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Path E3 > Neuropath > Flashcards

Neuropath Flashcards

1
Q

Hypoxic injury

A

Loss of ribonucleoproteins and desaturation of cytoskeletal proteins leads to cytoplasmic eosinophilia and nuclear pykknosis

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2
Q

Red neurons

A

Neuron shrinks and becomes eosinophilia

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3
Q

Astrocytes responds to

A

Injury by proliferation of cytoplasmic process and intermediate filaments

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4
Q

Reactive gliosis by astrocytes

A

Analogous to fibrous scar

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5
Q

Oligodendrocytes injury results in

A

Demyelinating disease (MS)

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6
Q

Microglia

A

Antigen presenting cell

Can sometimes appear as rod cells

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7
Q

Neuron response to injury

A

Shrinkage Cell Body
Nuclear and nuclei degeneration
Breaks down in blood brain barrier with acute injuries

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8
Q

Astrocytes response to injury

A

Primarily responsible for repair and scar formation

Rosenthal fibers

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9
Q

Rosenthal fibers

A

Thick eosinophilic protein aggregates seen in chronic gliosis

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10
Q

Microglia cells response to injury

A

Microglia nodules

Neuropnphagia (eating of neurons) at injured site

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11
Q

Ependymal Cell Response to injury

A

Certain pathogens cause extensive ependymal injury with viral inclusions

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12
Q

Cerebral Edema Etiology

A

1) Disrupted blood brain barrier; increased vascular permeability (vasogenic)
2) Increase in water content secondarily to glial or endothelial injury (cytotoxic)

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13
Q

Cerebral edema causes

A

Compressed ventricle
Brain shifting
Swollen gyro
Narrowed sulci

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14
Q

Cerebral Edema: Brain Swelling leads to

A

Brain swelling leads to increased intracranial pressure

Present as Severe headache vomiting papilledema (swelling of optic disc)

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15
Q

Brain herniation

A

Displacement of brain tissue from one intracranial compartment to another-may result from brain swelling, tumor

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16
Q

3 types of brain herniation

A

Subfalcine (cingulate)
transtentorial (uncinate)
Tonsillar (the worst)

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17
Q

Uncinate will compress

A

CN 3

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18
Q

Hydrocephalus

A

Accumulation of excess CSF within ventricular system

Expanded ventricles with increased crainial pressure

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19
Q

Hydrocephalus caused by

A

Decreased CSF resorption (CSF flow obstructed by: Tumor, hemorrhage or inflammation)

-Increased CSF production (tumors of choroid plexus)

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20
Q

Cerebrovascular Diseases Mechanism

A

“Stroke”

1) thrombus occluded vessels
2) Moving thrombus (embolus) occluded vessels
3) Rupture of blood vessel

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21
Q

Stroke

A

Acute non epileptic neurological deficit lasting > 24 hours

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22
Q

Strokes result from 2 major processes

A

Occlusion/hypoxia

Hemorrhage

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23
Q

Brain hemorrhages

A

Intra-parenchymal hemorrhage

Subarachnoid hemorrhage

Vascular malformations

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24
Q

Most frequently affected with brain infarction

A

Middle cerebral artery

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25
Q

Brain infection risk factors

A

Hypertension, smoking, diabetes

Atherosclerosis is the most common underlying cause

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26
Q

Acute infarction

A

24-36 hours

Neurons become eosinophils

Neutrophils infiltrate into brain parenchyma

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27
Q

Subacute infarction

A

3rd-5th day

Involved tissue becomes softer in consistency

Macrophages with foamy cytoplasm begin to infiltrate

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28
Q

Chronic infarction

A

Weeks to months

Softening and liquefaction results in smooth walled cystic cavity

Loss of brain tissue

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29
Q

Intraparenchymal hemorrhage

A

Basal ganglia most commonly affected

Pons thalamus and cerebellum also affected

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30
Q

Subarachnoid hemorrage

A

Severe headaches
Rupture saccular berry anyersms

Most arise at artisan bifurcations of the circle of Willis

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31
Q

Vascular malformations hemorrhage

A

Arteriovenous malformation most common

Collection of abnormal blood vessel

Sucharachnoid or parenchyma hemorrhage results in neurologic deficits

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32
Q

Epidural hematoma

A

Rupture of a meningeal artery-arterial bleeding

Lucid interval

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33
Q

In epidural hematoma blood between

A

Skull and dura mater

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34
Q

Subdural hematoma blood between

A

Dura and arachnoid membrane

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35
Q

subdural hematoma disruption of

A

Bridging veins-Venous bleeding

Acute- Whiplash shake a baby

Chronic-elderly with brain atrophy

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36
Q

Concussion

A

Loss of consciousness with full recovery

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37
Q

Contusion

A

Disruption and hemorrhage of superficial brain caused by blunt trauma

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38
Q

Laceration

A

Tearing of brain parenchyma

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39
Q

Coup lesion

A

Impact site that hits the bone in contusion

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40
Q

Contrecoup

A

Contusion that develops on site opposite front he point of impact

41
Q

Route of infection into CNS

A

1) Hematogenous spread
2) Extension of local infection
3) Direct implantation
4) Via peripheral nerves

