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Human Disease Systems > Neuro Pathology/Histology > Flashcards

Neuro Pathology/Histology Flashcards

1
Q

This is an example of a [?] hemorrhage

A

subdural (blood cannot cross midline)

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2
Q

This is an example of a [?] hemorrhage

A

epidural (blood cannot cross suture lines)

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3
Q

This is an example of a [?] hemorrhage

A

subarachnoid (blood cannot cross midline)

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4
Q

This is an example of a [?] hemorrhage

A

intraventricular and intraparenchymal

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5
Q

In T1-weighted MRIs, the [white/grey] matter is darker; while in T2-weight MRIs, the [white/grey] matter is darker.

A

In T1-weighted MRIs, the grey matter is darker; while in T2-weight MRIs, the white matter is darker.

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6
Q

Pathology?

A

multiple sclerosis (tan-colored demyelinated plaques in white matter)

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7
Q

Pathology?

A

Wallerian degeneration

(axon degenerates distal to the point of injury and macrophages ingest debris)

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8
Q

Pathology?

A

central chromatolysis

(cell body shows swelling, nuclear eccentricity, and dispersal of the Nissl substance to the periphery of the cell)

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9
Q

Pathology?

A

trick question!!

normal astrocytes stained with GFAP

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10
Q

Pathology?

A

reactive astrocytes stained with GFAP

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11
Q

Pathology?

A

Rosenthal fibers

(chronically reactive astrocytic process; lots of proteins, so brightly eosinophilic)

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12
Q

Pathology?

A

corpora amylacea

(elaboration of astrocytic processes seen in normal aging human brains; contain glucose polymers)

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13
Q

Pathology?

A

Alzheimer type II astrocyte

(large, comma-shaped vacuolated nuclei; seen in hepatic encephalopathy as a reaction to circulating toxins from liver failure)

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14
Q

Pathology?

A

trick question!!!

satellitosis

(normal clustering of up to 5-6 oligodendrocytes around neuronal cell bodies)

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15
Q

Pathology?

A

ependymal granulation

(astrocytic response to ependymal damage in encephalitis or meningitis)

normal ependymal cells shown here for comparison

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16
Q

Pathology?

A

gitter cells

(lipid-filled macrophages; a microglial response to injury)

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17
Q

Pathology?

A

rod cells

(elongated nuclei seen in microglia as a response to injury)

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18
Q

name the herniation categories

A
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19
Q

Pathology?

A

hydrocephalus ex-vacuo

(compensatory enlargement of the ventricles)

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20
Q

paraneoplastic syndromes can produce antibodies to neural tissue and result in ataxia; common in what cancers?

A

lung, ovarian, lymphatic, breast

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21
Q

childhood neurological disorder that causes degeneration in the cerebellum and small, widened blood vessels on the skin

A

ataxis-telangiectasia

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22
Q

inherited disorder that impairs the normal absorption of fats and fat-soluble vitamins from diet

A

abetalipoproteinemia

very rare inherited form of ataxia

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23
Q

rare inherited disease that causes progressive nervous system damage and movement problems, including ataxia

A

Friedreich ataxia

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24
Q

pathology of brain infarct: 12-18 hours

A

microscopic evidence of ischemia with cytoplasmic eosinophilia

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25
Q

pathology of brain infarct: 24 hours

A

softening macroscopically

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26
Q

pathology of brain infarct: 3 days

A

PMN response peaks

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27
Q

pathology of brain infarct: 7 days

A

monocyte/macrophage response peaks; macrophages are filled with fat vacuoles due to myelin

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28
Q

pathology of brain infarct: 2-3 weeks

A

astrocytosis (astrocytes act like fibroblasts to fill in void) => eventually results in cyst formation

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29
Q

[pathology] are minute aneurysms in small vessels that can rupture and cause hemorrhage; they are usually found in the basal ganglia

A

Charcot-Bouchard microaneurysms

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30
Q

Pathology?

