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(Other) Board Prep > Neuro - Path > Flashcards

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
Q

Restlessness and intense urge to move is what?

A

Akathisia

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26
Q

M.S. HLA association?

Is what? Dx?

Tx?

A

HLA-DR2

Autoimmune destruction of CNS myelin, MRI and LP (oligoclonal IgG bands)

High-dose steroids, IFN-B

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27
Q

What causes locked-in syndrome?

Loss of what eye movements?

A

Basilar artery infarction

Horizontal but not vertical

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28
Q

What shows histology of eosinophilic inclusions of alpha-synuclein in affected neurons?

A

Parkinson D

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29
Q

Werdnig-Hoffman is what?

A

Inherited (AR) degen of AH, floppy baby

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30
Q

Ependymoma Mal/B9?

Arises from where?

Biopsy finding?

A

Mal

4th ventricle

Perivascular psuedorosettes

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31
Q

Subarachnoid hemorrhage INC risk of developing what?

A

Communicating and/or obstructive hydrocephalus

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32
Q

Types of focal seizures?

A

Simple partial - intact consciousness
Complex partial - impaired consciousness
Epilepsy - recurrent
Status epliepticus - continuous > 5-30 min or recurring –> Brain injury

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33
Q

What presents w/period sharp waves on EEG and rapidly progressive dementia assoc. w/ataxia?

A

CJD

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34
Q

What is metachromatic leukodystrophy? Inheritance?

A

Def. in arylsulfatase, AR

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35
Q

Subdural hematoma caused by what?

Increased risk in whom?

A

Tearing of bridging veins due to trauma

Older, due to atrophy

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36
Q

Elevated AFP in the amniotic fluid and maternal blood indicate what?

A

Neural tube defect

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37
Q

Craniopharyngioma Mal/B9?

Arises from what?

Presents how?

A

B9

Remnants of Rathke’s pouch

Supratentorial mass in kids

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38
Q

Lateral pontine syndrome caused by what?

Affects what?

Symptoms?

A

Infarct of AICA

Facial nucleus

Facial droop, Dec lacrimation, Dec salivation, Dec taste from ant. 2/3

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39
Q

Moderate global ischemia damages what areas specifically?

A

Pyramidal neurons of cortex (3, 5, 6)
Pyramidal neurons of hippocampus (temporal lobe)
Purkinje layer of cerebellum

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40
Q

Early-onset dementia suggest what?

What sx?

A

Lewy body disease

Dementia, hallucinations, parkinson-like features

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41
Q

Abeta amyloid associated w/what?

What else?

A

Alzheimer’s

NFT-Tau proteins

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42
Q

Medulloblastoma derived from what?

Mal/b9?

Occurs in whom?

A

Granular cells of cerebellum (neuroectoderm)

Mal

Kids

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43
Q

LP for CSF where?

Why?

A

L4 and L5

SC ends at L2, subarachnoid and cauda equina continue to S2

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44
Q

Slow-onset memory loss, changes in behavior and personality, degen of cortex is what disease?

Cause?

A

Alzheimer’s

Sporadic

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45
Q

Mild global ischemia results in what?

Ex?

A

Transient confusion

Insulinoma

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46
Q

What is Worst headache of life? cause?

What site most frequently?

Assoc w/what syndromes?

A

Subarachnoid hemorrhage, berry aneurysm rupture

Anterior circle of Willis at branch points of anterior comm. artery

Marfan, ADPKD (adult polycystic)

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47
Q

Variant CJD in whom?

A

Younger pts, mad cow

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48
Q

What produces CSF?

A

Choroid plexus

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49
Q

Craniopharyngioma can compress what?

What is seen on imaging?

Can it recur?

A

Optic chiasm –> bitemp hemianopsia

Calcifications

YES

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50
Q

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

Duration?
Tx?

Describe

A

U/l, Females

4-72 hours
NSAID, triptans, dihydroergotamine

Pulsating pain w/nausea, photophobia, may have aura

51
Q

Medial medullary syndrome is caused by what?

Causes what?

A

Infarct of anterior spinal artery

B/l paralysis of arms and shoulders

52
Q

PCA lesion located where?

Causes what?

A

Occipital lobe

Contralateral hemianopia w/macular sparing

53
Q

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

Duration?
Tx?

Describe

A

U/l, MALES

15min - 3 hr
Sumatriptan

Excruciating periobital pain w/lacrimation and rhinorrhea

54
Q

Sustained, involuntary m. Contraction is what?

A

Dystonia

55
Q

Oligodendroglioma mal/B9?

What appearance on biopsy?

A

Malignant

Fried egg

56
Q

Uncal herniation is what?

A

Displacement of temporal lobe under the tentorium cerebelli

57
Q

Give the flow of CSF from start to finish

A

Lateral ventricles –> 3rd ventricle via Foramen of Monroe –> 4th ventricle via Cerebral aqueduct –> subarachnoid space via foramen of Magendie and Luschka

58
Q

Epidural hematoma may cause what?

A

CN3 palsy

59
Q

Normal pressure hydrocephalus can cause what in adults?

Presents how?