42
Q

Acute bacterial meningitis

A

Inflammation of leptomeninges and subarachnoid space

43
Q

Cerebral abscess

A

Focal suppurative infection

44
Q

Encephalitis

A

Diffuse inflammation of brain parenchyma; infections usually viral

45
Q

Inflammation of leptomeninges spread through

A

Subarachnoid space

46
Q

Acute bacterial meningitis caused by

A

Pyogenic bacteria

47
Q

Acute bacterial meningitis risk factors

A

Extreme age
Debilitated state
Poor hygiene
Crowded living conditions

48
Q

Acute bacterial meningitis the brain is swollen with

A

Purulent exudate under subarachnoid space over cerebral hemisphere and purulence within the ventricles

49
Q

Brain Abscess

A

Usually bacteria or fungal

50
Q

Brain abscess cavity contains

A

Pus surrounded by a thick wall of granulation tissue and fibrosis

51
Q

Tuberculous Meningitis (Chronic) will present as

A

> 2-3 weeks of headache, lethargy, nausea, and vomiting

52
Q

Tuberculous Meningitis (Chronic) exudate

A

Will be gelatinous and may appear Nodular

53
Q

Cryptococcal Meningitis

A

Spherical budding yeast, found in soil and bird excrement

54
Q

Cryptococcal Meningitis will present

A

With low grade fever, debility, headache

55
Q

Cryptococcal Meningitis mostly seen

A

In both healthy and HIV patients

56
Q

Cryptococcal Meningitis exudate

A

Slimy exudate capsular material

57
Q

Encephalitis

A

Diffuse inflammation of brain parenchyma

58
Q

Encephalitis infection is

A

Viral in origin

Hepesviruses-most common

59
Q

Viral encephalitis untreated is usually

60
Q

Viral inclusion bodies

A

Within nucleus of infected neuron

Protein aggreagate of herpes virus

61
Q

Encephalitis: perivascular lympocytosis

A

Lymphocytes collected around blood vessel

62
Q

Neuronophagia and microglia nodules found in

A

Encephalitis

63
Q

Multiple Sclerosis

A

Most common primary demyelinating disorder

64
Q

MS caused by

A

Autoimmune (T Cell mediated) plus genetics

65
Q

MS usually afffects

A

Young adults females

66
Q

Irregular areas of demyelination

A

MS plaques

67
Q

Alzheimer’s familal

68
Q

Alzheimer’s microscopically

A

Senile plaque of amyloid despoists

Neurofibrially tangles - filamenotous aggregates within neuronal cytoplasm

69
Q

Parkinson’s is a degeneration of

A

Dopamine-secreting pigmented neurons of substantia nigra in the midbrain

70
Q

Parkinson’s symtopms

A 
Rigidity
Expressionless face
Stooped Posture
Fine tremor
Slower gait
71
Q

Lewy bodies

A

Intracytoplasmic eosinophlic inclusions known as Lewy bodies within pigmented neurons

72
Q

Huntington’s Disease grossly

A

Atrophy of the basal ganglia

73
Q

Huntington’s Disease type

A

AD

Gene located in chromosome 4

74
Q

Huntington’s Disease will present with

A

Spontaneous involuntary movements and dementia

75
Q

Huntington’s Disease

A

Hereditary, progressively fatal disorder

76
Q

Primary neural tumor arise from

A

Cells of the brain spinal cord or their coverings

77
Q

Neural tumors _____ is more important than ______

A

Location

Type

78
Q

Neural tumors rarely

A

Metastasize outside the CNS

79
Q

Secondary nervous system tumors

A

Lung
Breast
Prostate
-Mets to brain: far more common than Mets FROM the brain

80
Q

Most common Adult Brain tumors

A

Astrocytomas

81
Q

WHO grades

A

II well differentiated
III anaplastic
IV glioblastoma

82
Q

Astrocytoma Grade II

A

Mild cellualrity and nuclear pleomorphism

83
Q

Astrocytoma Grade III

A

Highly cellular with mitosis figures

84
Q

Grade IV glioblastoma

A

Necrosis and microvascular proliferation

85
Q

Oligodendroglioma

A

Cerebral hemisphere, well circumscribed often calcified

86
Q

Oligodendroglioma Cells with

A

Uniform round nuclei and perinuclear halo

87
Q

Ependymoma lesions are

A

Well circumscribed lesions arising from ventricular wall

88
Q

Ependymoma cells are

A

Elongated with processes radiating around blood vessels

89
Q

Meningioma derived from

A

Arachnoid matter

90
Q

Meningioma predominance

91
Q

Meningioma lesions will be

A

Firm lobulated lesions with a pushing border into underlying brain

92
Q

Psammoma bodies

A

Calcification

93
Q

Meningioma microscopically

A

Cellular whorls

Psammoma bodies

94
Q

Pediatric brain tumors

A

Pilocytic astrocytoma

95
Q

Pilocytic Astorcytoma

A

Grade I tumor

Usually in the cerebellum, often cystic

96
Q

PA: Rosenthal fibers

A

Astrocytes with hair like processes

97
Q

Medulloblastoma

A

Cerebellum, aggressive growth pattern

Grade IV tumor

98
Q

Medulloblastoma Cells disseminate through

Path E3 (8 decks)

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