A

laminar necrosis

(uneven cortex surface due to laminar necrosis caused by cerebral ischemia)

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31
Q

Pathology?

A

watershed infarct

(wedge-shaped areas of infarction that occur in regions of the brain and spinal cord that lie at the most distal fields of arterial irrigation; usually seen after hypotensive episodes)

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32
Q

Pathology?

A

shower embolization

(widespread hemorrhagic lesions involving the white matter seen after fractures)

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33
Q

Pathology?

A

old MCA infarct leading to cystic cavity

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34
Q

Pathology?

A

lacunar infarct

cavities due to lost tissue with scattered fat-laden macrophages and surrounding gliosis; may be clinically silent or cause severe neurological impairment

occur in the lenticular nucleus > thalamus > internal capsule > deep white matter > caudate nucleus > pons

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35
Q

Pathology?

A

brain edema with petechiae seen on autopsy following hypertensive encephalopathy

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36
Q

Pathology?

A

subarachnoid hemorrhage

usually caused by bleeding from cerebral aneurysms

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37
Q

Pathology?

A

arteriovenous malformation

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38
Q

Pathology?

A

cavernous hemangiomas

(greatly distended, loosely organized vascular channels with thin, collagenized walls

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39
Q

localize the stroke:

weakness and sensory loss (arm>leg); if dominant hemisphere, aphasia; eyes looking toward lesion

A

middle cerebral artery complete occlusion

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40
Q

localize the stroke:

Wernicke’s receptive aphasia

A

temporoparietal branch occlusion of MCA

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41
Q

localize the stroke:

Broca’s expressive aphasia

A

frontal branch occlusion of MCA

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42
Q

localize the stroke:

contralateral weakness

A

frontal motor strip branch occlusion of MCA

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43
Q

localize the stroke:

contralateral sensory loss

A

parietal sensory strip branch occlusion of MCA

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44
Q

localize the stroke:

hemineglect

A

nondominant parietal lobe branch occlusion of MCA

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45
Q

localize the stroke:

ideomotor apraxia

A

dominant parietal lobe branch occlusion of MCA

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46
Q

localize the stroke:

weakness and sensory loss leg>arm

A

anterior cerebral artery (rarer than MCA)

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47
Q

localize the stroke:

hoarse, difficulty swallowing, Horner’s

A

PICA occlusion (Wallenberg syndrome), medial part of lateral medulla (nucleus ambiguous, descending sympathetics)

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48
Q

localize the stroke:

ipsilateral loss of pain and temperature for face; contralateral loss of pain and temperature for body; vertigo, nausea, vomiting, nystagmus

A

PICA occlusion (Wallenberg syndrome), lateral part of medulla (descending trigeminal, spinothalamic tract, vestibular nuclei)

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49
Q

localize the stroke:

ipsilateral ataxia

A

PICA occlusion (Wallenberg syndrome), far lateral medulla (inferior cerebellar peduncle)

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50
Q

localize the stroke:

Wallenberg + tinnitus and hearing loss

A

AICA occlusion

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51
Q

localize the stroke:

limited weakness, dysarthria

A

paramedian pontin infarcts (lacunae)

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52
Q

localize the stroke:

more weakness and dysarthria; eyes looking away from lesion

A

large hemi-pontine infarct (lagoonar infarct)

eyes look away from lesion if 6th nerve nucleus is hit

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53
Q

localize the stroke:

locked-in syndrome (fully away but quadriplegic except for vertical eye moments and blink)

A

basilar artery occlusion where whole pons is infarcted

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54
Q

localize the stroke:

diplopia (Weber syndrome)

A

top of the basilar artery occlusion (top of the basilar syndrome), midline midbrain

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55
Q

localize the stroke: homonomous hemianopsia (loss of the same half of vision in both eyes)

