcified tumor in the white matter, involves frontal lobe, present w/seizures?

A

Oligodendroglioma

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22
Q

ALS main sx?

Inherited form has what mutation?

A

UMN and LMN paralysis
No sensory sx

SOD1

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23
Q

What causes subacute sclerosing panencephalitis?

Characterized how?

A

Measles virus

Viral inclusions w/in neurons and oligodendrocytes

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24
Q

What makes up leptomeninges?

A

Pia and arachnoid

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25
Restlessness and intense urge to move is what?
Akathisia
26
M.S. HLA association? Is what? Dx? Tx?
HLA-DR2 Autoimmune destruction of CNS myelin, MRI and LP (oligoclonal IgG bands) High-dose steroids, IFN-B
27
What causes locked-in syndrome? Loss of what eye movements?
Basilar artery infarction Horizontal but not vertical
28
What shows histology of eosinophilic inclusions of alpha-synuclein in affected neurons?
Parkinson D
29
Werdnig-Hoffman is what?
Inherited (AR) degen of AH, floppy baby
30
Ependymoma Mal/B9? Arises from where? Biopsy finding?
Mal 4th ventricle Perivascular psuedorosettes
31
Subarachnoid hemorrhage INC risk of developing what?
Communicating and/or obstructive hydrocephalus
32
Types of focal seizures?
Simple partial - intact consciousness Complex partial - impaired consciousness Epilepsy - recurrent Status epliepticus - continuous > 5-30 min or recurring --> Brain injury
33
What presents w/period sharp waves on EEG and rapidly progressive dementia assoc. w/ataxia?
CJD
34
What is metachromatic leukodystrophy? Inheritance?
Def. in arylsulfatase, AR
35
Subdural hematoma caused by what? Increased risk in whom?
Tearing of bridging veins due to trauma Older, due to atrophy
36
Elevated AFP in the amniotic fluid and maternal blood indicate what?
Neural tube defect
37
Craniopharyngioma Mal/B9? Arises from what? Presents how?
B9 Remnants of Rathke's pouch Supratentorial mass in kids
38
Lateral pontine syndrome caused by what? Affects what? Symptoms?
Infarct of AICA Facial nucleus Facial droop, Dec lacrimation, Dec salivation, Dec taste from ant. 2/3
39
Moderate global ischemia damages what areas specifically?
Pyramidal neurons of cortex (3, 5, 6) Pyramidal neurons of hippocampus (temporal lobe) Purkinje layer of cerebellum
40
Early-onset dementia suggest what? What sx?
Lewy body disease Dementia, hallucinations, parkinson-like features
41
Abeta amyloid associated w/what? What else?
Alzheimer's NFT-Tau proteins
42
Medulloblastoma derived from what? Mal/b9? Occurs in whom?
Granular cells of cerebellum (neuroectoderm) Mal Kids
43
LP for CSF where? | Why?
L4 and L5 | SC ends at L2, subarachnoid and cauda equina continue to S2
44
Slow-onset memory loss, changes in behavior and personality, degen of cortex is what disease? Cause?
Alzheimer's Sporadic
45
Mild global ischemia results in what? Ex?
Transient confusion Insulinoma
46
What is Worst headache of life? cause? What site most frequently? Assoc w/what syndromes?
Subarachnoid hemorrhage, berry aneurysm rupture Anterior circle of Willis at branch points of anterior comm. artery Marfan, ADPKD (adult polycystic)
47
Variant CJD in whom?
Younger pts, mad cow
48
What produces CSF?
Choroid plexus
49
Craniopharyngioma can compress what? What is seen on imaging? Can it recur?
Optic chiasm --> bitemp hemianopsia Calcifications YES
50
Migraine HA: U/l or b/l? FM or M? Duration? Tx? Describe
U/l, Females 4-72 hours NSAID, triptans, dihydroergotamine Pulsating pain w/nausea, photophobia, may have aura
51
Medial medullary syndrome is caused by what? Causes what?
Infarct of anterior spinal artery B/l paralysis of arms and shoulders
52
PCA lesion located where? Causes what?
Occipital lobe Contralateral hemianopia w/macular sparing
53
Cluster HA: U/l or b/l? FM or M? Duration? Tx? Describe
U/l, MALES 15min - 3 hr Sumatriptan Excruciating periobital pain w/lacrimation and rhinorrhea
54
Sustained, involuntary m. Contraction is what?
Dystonia
55
Oligodendroglioma mal/B9? What appearance on biopsy?
Malignant Fried egg
56
Uncal herniation is what?
Displacement of temporal lobe under the tentorium cerebelli
57
Give the flow of CSF from start to finish
Lateral ventricles --> 3rd ventricle via Foramen of Monroe --> 4th ventricle via Cerebral aqueduct --> subarachnoid space via foramen of Magendie and Luschka
58