What improves sx? Tx how?

A

Dementia due to increased CSF and dilated ventricles

Urinary incontinence, gait instability, dementia

LP, therefore tx w/VP shunt

60
Q

What disease causes relapsing neurologic deficits w/periods of remission?

A

M.S.

61
Q

M.S. Symptom triad?

A

SIN
Scanning speech
INO/Intention tremor
Nystagmus

62
Q

Where is Broca’s area?

Lesion causes what?

A

Inferior frontal gyrus of frontal lobe

Pt can’t speak, they are frustrated, CAN comprehend

63
Q

Moderate global ischemia leads to what?

Where?

A

Infarct in watershed areas

Area bw ACA and MCA

64
Q

What presents w/foot deformities (pes cavus, hammer toe), LE weakness (foot drop) and sensory deficits?

Inheritance?

A

Charcot-Marie-Tooth

AD

65
Q

Give the microscopic cellular changes of ischemic stroke timeline

A

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
Q

What causes intracerebral (parenchyma) hemorrhage?

Due to what?

Most common site?

A

Charcot-Bouchard microaneurysms of lenticulostriate vessels

HTN

Basal ganglia

67
Q

Alzheimer’s has what inherited increase risk?

Decreased?

A

APOE4

E2

68
Q

Where is Wernicke’s area?

Lesion causes what?

A

Superior temporal gyrus of temporal lobe

Fluent speech that makes no sense (No comprehension)

69
Q

Pathogenesis of Migraine HA?

A

Irritation of CN 5, meninges, or blood vessels

70
Q

What is Krabbe Disease?

Inheritance?

A

Def. of glactocerbrosidase, accumulates in macrophages –> leukodystrophy

AR

71
Q

Lesion of MCA affects what?

Symptoms?

A

Upper limb and face, temporal lobe-Wernicke, frontal lobe-Broca

Contralateral paralysis and sensory loss
Aphasia if dominant hemisphere

72
Q

Meningioma occurs in whom?

Mal/B9? Of what?

Histology shows what?

A

Adult female

B9 tumor of arachnoid cells

Whorled pattern, psammoma bodies

73
Q

Lacunar stroke due to what?

Involves what?

A

Hyaline arteriosclerosis (from HTN or DM)

Lenticulostriate vessels –> cystic areas of infarction

74
Q

What causes Lateral medullary (Wallenberg) syndrome?

Sx?

A

Infarct of PICA

Dysphagia, hoarseness, dec. Gag reflex (Nuc. ambiguus - CN 9-11)

75
Q

Lenticulostriate lesion affects what?

Sx?

A

Striatum, IC

Contralateral paralysis and/or sensory loss

76
Q

Thrombotic stroke due to what?

Most common spot?

What kind of infarct?

A

Rupture of atherosclerotic plaque

Atherosclerosis at branch points of bifurcation in ICA and MCA

Pale

77
Q

Glioblastoma occurs in whom?

Mal/B9?

Arises where?

Prognosis?

A

Adults

Mal

Cerebral hemisphere –> crosses corpus callusum

Poor

78
Q

Focal seizures most commonly affect what part of the brain?

Often preceded by what?

A

Medial temporal lobe

Aura

79
Q

Spongiform encephalopathy due to what?

A

PrPc converted to Beta-pleated PrPsc

80
Q

Schwannoma involves what?

+ for what?

B/l tumors seen in what?

A

CN8, CPA

S100

NF2

81
Q

Medulloblastoma prognosis?

What can happen?

A

Poor, metastasis via CSF

Metastasize to cauda equina

82
Q

PML is caused by what?

Presents how?

A

JC virus

In immunosuppressed or AIDS, rapidly progressive neurological signs

83
Q

What adult tumor presents as seizures and compresses but does not invade the cortex?

A

Meningioma

84
Q

Syringomyelia main defects?

A

Cystic degen of SC
Loss of pain/temp in cape like dist (AWC)
Dorsal expan –> destroys AH (LMN)
Horner Syndrome (lateral horn)

85
Q

Biopsy of what tumor shows thick eosinophilic processes of astrocytes and eosinophilic granular bodies? Aka what?

tumor + for what?

A

Pilocytic astrocytoma, Rosenthal fibers

GFAP

86
Q

Congenital failure of cerebellar vermis to develop?

Presents how?

A

Dandy-walker

Absent cerebellum, dilated 4th ventricle, hydrocephalus

87
Q

ACA lesion affects what?

Sx?

A

Lower limb

Contralateral paralysis and sensory loss

88
Q

Congenital downward displacement of cerebellar vermis and tonsil through foramen magnum is what?

Assoc w/what?

A

Arnold-Chiari

Meningomyelocele

89
Q

Tonsillar herniation is what?

Leads to what?

A

Cerebellar tonsil into foramen magnum

Compression of brain stem –> cardiopulmonary arrest

90
Q

Most common form of spongiform encephalopathy is what?

Contracted how?

A

Creutzfeldt-Jakob

Sporadic, or infected via HGH or corneal transplant

91
Q

What is Adrenoleukodystrophy due to?