A

top of the basilar artery occlusion (top of the basilar syndrome), bilateral PCA

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56
Q

warning signs before full basilar occlusion: vestibular nuclei

A

vertigo

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57
Q

warning signs before full basilar occlusion: corticospinal tract

A

hemiparesis/bilateral leg weakness

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58
Q

warning signs before full basilar occlusion: corticobulbar tract

A

dysarthria

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59
Q

warning signs before full basilar occlusion: cerebellar peduncle/cerebellum

A

ataxia

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60
Q

warning signs before full basilar occlusion: vestibular nucleus

A

nystagmus

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61
Q

warning signs before full basilar occlusion: lower midbrain reticular activating system

A

loss of consciousness

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62
Q

posterior circulation stroke signs

A

dangerous D’s: dizziness, dysphagia, dystaxia, diplopia, dysarthria, drop attacks

nasty N’s: nausea, numbness, nystagmus

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63
Q

picornavirus family viruses are small, [enveloped/non-enveloped], [ss/ds] [RNA/DNA] viruses

A

picornavirus family viruses are small, non-enveloped, ss RNA viruses

they serve as their own mRNA (do not carry RNA polymerase)

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64
Q

picornaviruses that cause meningitis include [?]

A

poliovirus types 1, 2, 3; coxsackie virus; echovirus types 1-34

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65
Q

picornaviruses are spread via [?]

A

fecal-oral route

there are no animal reservoirs, but flies can mechanically transmit viruses

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66
Q

name the pathogen:

paralysis caused by destruction of anterior horn cells in spinal cord and brainstem motor neurons => asymmetric flaccid paralysis with no sensory loss

A

poliovirus types 1, 2, 3

bulbar polio affects the pharynx, vocal cords, and diaphragm => ventilatory support or death

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67
Q

treatment for picornavirus infection is supportive for immunocompetent and [drug] for infants and immunodeficient

A

pleconoril

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68
Q

what vaccines exist for poliovirus?

A

sabin vaccine (live-attenuated organisms from all 3 strains, discontinued in US)

salk vaccine (killed virus)

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69
Q

name the pathogen:

vesicular lesions (hand, foot, and mouth disease) and herpes-like vesicles in buccal mucosa

A

Group A coxsackie virus

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70
Q

name the pathogen:

meningitis, myocarditis, pericarditis

A

Group B coxsackie virus

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71
Q

name the pathogen:

leading cause of viral meningitis; also causes a rash (maculopapular, petechial, or vesicular); usually self-limiting

A

echovirus types 1-34

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72
Q

name the pathogen:

protozoan parasite that accesses host through the nose, travels along olfactory nerve to the brain to cause primary amebic meningoencephalitis

A

Naegleria fowleri

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73
Q

though usually fatal within 3-6 days, some cases of N. fowleri have been successfully treated with [drug]

A

amphotericin B + miltefosine

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74
Q

name the pathogen:

long, very thin spirochet with hook on one or both ends; highly motile; transmission via contact with water, food, or soil contaminated with infected urine => entry via ingestion or abrasian

A

Leptospira interrogans

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75
Q

name the pathogen:

leptospirosis: ranges from subclinical to mild flu-like symptoms, meningitis, or severe system disease (Weil’s disease)

A

Leptospira interrogans

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76
Q

Dengue virus is [enveloped/non-enveloped], [ss/ds] [RNA/DNA] virus

A

Dengue virus is an enveloped, ss RNA virus

(genome serves as mRNA)

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77
Q

Dengue virus transmission is via [vector]

A

urban mosquito Aedes aegypti; common in tropical areas

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78
Q

name the pathogen:

fever, chills, headache, myalgias, bone pain; rash frequently present; typically extremely painful and runs its course in 5-7 days

A

Dengue virus

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79
Q

Dengue virus immunity is characterized by [?], which cause a more severe secondary infection

A

enhancing antibodies

infection with a second serotype => formation of immune complexes that are internalized via Fc receptors on macrophages => more efficient infection and increased replication