Epidural hematoma may cause what?
CN3 palsy
59
Normal pressure hydrocephalus can cause what in adults? Presents how? What improves sx? Tx how?
Dementia due to increased CSF and dilated ventricles Urinary incontinence, gait instability, dementia LP, therefore tx w/VP shunt
60
What disease causes relapsing neurologic deficits w/periods of remission?
M.S.
61
M.S. Symptom triad?
SIN Scanning speech INO/Intention tremor Nystagmus
62
Where is Broca's area? Lesion causes what?
Inferior frontal gyrus of frontal lobe Pt can't speak, they are frustrated, CAN comprehend
63
Moderate global ischemia leads to what? Where?
Infarct in watershed areas Area bw ACA and MCA
64
What presents w/foot deformities (pes cavus, hammer toe), LE weakness (foot drop) and sensory deficits? Inheritance?
Charcot-Marie-Tooth AD
65
Give the microscopic cellular changes of ischemic stroke timeline
Red neurons w/in 12 hours Necrosis (24 hours) w/ neutrophils (1-3) days and microglia (4-7 days) Granulation tissue after 1 week Cyst (gliosis) after 1 month
66
What causes intracerebral (parenchyma) hemorrhage? Due to what? Most common site?
Charcot-Bouchard microaneurysms of lenticulostriate vessels HTN Basal ganglia
67
Alzheimer's has what inherited increase risk? | Decreased?
APOE4 E2
68
Where is Wernicke's area? Lesion causes what?
Superior temporal gyrus of temporal lobe Fluent speech that makes no sense (No comprehension)
69
Pathogenesis of Migraine HA?
Irritation of CN 5, meninges, or blood vessels
70
What is Krabbe Disease? Inheritance?
Def. of glactocerbrosidase, accumulates in macrophages --> leukodystrophy AR
71
Lesion of MCA affects what? Symptoms?
Upper limb and face, temporal lobe-Wernicke, frontal lobe-Broca Contralateral paralysis and sensory loss Aphasia if dominant hemisphere
72
Meningioma occurs in whom? Mal/B9? Of what? Histology shows what?
Adult female B9 tumor of arachnoid cells Whorled pattern, psammoma bodies
73
Lacunar stroke due to what? Involves what?
Hyaline arteriosclerosis (from HTN or DM) Lenticulostriate vessels --> cystic areas of infarction
74
What causes Lateral medullary (Wallenberg) syndrome? Sx?
Infarct of PICA Dysphagia, hoarseness, dec. Gag reflex (Nuc. ambiguus - CN 9-11)
75
Lenticulostriate lesion affects what? Sx?
Striatum, IC Contralateral paralysis and/or sensory loss
76
Thrombotic stroke due to what? Most common spot? What kind of infarct?
Rupture of atherosclerotic plaque Atherosclerosis at branch points of bifurcation in ICA and MCA Pale
77
Glioblastoma occurs in whom? Mal/B9? Arises where? Prognosis?
Adults Mal Cerebral hemisphere --> crosses corpus callusum Poor
78
Focal seizures most commonly affect what part of the brain? Often preceded by what?
Medial temporal lobe Aura
79
Spongiform encephalopathy due to what?
PrPc converted to Beta-pleated PrPsc
80
Schwannoma involves what? + for what? B/l tumors seen in what?
CN8, CPA S100 NF2
81
Medulloblastoma prognosis? What can happen?
Poor, metastasis via CSF Metastasize to cauda equina
82
PML is caused by what? Presents how?
JC virus In immunosuppressed or AIDS, rapidly progressive neurological signs
83
What adult tumor presents as seizures and compresses but does not invade the cortex?
Meningioma
84
Syringomyelia main defects?
Cystic degen of SC Loss of pain/temp in cape like dist (AWC) Dorsal expan --> destroys AH (LMN) Horner Syndrome (lateral horn)
85
Biopsy of what tumor shows thick eosinophilic processes of astrocytes and eosinophilic granular bodies? Aka what? tumor + for what?
Pilocytic astrocytoma, Rosenthal fibers GFAP
86
Congenital failure of cerebellar vermis to develop? Presents how?
Dandy-walker Absent cerebellum, dilated 4th ventricle, hydrocephalus
87
ACA lesion affects what? Sx?
Lower limb Contralateral paralysis and sensory loss
88
Congenital downward displacement of cerebellar vermis and tonsil through foramen magnum is what? Assoc w/what?
Arnold-Chiari Meningomyelocele
89
Tonsillar herniation is what? Leads to what?
Cerebellar tonsil into foramen magnum Compression of brain stem --> cardiopulmonary arrest
90
Most common form of spongiform encephalopathy is what? Contracted how?
Creutzfeldt-Jakob Sporadic, or infected via HGH or corneal transplant
91
What is Adrenoleukodystrophy due to? Inheritance? Damages what?
Impaired add. Of CoA to long-chain FA's X-linked Adrenals, white matter of brain
92
What 3 structures does an uncal herniation compress? What does each one cause?
