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Neurology > Neuropathology > Flashcards

Neuropathology Flashcards

1
Q

What are the roles of these cells:

  1. Oligodendrocytes
  2. Ependyma
  3. Microglia
A
  1. Wrap around axons forming myelin sheath
  2. Line the ventricular system
  3. Serve as a fixed macrophage system (originate from bone marrow)
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2
Q

What must you consider in an elderly patient with symptoms suggestive of dementia?

A

A vitamin deficiency

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3
Q

What occurs when neurons are subjected to hypoxia?

A
  • Activation of glutamate receptors results in uncontrolled calcium entry into cells
  • Cannot metabolise glucose anaerobically
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4
Q

What is the most important histopathological indicator of CNS injury?

A

Gliosis

  • Astrocyte hyperplasia and hypertrophy
  • Nucleus enlargement
  • Cytoplasmic enlargement
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5
Q

What are ependymal granulations?

A

Irregularities on the ventricular surface due to proliferation of astrocytes following ependymal cell disruption

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6
Q

What range of diastolic BP’s can the brain autoregulate its blood flow?

A

50 - 130 mmHg

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7
Q

What symptoms are typical in an anterior cerebral artery occlusion?

A
  • Contralateral sensory loss in foot & leg

- Paresis of arm & foot, sparing of thigh & face

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8
Q

What symptoms are typical in a middle cerebral artery occlusion?

A
  • Hemiparesis (one sided muscle weakness)
  • Hemisensory loss
  • Aphasia/dysphasia
  • Apraxia (inability to perform actions)
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9
Q

What form of visual defect occurs following insult to the occipital lobe?

A

Homonymous hemianopia with macular sparing

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10
Q

What symptoms are typical following insult to the cerebellum?

A
  • Ataxia (loss of control of body movements)
  • Nystagmous
  • Intention tremor
  • Pendular reflexes (dampened, non-brisk)
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11
Q

Which cells are most sensitive to ischaemia?

A

Neurons (more so than glial cells)

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12
Q

What is the definition of a stroke?

A

Sudden disturbance of cerebral function of vascular origin that causes death or lasts over 24 hours

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13
Q

What is the most common cause of a spontaneous subarachnoid haemorrhage?

A

Rupture of a saccular aneurysm (Berry aneurysm)

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14
Q

What symptoms would make you suspect a subarachnoid haemorrhage?

A
  • Abrupt onset
  • Severe headache
  • Vomiting
  • Loss of conciousness
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15
Q

What are lacunar infarcts that occur in hypertension within the brain?

A

Small cavities up to 10mm diameter found in the basal ganglia, thalamus and pons of elderly patient’s brains

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16
Q

What are some common symptoms that MS complain of?

A
  • Visual/speech disturbances
  • Parasthesia
  • Spasticity of one or more of the extremities
  • Gait abnormalities
17
Q

Why does the external appearance of the brain normally look normal in MS?

A

Is a disease of the white matter which is a deep structure within the brain

18
Q

Describe the plaques seen in:

  1. Acute MS
  2. Chronic MS
A
  1. Appear yellow/brown, ill-defined edges which blend into surrounding WM
  2. Grey/brown, well-demarcated in WM situated around lateral ventricles
19
Q

What are some pathological changes that occur in the brain of an Alzheimer’s patient?

A
  • Cortical atrophy
  • Widening of sulci
  • Narrowing of gyri
  • Dilatation of ventricles
    (Brainstem and cerebellum unaffected)
20
Q

What are the hallmarks of Dementia with Lewy bodies?

A

Hallucinations and fluctuating levels of attention

21
Q

What are the pathological features of dementia with Lewy bodies?

A
  • Degeneration of the substansia nigra (as seen in Parkinson’s)
  • Remaining nerve cells contain Lewy bodies
  • Cortical areas degenerate (as seen in Alzheimer’s)
22
Q

Which protein is detected following immunochemical stain in dementia with Lewy bodies?

A

Ubiquitin

23
Q

What inheritance pattern does Huntington’s follow and which gene is affected?

A
  • Autosomal dominant

- Huntingtin gene on chromosome 4p

24
Q

What are the clinical features of Huntington’s disease?

A

Triad of emotional, cognitive and motor disturbances

25
Q

What are the pathological changes within the brain of a Huntington’s patient?

A

Loss of neurons in caudate nucleus and cortex accompanied by reactive fibrillary gliosis

26
Q

What are the cerebral changes in Pick’s disease?

A

Extreme atrophy of cerebral cortex in frontal and temporal lobes (brain weight

27
Q

What are the symptoms associated with Pick’s disease?

A
  • Personality/behavioural changes
  • Speech and communication problems
  • Changes in eating habits
  • Reduced attention span
28
Q

What causes mutli-infarct dementia?

A

Damage to brain tissue from hypoxia or anoxia as a result of multiple clots with the blood vessels supplying the brain

29
Q

What signs suggest multi-infarct dementia over Alzheimer’s dementia?

A
  • Abrupt onset
  • Stepwise progression
  • History of hypertension/stroke
  • Evidence of stroke on CT or MRI
30
Q

Where is CSF produced?

A

Produced by choroid plexuses in the lateral and fourth ventricles

31
Q

What is the difference between communicating and non-communicating hydrocephalus?

A

Communicating is an obstruction of CSF flow outside the ventricular system

32
Q

What are the clinical signs of raised ICP?

A
  • Papilloedema
  • Nausea/vomiting
  • Headache
  • Neck stiffness
33
Q

Which malignant tumour has a high incidence in children?

A

Medulloblastoma

34
Q

What are common causes of single brain abscesses?

A
  • Otitis media
  • Sinusitis
  • Nasal, facial and dental infections
  • Skull fracture/trauma
35
Q

Which arteries are normally damaged to cause an extradural haemorrhage?

A

Middle meningeal arteries deep to the pterion (thinnest part of the skull)

36
Q

What is the cause for a subdural haemorrhage?

A

Disruption of bridging veins that extend from the brain surface into the subdural space

37
Q

What are the clinical symptoms for a chronic subdural haemorrhage?

A
  • Altered mental status
  • Focal neurological deficit
    (Easily confused with dementia)

Neurology (11 decks)

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