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80
Q

secondary infection with a different serotype of [virus] can cause [clinical syndrome] due to the action of enhancing antibodies

A

secondary infection with a different serotype of Dengue virus can cause dengue hemorrhagic fever (DHF) or dengue shock syndrome

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81
Q

[virus family] are enveloped, ambisense RNA

A

Arenaviruses

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82
Q

Arena viruses are enveloped, ambisense RNA viruses that cause [clinical syndromes]

A

Lassa, Machupo, Junin

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83
Q

Filoviruses are [enveloped/non-enveloped], [positive/negative] sense [RNA/DNA] viruses that cause [clinical syndromes]

A

Filoviruses are enveloped, negative sense RNA viruses that cause Marburg and Ebola

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84
Q

minor outbreaks of [virus] in the US have been associated with contact with aerosolized mouse feces/urine

A

hantaan virus

85
Q

their vector is the deer mouse, and outbreaks of [virus] coincide with high rainfall

A

sin nombre virus

86
Q

name the pathogen:

hemorrhagic fever or pulmonary shock syndrome (coagulopathy, petechial hemorrhage, bleeding from gums/eyes/ears/GI tract, DIC, organ failure, death)

A

hantaan virus

87
Q

name the pathogen:

pulmonary shock syndrome (pulmonary edema, respiratory failure, death)

A

sin nombre virus

88
Q

[virus] viral particles are bull-shaped

A

rhabdovirus

89
Q

rhabdovirus is [enveloped/non-enveloped], [ss/ds] [RNA/DNA] virus

A

rhabdovirus is an enveloped, ss negative sense RNA virus

90
Q

[virus] can be identified by the excess nucleocapsid material that accumulates in host cytoplasm (Negri bodies)

A

rhabdovirus

91
Q

name the pathogen:

virus remains near bite site and replicates in local tissue, then infects peripheral nerves => retrograde axonal transport to dorsal root ganglia => travels up CNS to brain

A

rhabdovirus

92
Q

name the pathogen:

prodromal phase: once virus reaches peripheral nerves; fever, nausea, vomiting, headache, lethargy

neurologic phase: once virus reaches CNS; depression, anxiety, hallucinations, hydrophobia, photophobia, hypersalivation, paralysis, delirium, seizures

A

rhabdovirus

93
Q

rhabdovirus infections can be treated with [?]

A

rabies immune globulin (RIG) from human serum

94
Q

rhabdovirus vaccine is [?]

A

inactivated virus prepared from purified virus

95
Q

Streptococcal agalactiae are gram [positive/negative] cocci in [chains/clusters], [?]-hemolytic, catalase [positive/negative], and [?] resistant

A

Streptococcal agalactiae are gram positive cocci in chains, B-hemolytic, catalase negative, bacitracin resistant

96
Q

the number one cause of neonatal sepsis and meningitis is [?]

A

Streptococcal agalactiae

97
Q

name the pathogen:

respiratory distress, fever, lethargy, hypotension; pneumonia => bacteremia => meningitis

A

Streptococcal agalactiae

98
Q

Streptococcal agalactiae is treated with [?]

A

penicillin or ampicillin IV, sometimes and aminoglycoside

99
Q

one of the two most common causes of neonatal sepsis and meningitis, [?] has an antiphagic K1 capsular polysaccharide

A

Escherichia coli

100
Q

[?] is the most common cause of non-neonatal meningitis in children <6 years old

A

Streptococcus pneumoniae

frequent cause of cortical deafness/deficits

101
Q

unimmunized children <2 years old are at risk for meningitis from [?]

A

Haemophilus influenzae

102
Q

Neisseria meningitidis is a gram [positive/negative] [shape] transmitted via [?]

