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Pathology > Neuropathology > Flashcards

Neuropathology Flashcards

1
Q

What is the central nervous system (CNS) made up of?

A

Brain and Spinal cord

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2
Q

What is the peripheral nervous system (PNS) made up of?

A

Somatic nervous system

Autonomic nervous system
- sympathetic nervous system
- parasympathetic nervous system

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3
Q

Sympathetic nervous system

A

almost always has a positive function
Neurons send fibres (exons)

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4
Q

Parasympathetic nervous system

A
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5
Q

Epidemiology of stroke

A

2nd most common cause of death worldwide - 100,000 cases each year in the UK
Life time risk over 25 years is approximately 25%

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6
Q

What is a stroke?

A

Is a loss of brain function caused by disruption of blood supply

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7
Q

What is a stroke mainly caused by?

A

Caused by acute interruption of brain arterial blood supply by a thrombus

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8
Q

What does a stroke lead to?

A

Leads to tissue ischemia
- Lack of blood supply
- Cells starved of oxygen and glucose
- Cells suffer rapid necrotic death

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9
Q

How are strokes diagnosed?

A

sign and symptoms CT, MRI, angiography

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10
Q

How are strokes treated?

A

Thrombolysis – “clot buster” medicine e.g. Alteplase, urokinase
Thrombectomy
Aspirin and other antiplatelets for ischemic stroke and not for hemorrhagic storke

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11
Q

What are the two types of stroke?

A

Ischemic stroke (80%)
Haemorrhagic stroke (10-20%)

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12
Q

Mechanisms of injury in stroke

A
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13
Q

What is epilepsy?

A

Brain disorder characterised by recurrent seizures
Imbalance in excitatory and inhibitory neurotranmitters
Disordered electrical discharge (“firing”) of neurons

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14
Q

How much of the population does epilepsy affect?

A

Affects 1-2% of the population

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15
Q

How is epilepsy diagnosed?

A

Patient history, EEG and MRI

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16
Q

What are the two types of seizures?

A

generalised and focal seizures

17
Q

Generalised seizures

A

Loss of consciousness accompanied by symmetrically synchronous EEG discharges
Falling fits lasting minutes – tonic and clonic phases
Transient ‘absence’ of 10-15 seconds

18
Q

Focal seizures

A

Consciousness retained
Discharge from a localised area of the cortex
Example: Temporal lobe epilepsy
Hallucinations of smell, taste, hearing, sight

19
Q

What is the cause of epilepsy?

A

Idiopathic (‘unknown’) – most common
Genetic – rare (<1%)
Mutations in Na+ and K+ channel proteins
Injury of cerebral cortex by trauma, vascular defects or infection

20
Q

What is the treatment of epilepsy?

A

Antiepileptic drugs
Vagal nerve stimulation (VNS) device.
Ketogenic diet
Surgery

21
Q

What is a neurodegenerative disorder?

A

Group of illnesses with the common feature of progressive neuronal cell loss, but distinct clinical phenotypes and genetic characteristics

22
Q

Alzheimer disease (AD)

A

Most common neurodegenerative disease
Most common cause of dementia in older adults

23
Q

What are the clinical manifestations of alzheimer’s disease?

A

Massive shrinkage of brain cortex
Widening of sulci
Enlargement of ventricles
drastic changes in behaviour
loss of memory
disorientation in space and time
difficulty in having elaborate thoughts
problems in speaking reading and writing

24
Q

What are the two classical lesions found in the CNS with Ahzheimer’s disease?

A

Amyloid plaques - extracellular deposits of b-amyloid peptide (AB)
Neurofibrillary tangles - intracellular bundles of microtubule-associated phosphorylated (MAP) protein ‘tau’

25
Q

How is alzheimer’s disease diagnosed?

A

Complete and accurate medical history
exclude other causes of dementia
test for mental status
full neurological exam
Brain imaging: PET, MRI, CT

26
Q

How is Alzheimer’s disease treated?

A

Acetylcholinesterase inhibitors - prevents the breakdown of acetylcholine - leads to better communication between nerve cells e.g. donepezil, galantamine, rivastigmine

Glutamate receptor antagonist: e.g. memantine

27
Q

What is Huntington disease (HD)?

A

Autosomal dominant movement disorder, characterised by involuntary jerky movements of parts of the body. Symptoms starts in the 30s and 40s

28
Q

What are the early symptoms of HD?

A

Forgetfulness and thought disorders - eventual dementia

29
Q

What area of the brain is affected with HD?

A

Primary area of the brain is affected by neuronal loss is the striatum.

30
Q

How is HD transmitted?

A

Dominantly transmitted with 50% risk to develop the disease in each child.

31
Q

What are the manifestations of Huntington’s disease?

A

Cognitive - language difficulties, decreased attention
Motor - chorea, bradykinesia, impaired speech, impaired walking
Behavioural - apathy, depression

32
Q

Treatment of HD

A

Only symptomatic treatment, no permanent cure
Tetrabenazine: symptomatic treatment of hyperkinetic movement

Pathology (11 decks)

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