CN3 - down and out dilated pupil PCA - contralateral homonymous hemianopsia Paramedian artery - Duret hemorrhage
93
Huntington's is due to what? Inheritance? W/what?
Degen of GABAnergic neurons in the caudate nucleus AD, w/CAG repeats
94
What has morphologic changes of cerebral atrophy, narrowed gyri, widened sulci, dilation of ventricles?
Alzheimer's
95
What is Sturge Weber syndrome?
Neural crest anomaly ``` Sporadic, port wine Stain Tram track calcification Unilateral Retardation Glaucoma, GNAQ gene Epilepsy ```
96
Tuberous Sclerosis on what chromosome? Inheritance? CFs?
16 AD Ash-leaf spots, Shagreen patches, renal angiomyolipoma
97
VHL on what ch.? Inheritance? What tumors assoc w/it?
3, AD HARP Hemangioblastoma, angiomastosis, RCC, Pheos
98
NF1 on what ch.? NF2?
17 22
99
What tumor has perivascular rosettes w/rod-shaped blepharoplasts? Prognosis?
Ependymoma Poor
100
"Motor oil" fluid from tumor? What characteristic about it?
Craniopharyngioma Most common childhood supratentorial tumor
101
What childhood tumor can cause precocious puberty in males? Due to what?
Pinealoma --> cause Parinaud syndrome (Vertical gaze palsy) B-hCG production
102
Subfalcine herniation may compress what structure?
ACA
103
What causes Tabes Dorsalis? Results from what? Sx?
Tertiary syphilis Demyelination of dorsal columns and roots Shooting pain, Argyll Robertson pupil, loss of DTRS
104
What has a + Romberg sign?
Tabes Dorsalis
105
Vit B12 def causes what?
Demyelination of spinocerebellar tracts, LCST, and dorsal columns
106
What has unilateral sx including radicular pain, absent knee and ankle reflex w/loss of bladder control, may cause saddle anesthesia? Often caused by what?
Cauda equina syndrome intracerebral disk herniation or tumor
107
Name the 5 pathologic findings in Brown-Sequard syndrome
1 - ipsilateral loss of all sensation at level of lesion 2 - ipsilateral LMN loss at level 3 - Ipsilateral UMN loss below lesion 4 - Ipsilateral loss of 2pt tactile below lesion 5 - contralateral loss of pain/temp below lesion
108
CN 10 lesion results in what? Ex. Lesion on Right side
Uvula deviates AWAY from side of lesion Uvula deviates to the left
109
Where are high frequency sounds heard? Describe
Base of cochlea (thin and rigid)
110
Where are low frequency sounds heard? Describe
Apex near helicotremma (wide and flexible) LA helicopter
111
Most common cause of viral conjuctivitis?
Adenovirus
112
What is myopia? How to correct?
Nearsightedness, eye too long for refractive power Diverging lens (concave)
113
What is hyperopia? How to correct
Farsightedness, eye too short Converging (convex) lens
114
What is an astigmatism? How to correct?
Abnormal curvature of retina, diff refractive power at diff axes Cylindrical lens
115
Where is aqueous humor of the eye made? How do you decrease it?
nonpigmented epithelium of ciliary body Beta blockers, a2 agonists, CAI's
116
What are 3 causes of secondary open-angle glaucoma? More common in whom?
Blocked trabecular mesh work from wbc's (uveitis) From rbc's From retinal elements Older nyukkas
117
Primary cause of closed-angle glaucoma?
Enlargement or forward movement of lens against central iris -> obstruction of normal aqueous flow through pupil, impedes flor through trabecular meshwork
118
Secondary cause of closed-angle glaucoma?
Hypoxia from retinal disease
119
Acute closure glaucoma sx? Do not give what? Why?
Very painful, red eye, sudden vision loss, frontal HA, dilated pupil Epi, due to mydriasis effect
120
Describe the pathway of the pupillary light reflex
Light sends signal via CN2 to pretectal nuclei In midbrain it activates b/l Edinger-Westphal nuclei Pupils constrict b/l
121
An afferent pupillary defect due to optic nerve damage or retinal injury results in what? Called what?
DEC b/l pupillary constriction when light is shone in affected eye Marcus Gunn pupil
122
Describe pathway of miosis
1st neuron in EW nucleus to ciliary ganglion of CN 3 | 2nd neuron in short ciliary nerves to sphincter pupillae muscles
123
What nerves are in the cavernous sinus? Which artery? Which is most susceptible to injury? How does blood from the eye and sup. Cortex drain?
CN 3, 4, V1, V2, 6, ICA CN 6 Cavernous sinus --> IJV
124
What causes disinhibited behavior (hyperphagia, hypersexuality, hyperorality)? Due to what lesion? Example of inciting cause?
Kluver-Bucy syndrome amygdala b/l HSV-1 encephalitis

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