A

Neisseria meningitidis is a gram negative diplococci transmitted via airborne droplets

103
Q

name the pathogen:

meningococcemia (skin involvement - petechial rash, may produce purpura); meningitis; fulminating meningitis; Waterhouse-Friedrichsen syndrome (DIC and shock)

A

Neisseria meningitidis

104
Q

Neisseria meningitis tests:

[?] is positive for glucose only, while [?] is positive for glucose and maltose

A

N. gonorrhoeae is positive for glucose only, while N. meningitidis is positive for glucose and maltose

105
Q

Neisseria meningitidis infection is treated with [?]

A

penicillin G (alternatives = ceftriaxone, chloramphenicol)

106
Q

prophylaxis for close contacts of someone infected with Neisseria meningitis includes [?]

A

rifampin

107
Q

Pathology?

A

acute pyogenic meningitis (S. pneumoniae; suppurative inflammation)

108
Q

Pathology?

A

H. influenzae meningitis (basal inflammation)

109
Q

Pathology?

A

Neisseria meningitidis

last photo is Waterhouse-Frederichson syndrome: overwhelming meningococcemia leads to massive hemorrhage in the adrenal glands

110
Q

Pathogen?

A

S. pneumoniae

gram positive cocci arranged in pairs (gram positive diplococci)

111
Q

Pathogen?

A

Neisseria fowleri

gram negative cocci arranged in pairs (gram negative diplococci)

112
Q

Pathogen?

A

H. influenzae

(gram negative rod)

113
Q

Pathology?

A

brain abscess

centrally liquefactive necrosis, surrounded by fibrous capsule, associated cerebral edema

114
Q

Pathology?

A

brain abscess

centrally liquefactive necrosis, surrounded by fibrous capsule, associated cerebral edema

115
Q

Pathology?

A

tuberculous meningoencephalitis

creamy or gelatinous exudate centered at the base of the brain

116
Q

Pathology?

A

caseating granuloma in tuberculous meningoencephalitis

117
Q

Pathology?

A

obliterative endarteritis

severe proliferating endarteritis; a complication of tuberculous meningoencephalitis

118
Q

Pathology?

A

tuberculoma

inflammation may become localized and form a mass-like lesion; a complication of tuberculous meningoencephalitis

119
Q

Pathology?

A

pott disease

vertebral tuberculosis (collapse of vertebral bodies with resultant spinal cord compression); complication of tuberculous meningoencephalitis

120
Q

HIV is a spherical, [enveloped, non-enveloped], [ss/ds] [RNA/DNA] virus

A

HIV is a spherical, enveloped, positive sense ss RNA virus

121
Q

genome elements found in retroviruses:

A

pol: encodes RT, IN, and protease
env: encodes gp120 and gp41
gag: encodes nucleocapsid, capsid, matrix proteins
long terminal repeat: regulates viral gene expression

122
Q

genome elements unique to HIV-1:

A

tat: boosts expression of viral genes
rev: promotes viral RNA transport from nucleus to cytoplasm

123
Q

[?] is a structural protein that makes up most of the HIV viral core (capsid); measurement provides indication of viral load

A

p24

124
Q

HIV viral DNA is detectable [?] after infection, p24 is detectable [?] after RNA

A

HIV viral DNA is detectable 10 days after infection, p24 is detectable 4-10 days after RNA

125
Q

Pathogen?

A

toxoplasma gondii

intracellular tachyzoite within macrophage

126
Q

Pathogen?

A

toxoplasma gondii

bradyzoite or cyst in brain tissue

127
Q

Pathogen?

A

cryptococcus neoformans

India ink stain

128
Q

Pathogen?

A

pneumocystis jirovecii

trophozoites stained with giemsa (can also be visualized with Gomeri stain)

129
Q

Pathogen?

A

kaposi’s sarcoma

non-tender, purple-reddish maculopapular skin lesions caused by human herpes virus 8

130
Q

Pathology?

A

Primary CNS lymphoma

single lesion; contrast enhancing

131
Q

Pathology?