Inheritance?

Damages what?

A

Impaired add. Of CoA to long-chain FA’s

X-linked

Adrenals, white matter of brain

92
Q

What 3 structures does an uncal herniation compress? What does each one cause?

A

CN3 - down and out dilated pupil
PCA - contralateral homonymous hemianopsia
Paramedian artery - Duret hemorrhage

93
Q

Huntington’s is due to what?

Inheritance? W/what?

A

Degen of GABAnergic neurons in the caudate nucleus

AD, w/CAG repeats

94
Q

What has morphologic changes of cerebral atrophy, narrowed gyri, widened sulci, dilation of ventricles?

A

Alzheimer’s

95
Q

What is Sturge Weber syndrome?

A

Neural crest anomaly

Sporadic, port wine Stain
Tram track calcification
Unilateral
Retardation
Glaucoma, GNAQ gene
Epilepsy
96
Q

Tuberous Sclerosis on what chromosome?

Inheritance?

CFs?

A

16

AD

Ash-leaf spots, Shagreen patches, renal angiomyolipoma

97
Q

VHL on what ch.? Inheritance?

What tumors assoc w/it?

A

3, AD

HARP
Hemangioblastoma, angiomastosis, RCC, Pheos

98
Q

NF1 on what ch.?

NF2?

A

17

22

99
Q

What tumor has perivascular rosettes w/rod-shaped blepharoplasts?

Prognosis?

A

Ependymoma

Poor

100
Q

“Motor oil” fluid from tumor?

What characteristic about it?

A

Craniopharyngioma

Most common childhood supratentorial tumor

101
Q

What childhood tumor can cause precocious puberty in males?

Due to what?

A

Pinealoma –> cause Parinaud syndrome (Vertical gaze palsy)

B-hCG production

102
Q

Subfalcine herniation may compress what structure?

A

ACA

103
Q

What causes Tabes Dorsalis?

Results from what?

Sx?

A

Tertiary syphilis

Demyelination of dorsal columns and roots

Shooting pain, Argyll Robertson pupil, loss of DTRS

104
Q

What has a + Romberg sign?

A

Tabes Dorsalis

105
Q

Vit B12 def causes what?

A

Demyelination of spinocerebellar tracts, LCST, and dorsal columns

106
Q

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?

A

Cauda equina syndrome

intracerebral disk herniation or tumor

107
Q

Name the 5 pathologic findings in Brown-Sequard syndrome

A

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
Q

CN 10 lesion results in what?

Ex. Lesion on Right side

A

Uvula deviates AWAY from side of lesion

Uvula deviates to the left

109
Q

Where are high frequency sounds heard? Describe

A

Base of cochlea (thin and rigid)

110
Q

Where are low frequency sounds heard? Describe

A

Apex near helicotremma (wide and flexible)

LA helicopter

111
Q

Most common cause of viral conjuctivitis?

A

Adenovirus

112
Q

What is myopia?

How to correct?

A

Nearsightedness, eye too long for refractive power

Diverging lens (concave)

113
Q

What is hyperopia?

How to correct

A

Farsightedness, eye too short

Converging (convex) lens

114
Q

What is an astigmatism?

How to correct?

A

Abnormal curvature of retina, diff refractive power at diff axes

Cylindrical lens

115
Q

Where is aqueous humor of the eye made?

How do you decrease it?

A

nonpigmented epithelium of ciliary body

Beta blockers, a2 agonists, CAI’s

116
Q

What are 3 causes of secondary open-angle glaucoma?

More common in whom?

A

Blocked trabecular mesh work from wbc’s (uveitis)
From rbc’s
From retinal elements

Older nyukkas

117
Q

Primary cause of closed-angle glaucoma?

A

Enlargement or forward movement of lens against central iris -> obstruction of normal aqueous flow through pupil, impedes flor through trabecular meshwork

118
Q

Secondary cause of closed-angle glaucoma?

A

Hypoxia from retinal disease

119
Q

Acute closure glaucoma sx?

Do not give what? Why?

A

Very painful, red eye, sudden vision loss, frontal HA, dilated pupil

Epi, due to mydriasis effect

120
Q

Describe the pathway of the pupillary light reflex

A

Light sends signal via CN2 to pretectal nuclei
In midbrain it activates b/l Edinger-Westphal nuclei
Pupils constrict b/l

121
Q

An afferent pupillary defect due to optic nerve damage or retinal injury results in what?

Called what?

A

DEC b/l pupillary constriction when light is shone in affected eye

Marcus Gunn pupil

122
Q

Describe pathway of miosis

A

1st neuron in EW nucleus to ciliary ganglion of CN 3

2nd neuron in short ciliary nerves to sphincter pupillae muscles

123
Q

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?

A

CN 3, 4, V1, V2, 6, ICA
CN 6

Cavernous sinus –> IJV

124
Q

What causes disinhibited behavior (hyperphagia, hypersexuality, hyperorality)?

Due to what lesion?

Example of inciting cause?

A

Kluver-Bucy syndrome

amygdala b/l

HSV-1 encephalitis

(Other) Board Prep (19 decks)

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