neuro path

Question 1

most common cause of primary parenchymal hemorrhage

Answer 1

hypertension

Question 2

as vessel walls weaken, rupture and hemorrhage is the most common in the regions of:

Answer 2

the basal ganglia, followed by pons, thalamus, and cerebellum

Question 3

signs/symptoms of intraparenchymal hemorrhage

Answer 3

severe headache, hemiparesis, and hemisensory loss

Question 4

most subarachnoid hemorrhages arise at _____ due to rupture of vessels in _____

Answer 4

arterial bifurcations of the circle of willis; the arachnoid space

Question 5

chief complaint of subarachnoid hemorrhage

Answer 5

“worst headache of my life”

Question 6

ruptured _____ is the most common cause of non-traumatic subarachnoid hemorrhage

Answer 6

berry (saccular) aneurysm (of major brain arteries)

Question 7

vascular malformations are most commonly from _____ in developing brain

Answer 7

abnormal angiogenesis

Question 8

types of vascular malformations

Answer 8

arteriovenous malformation (AVM), cavernous angioma, capillary telangiectasias, and venous angioma

Question 9

collection of abnormal blood vessels of variable caliber; most common type of vascular malformation; most likely to result in intraparenchymal and/or subarachnoid hemorrhages

Answer 9

arteriovenous malformations

Question 10

most common route by which microbes reach the brain

Answer 10

hematogenous spread

Question 11

infections resulting in inflammation of the leptomeninges (arachnoid and pia mater) and subarachnoid space; characterized by purulent exudate under subarachnoid space (over cerebral hemispheres) and within the ventricles

Answer 11

acute bacterial meningitis

Question 12

acute purulent meningitis caused by:

Answer 12

pyogenic bacteria (E. coli, group B strep, H. influenza, n. meningitis)

Question 13

chronic leptomeningitis caused by:

Answer 13

both bacterial (m. tuberculosis) and fungal (c. neoformans) organisms

Question 14

> 2-3 weeks of headache, lethargy, nausea and vomiting; CN palsies and epilepsy; gelatinous exudate, may appear nodular

Answer 14

tuberculous meningitis (chronic meningitis)

Question 15

caused by spherical budding yeast, found in soil and bird excrement; low grade fever, debility and headache; slimy exudate, capsular material

Answer 15

cryptococcal meningitis (chronic meningitis)

Question 16

50% of brain abscesses are spread from _____; ____ is the most commonly identified organism

Answer 16

adjacent infections (dental root, ear, sinus)- also spread hematogenously; streptococcus milleri

Question 17

diffuse inflammation of the brain parenchyma caused by a number of viral agents; usually fatal without treatment

Answer 17

encephalitis (HSV most common)

Question 18

seen microscopically in encephalitis

Answer 18

perivascular lymphocytosis, microglial nodules, and neuronophagia; may also note viral inclusions like Cowdry A (in HSV) and negri bodies (in rabies)

Question 19

autoimmune (T-cell mediated), demyelinating disease; most common demyelinating disease of the brain

Answer 19

multiple sclerosis (MS)

Question 20

common manifestations of MS include:

Answer 20

visual disturbances, speech and gait abnormalities, paresthesias, and emotional disturbances

Question 21

characteristic lesion of MS- irregular area of demyelination

Answer 21

MS plaque

Question 22

MS plaques can arise anywhere in the brain and spinal cord but most common sites are _____ and _____

Answer 22

periventricular white matter; optic nerve

Question 23

microscopically, MS plaques demonstrate areas of demyelination, accomp. by ____ and _____

Answer 23

perivascular lymphocytosis; infiltration by foamy macrophages

Question 24

most common cause of dementia in the elderly; increasing incidence with increasing age

Answer 24

alzheimer’s disease

Question 25

alzheimer’s disease characterized by ____ and _____

Answer 25

brain atrophy (loss of volume and weight); dilation of the ventricular system

Question 26

microscopically seen in alzheimer’s disease

Answer 26

neuritic (senile) plaques and neurofibrillary tangles

Question 27

degeneration of the dopamine secreting pigmented neurons of the substantia nigra in the midbrain; unknown etiology

Answer 27

parkinson disease

Question 28

intracytoplasmic, eosinophilic inclusion bodies within pigmented neurons of the substantia nigra and locus ceruleus- diagnostic of Parkinson’s disease

Answer 28

Lewy bodies

Question 29

hereditary, progressive disorder characterized by spontaneous, involuntary movement called chorea and also dementia

Answer 29

Huntington’s disease

Question 30

etiology of huntington’s disease is mutations in the ____ located on the short arm of chromosome 4

Answer 30

huntingtin gene

Question 31

Huntington’s disease is characterized by atrophy of:

Answer 31

the basal ganglia