A

toxoplasmosis

multiple ring-enhancing lesions

132
Q

Pathology?

A

progressive multifocal leukoencephalopathy

lesions occur int he white matter and DO NOT have an enhancing rim

133
Q

name the pathogen:

obligate intracellular parasite found within macrophages; main reservoir is the house cat, intermediate hosts include sheep and cattle

A

toxoplasma gondii

134
Q

name the pathogen:

reactivation disease in immunocompromised individuals includes encephalitis, cerebral mass lesions, pneumonitis, chorioretinitis, and systemic disease

A

toxoplasma gondii

135
Q

in infected pregnant women, newborns, and infants, toxoplasmosis is treated with [?]

A

pyrimethamine, suladiazine

136
Q

name the pathogen:

asexual growth as budding yeast at both 25 and 37 degrees (NOT dimorphic); found in the excrete of pigeons (NO person-to-person transmission)

A

cryptococcus neoformans

137
Q

name the pathogen:

primary infection occurs in the lung (usually asymptomatic); hematogenous spread => meningitis, disseminated disease (skin and bone lesions, brain abscess), leading cause of fungal meningitis

A

cryptococcus neoformans

138
Q

name the pathogen:

primitive fungus that lacks ergosterol; transmitted via droplet inhalation

A

pneumocystis jirovecii

139
Q

name the pathogen:

onset usually insidious; bilateral diffuse interstitial pneumonitis (ground glass appearance radiographically) with plasma cell infiltrates

A

pneumocystis jirovecii

140
Q

name the pathogen:

identified in tissue specimen or lavage fluids using Gomeri silver stain or Giemsa stain

A

pneumocystis jirovecii

141
Q

pneumocystis jirovecii is treated with [?]

A

TMP/SMX

resistant to antifungal drugs due to absence of ergosterol

142
Q

cytomegalovirus is a large [enveloped/non-enveloped], [ss/ds] [RNA/DNA] virus

A

cytomegalovirus is a large, enveloped, linear ds DNA virus

buds from nuclear membrane

143
Q

name the pathogen:

ubiquitous; transmitted via direct person-to-person contact, sexually, blood transfusions, tissue transplants, and from mother to infant before/during/after birth; can be isolated from tears, saliva, pharynx, semen, cervical secretions, peripheral blood leukocytes, amniotic fluid, and urine

A

cytomegalovirus

144
Q

name the pathogen:

usually asymptomatic; reactivation disease in immunocompromised host = interstitial pneumonia, retinitis, esophagitis, GI tract upset

A

cytomegalovirus

145
Q

cytomegalovirus treatment

A

ganciclovir, cidofovir, foscarnet

146
Q

primary CNS lymphoma is a diffuse, large cell non-Hodgkin lymphoma of B cell origin caused by [?]

A

Epstein Barr virus

147
Q

name the pathology:

lethargy, headache, personality changes, memory loss, confusion, weakness, seizures, cranial nerve involvement

A

primary CNS lymphoma (caused by EBV)

148
Q

progressive multifocal leukoencephalopathy is caused by [?]

A

polyoma virus JC

149
Q

polyoma virus JC is a [enveloped/non-enveloped] [ss/ds] [RNA/DNA] virus that causes [?]

A

polyoma virus JC is a non-enveloped ds DNA virus that causes progressive multifocal leukoencephalopathy

150
Q

name the pathology:

EMG:
slow repetitive nerve stimulation => decremental response

fast RNS or exercise => incremental response

A

Lambert-Eaton myasthenic syndrome (LEMS)

151
Q

Lambert-Eaton myasthenic syndrome symptoms can be treated with [?]

A

pyridostigmine (cholinesterase inhibitors)

152
Q

name the pathology:

EMG:
slow repetitive nerve stimulation => decremental response

fast RNS or exercise => no incremental response

A

myasthenia gravis

153
Q

myasthenia gravis is treated with [?]

