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MRCPsych > Neuropathology > Flashcards

Neuropathology Flashcards

1
Q

When are balloon cells and Hirano bodies seen together?

A

Pick’s disease

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2
Q

What happens to frontal and temporal lobes in Pick’s disease?

A

Asymmetrical atrophy

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3
Q

What are pick cells?

A

Swollen cortical pyramidal cells

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4
Q

What is the spongiform encephalopathy secondary to in CJD?

A

Neutropil vacuolation

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5
Q

Protective factor against Alzheimer’s dementia

A

Smoking
NSAIDs
Oestrogen
Premorbid intelligence and education

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6
Q

Macroscopic changes in Alzheimer’s

A

Enlargement of lateral and 3rd ventricles
Global brain atrophy
Reduction in brain weight
Sulcal widening

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7
Q

Microscopic changes in cerebral cortex in Alzheimer’s

A 
Neuronal loss
Senile plaques
Neurofibrillary tangles
Reactive astrocytosis
Shrinking of dendritic branching
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8
Q

Stain used in detection of Pick bodies

A

Anti-tau antibodies

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9
Q

Which memories are lost in dissociative amnesia?

A

Loss of memory of personal events well rehearsed

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10
Q

Histological changes of dementia pugilistica

A

Neuronal loss

Neurofibrillary tangles

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11
Q

Macroscopic changes in dementia pugilistica

A

Thinning of corpus callosum
Perforation of septum pellucidum
Ventricular enlargement

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12
Q

What are lewy bodies made of?

A

Alpha synuclein

Ubiqutin

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13
Q

What are lewy bodies made of?

A

Alpha synuclein

Ubiqutin

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14
Q

Where would you find the degenerative changes associated with Wernicke’s encephalopathy?

A

Gliosis and small haemorrhages in structures surrounding the third ventricle and aqueduct - mamillary bodies, hypothalamus, mediodorsal thalamic nucleus, colliculi and midbrain tegmentum

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15
Q

Findings in CSF of somebody with Alzheimer’s

A

Reduced beta-amyloid
Increased tau and phosphorylated tau
Increased tau-to-amyloid ratio

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16
Q

MRI findings of somebody with aggression and stereotyped motor behaviour

A

Hypoplastic cerebellum

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17
Q

What are hirano bodies made of?

A

Intracellular aggregates of actin and actin-associated proteins

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18
Q

What is Binswanger’s disease?

A

Subcortical vascular dementia

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19
Q

What is Binswanger’s characterised by?

A

Presence of many small infarctions of the white matter that spares the cortical regions

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20
Q

Is there correlation between number of lewy bodies and cognitive decline?

A

There is no simple correlation

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21
Q

Which antibody could be used to identify Lewy bodies?

A

Antibody to protease ubiquitin

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22
Q

What stain could you use to identify lewy bodies?

A

Antibodies to alpha-synuclein

23
Q

What are lewy body neurites?

A

Nerve cell processes that contain alpha-synuclein

24
Q

List 5 tauopathies

A
  1. AD
  2. Pick’s disease
  3. PSP
  4. Corticobasal degenerations
  5. Frototemporal dementia with parkinsonism
25
Q

List 3 synucleinopathies

A
  1. PD
  2. DLB
  3. MSA
26
Q

Most common type of frontotemporal dementia

A

Frontal lobe degeneration type

27
Q

Pathology of frontal lobe degeneration of FTD

A

Spongiform degeneration or microvacuolation of the superficial neutropil seen chiefly in layers III and V of the cortex

28
Q

Loss of which type of cells occurs in frontal lobe degeneration type of FTD

A

Large cortical nerve cells

Minimal gliosis

29
Q

How is Pick’s disease characterised?

A

Preponderance atrophy in the frontotemporal regions

30
Q

What are the 3 types of FTD?

A
  1. Frontal lobe degeneration type
  2. Pick’s type
  3. Motor neurone disease type
31
Q

What are Pick’s bodies?

A

Masses of cytoskeleton elements

32
Q

What are Pick’s cells?

A

Abnormal swollen oval-shaped neuronal cells with loss of Nissl’s substance and peripherally displaced nucleus

33
Q

Pathology associated with Pick’s type FTD

A

Loss of large cortical cells
Abundant gliosis
Pick’s bodies

34
Q

How does MND type of FTD differ from the others?

A

Cerebral atrophy is less marked

35
Q

What are the 3 forms of CJD?

A
  1. Sporadic
  2. Familial
  3. Variant
36
Q

What type of CJD is related to bovine spongiform encephalopathy?

A

Variant

37
Q

Microscopic pathology of CJD

A

Spongiform encephalopathy secondary to neutropil vacuolisation

38
Q

Where is prion protein coded?

A

Chromosome 20

39
Q

Which stain can be used to identify prion protein?

A

Immunoperoxidase

40
Q

What is there accumulation of in vCJD?

A

Prion protein

41
Q

What is the best test for vCJD?

A

MRI

42
Q

Features of classic CJD - age & course

A

Elderly

Short course

43
Q

Is pulvinar sign seen in classic CJD?

A

No

44
Q

In which type of CJD can prion protein be isolated from tonsillar tissue?

A

vCJD

45
Q

What is the most common psychiatric presentation in AIDS?

A

HIV-related dementia

46
Q

Where is the primary auditory cortex?

A

Heschl’s gyrus

47
Q

What gross pathological changes occur in the brain in schizophrenia?

A

Brain weight, length and volume of cerebral hemispheres decrease

48
Q

What enlarges in the brain in schizophrenia?

A

Lateral ventricles

49
Q

What would reduced in the parahippocampla gyrus or hippocampus?

A

White matter

50
Q

What histological changes would you see in schizophrenia?

A

Reduced cell numbers or cell size in hippocampus and DLPFC

51
Q

MRI in bipolar and unipolar mood disorders

A

White matter hyperintensities particularly in deep subcortical white matter

52
Q

Which group of people with mood disorders are white matter hyperintensities most associated?

A

Elderly - linked to risk factors for vascular disease

53
Q

In terms of prognosis, what do white matter hyperintensities suggest?

A

Poor prognosis

MRCPsych (19 decks)

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