A

pyridostigmine

immunosuppressants (steroids, azathioprine, mucophenylate, IVIG, and plasma exchange)

thymectomy

154
Q

name the neuropathy:

pain, paresthesia, and sensory loss in thumb, index, and lateral half of ring fingers of affected hand; weakness of thumb abduction and atrophy of thenar eminance

A

median nerve entrapment (carpal tunnel syndrome)

155
Q

name the neuropathy:

decreased grip and problems with finger dexterity; numbness of little finger and half of ring finger

A

ulnar neuropathy

156
Q

name the neuropathy:

wrist drop, finger drop, and weakness of supination; mild elbow flexion weakness

A

radial neuropathy

157
Q

name the neuropathy:

weakness of tow and foot dorsiflexion and foot eversion; sensory loss over dorsum of foot and lateral distal lower extremity

A

peroneal neuropathy

158
Q

name the neuropathy:

paresthesia of lateral thigh

A

lateral femoral cutaneous neuropathy

159
Q

name the radiculopathy:

weakness of shoulder abduction, elbow flexion, wrist flexion/extension; sensory loss of lateral forearm, thumb, and index finger; loss of biceps and brachioradialis reflex

A

C6 radiculopathy

160
Q

name the radiculopathy:

weakness of elbow and wrist extension, sensory disturbance of middle finger, pain in neck and dorsum of forearm, loss of triceps reflex

A

C7 radiculopathy

161
Q

name the radiculopathy:

acute back pain radiating around the anterior aspect of the thigh down into knee and occasionally down the medial aspect of lower leg as far down as the arch of the foot

A

L2, 3, 4 radiculopathy

162
Q

name the radiculopathy:

back pain that radiates down lateral aspect of the leg into the dorsum foot; decreased strength in foot dorsiflexion, toe extension, and foot eversion; leg abduction weakness in severe cases; atrophy of extensor digitorum brevis muscle of foot and tibialis; reflexes are normal

A

L5 radiculopathy

163
Q

name the radiculopathy:

pain radiates down posterior aspect of leg into foot from the back; weakness of plantar flexion, leg extension, and knee flexion; sensation reduced on posterior leg and lateral edge of the foot; loss of ankle reflex

A

S1 radiculopathy

164
Q

Pathology?

A

necrotic muscle fiber amid normal ones

165
Q

Pathology?

A

increase in inflammatory cells to digest dead myocyte

166
Q

Pathology?

A

regenerating muscle (central enlarged nuclei with prominent nucleoli in a basophilic cytoplasm)

167
Q

Pathology?

A

fiber type grouping (muscle fiber response to injury/atrophy followed by regeneration)

compare to normal checkerboard pattern (here)

168
Q

Pathology?

A

Duchenne muscular dystrophy (dystrophin absent) or Becker muscular dystrophy (dystrophin defective)

myofiber hypertrophy => myofibers degenerate and replaced by adipose tissue and endomysial fibrosis

169
Q

Pathology?

A

mitochondrial myopathy

ragged red fibers due to aggregates of abnormal mitochondria

170
Q

Pathology?

A

inclusion body myositis

trichrome stain = myofibers containing rimmed vacuoles (inclusions with reddish granular rimming)

171
Q

autosomal recessive (22q) deficiency in lysosomal enzyme arylsulfatase A

A

metachromatic leukodystrophy

172
Q

autosomal recessive (14q31) deficiency in galactocerebroside-b galactosidase

A

Krabbe globoid cell leukodystrophy

173
Q

X-linked recessive loss of function mutations in ABCD1, which encodes a protein needed to transport fatty acids into peroxisomes

A

adrenoleukodystrophy

174
Q

Pathology?

A

Krabbe globoid cell leukodystropy

deficiency in galactocerebroside-b galactosidase

CNS and PNS demyelination with yellow/gray discoloration of white matter; globoid cells (large, multinucleated macrophages filled with abnormal lipid breakdown products)

175
Q

Pathology?

A

Wernicke Korsakoff

small mamillary bodies; petechiae in mammillary bodies

176
Q

Pathology?

A

vitamin B12 deficiency

degeneration of spinal white matter, which is concentrated in the posterior and lateral columns of the spinal cord

177
Q

Pathology?

A

degeneration of cerebellar vermis due to chronic ethyl alcohol use

178
Q

Pathology?

A

hepatic encephalopathy

liver failure leads to disturbed consciousness, asterixis, and elevated serum ammonia => Alzheimer type II astrocytes in brain (large gray matter astrocytes with intranuclear glycogen)

179
Q

the only medication currently approved for primary progressive MS is [?]

A

ocrelizumab

180
Q

Pathology?

A

multiple sclerosis plaque

181
Q

Pathology?

A

multiple sclerosis plaque

182
Q

Pathology?

A

multiple sclerosis plaque showing macrophages and lymphocutes

183
Q

Pathology?

A

perivascular lymphocytes in MS plaque

184
Q

Pathology?

A

gliosis seen in a healed MS plaque

185
Q

Pathology? (right image; left is normal comparison)

A

Parkinson disease

loss of pigmented catecholaminergic neurons

186
Q

Pathology?

A

Lewy body in a substantia nigra neuron (Parkinson disease)

187
Q

Pathology?

A

Lewy body in a substantia nigra neuron (Parkinson disease)

188
Q

Pathology?

A

Huntington’s disease

gross: small brain with severe atrophy of caudate nucleus and putamen

histology: protein aggregates containing huntingtin in neurons of striatum and cerebral cortex

189
Q

Pathology?

A

diffuse astrocytoma

increased density of astrocytes without the histological features associated with high grade astrocytomas

190
Q

Pathology?

A

glioblastoma

necrosis shows a pseudo-palisaded appearance

191
Q

Pathology?

A

glioblastoma

some areas firm and others are soft due to necrosis

primary GBM = de novo in older patients, typically IDH-wildtype; secondary GBM = arise from lower grade precursor lesion in younger patients, IDH mutations

192
Q

Pathology?

A

pilocytic astrocytoma

gross: most common in cerebellum; limited infiltration of surrounding brain

histology: long, thin, “hairlike” processes that form dense fibrillary meshworks; rosenthal fibers and eosinophilic granular bodies

DO NOT have IDH mutatations

common in children and young adults

193
Q

Pathology?

A

oligodendroglioma

fried egg appearance

IDH mutation and 1p/19q codeletion REQUIRED for diagnosis

194
Q

Pathology?

A

ependymoma

micro: rosettes

195
Q

Pathology?

A

medulloblastoma

predominantly in children; exclusively in cerebellum

micro: very densely cellular with sheets of anaplastic cells and rosettes

196
Q

Pathology?

A

meningioma

predominately benign tumors of adults

197
Q

Pathology?

A

meningioma

micro: psammoma bodies

198
Q

Pathology?

A

traumatic neuroma

micro: mixture of axons, Schwann cells, and connective tissue

199
Q

Pathology?

A

schwannoma

Antoni A: highly ordered cellular component
Antoni B: loose myxoid component

200
Q

Pathology?

A

neurofibroma

201
Q

Pathology?

A

plexiform neurofibroma

202
Q

Pathology?

A

malignant peripheral nerve sheath tumor

203
Q

Pathology?

A

lacunar infarcts

204
Q

Pathology?

A

lacunar infarcts

fat-laden (foamy) macrophages and gliosis surrounding a cavity

205
Q

Pathology?

A

Alzheimer’s

brain atrophy

206
Q

Pathology?

A

Alzheimer’s

dystrophic neurites around central amyloid core

207
Q

Pathology?

A

Alzheimer’s

neurofibrillary tangle within neuron

208
Q

Pathology?

A

frontotemporal degeneration

Human Disease Systems (11 decks)

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