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JL Neurology > Neuropathology > Flashcards

Neuropathology Flashcards

1
Q

What part of the CNS is most vulnerable to hypoxic damage?

A

Neurones

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2
Q

What damage to CNS is described here - activation of glutamate receptors results in uncontrolled calcium entry into cell, neurones cant use anaerobic glyclysis?

A

Hypoxic damage

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3
Q

What is the term for a reaction within the cell body that is associated with axonal injury?

A

Axonal reaction

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4
Q

What is the most important histopathological indicator of CNS injury regardless of cause?

A

Gliosis

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5
Q

What happens to astrocytes in gliosis?

A

Undergo hyperplasia and hypertrophy

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6
Q

Disruption to what cells often associates with a local proliferation of sub-ependymal astrocytes to produce small irregularities on the ventricular surfaces termed ependymal granulations?

A

Ependymal cells

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7
Q

How much cardiac output does the brain recieve?

A

15%

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8
Q

How much oxygen does brain consume?

A

20% of body oxygen

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9
Q

Blood is supplied to the brain via what two arteries?

A

Branches of internal carotid and vertebral arteries

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10
Q

What artery is affected with frontal lobe dysfunction, contralateral sesnory loss in foot and leg, paresis of arm and foot relative sparing of thigh and face?

A

Anterior cerebral artery

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11
Q

What artery is affected with hemiparesis, hemisensory loss, aphasia/dysphasia and apraxia?

A

Middle cerebral artery

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12
Q

What does vertebrobasilar - posterior supply (three things)?

A

Brainstem
Cerebellum
Occipital lob

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13
Q

Where does Webers syndrome affect?

A

Midbrain

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14
Q

Where does medial and lateral inferior pontine sundromes afect?

A

Pons

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15
Q

Where does lateral medullary syndrome affect?

A

Medulla

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16
Q

Where is affected to cause homonymous hemianopia with macular sparing?

A

Occipital lobe

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17
Q

Where is affected to cause ataxia,. nystagmous, intention tremor and pendular reflexes?

A

Cerebellum

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18
Q

Below systolic BP of what are autoregulatory mechanisms inadequate to compensate leading to parenchymal injury?

A

50 mmHg

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19
Q

What are watershed areas (hypoxic ischaemic damage)?

A

Junctions of arterial territories which are first to be deprived of blood

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20
Q

What is the term for sudden disturbance of cerebral function of vascular origin that causes death or lasts over 24 hours?

A

Stroke

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21
Q

What is the most common type of stroke?

A

Infarction - thrombotic

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22
Q

Most common cause of spontaneous subarachnoid haemorrhage?

A

Berry aneurysm rupture 90& in internal carotid artery territory

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23
Q

What is associated with severe headache, vomiting and loss of consciousness?

A

Subarachnoid haemorrhage

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24
Q

What is associated with lacunes - small cavities found in basal ganglia, thalami and pons of elderly?

A

Hypertension

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25
Q

Lucunar infarcts?

A

Hypertension and the brain

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26
Q

What disease has primary demyelination?

A

Multiple Sclerosis

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27
Q

What three toxins can cause demyelination?

A

Cyanide, CO, solvents

28
Q

What type of demyelination are central pontine myelinosis, progressive multifocal leucoencephalopathy, subacute sclerosing panencephalitis, AIDS and axonal degeneration?

A

Secondary

29
Q

What is the most common demyelinating disease?

A

Multiple Sclerosis

30
Q

What sort of episodes does multiple sclerosis cause?

A

Relapsing and remitting flare up episodes

31
Q

What is the morphology like in multiple sclerosis?

A

External appearance of brain and spinal cord usually normal, cut surface shows multiple areas of demyelination termed plaques

32
Q

What matter does MS affect?

A

White matter

33
Q

well-demarcated plaques in white matter?

A

MS

34
Q

What CN is MS commonly seen in?

A

Optic nerve

35
Q

What type of MS has yellow/brown demyelinated plaques with an ill-defined edge which blends into surrounding white matter?

A

Acute MS

36
Q

What type of MS has plaques that are well demarcated, grey/brown lesions in white matter and classically sit around lateral ventricles?

A

Chronic MS

37
Q

What patholkogical condition can huntingtons disease and picks disease cause?

A

Dementia (primary)

38
Q

In Alzheimers disease what happens to the macroscopic pathology of the brain?

A

Decreased size and weight - cortical atrophy

39
Q

In Alzheimers disease what happens to the macroscopic pathology of sulci?

A

Widening

40
Q

In Alzheimers disease what happens to the macroscopic pathology of gyri?

A

Narrowing

41
Q

What lobes are affected in Alzheimers?

A

Frontal
Temporal
Parietal

42
Q

What happens to brainstem and cerebellum in alzheimers?

A

Normal

43
Q

What disease has intracytoplasmic neurofibrillary tangles, Amyloid plaques (extracellular senile or neuritic plaques), amyloid angiopathy and extensive neuronal loss with astrocytosis?

A

Alzheimers disease

44
Q

What protein is affected with neurofibrillary tangles in Alzheimrs?

A

Tau protein

45
Q

What colour does perivascular amyloid stain in Alzheimers?

A

Congo red

46
Q

What are the hallmarks of dementia with Lewy bodies?

A

Hallucinations and fluctuating levels of attention

47
Q

What is degenerated in dementia with Lewy bodies - same as PD?

A

Substantia nigra

48
Q

Name a neuropsychiatric disorder, onset common between 35-50 but can occur anytime?

A

Huntington’s disease

49
Q

What is the hungtintons disease triad?

A
  1. Emotional disturbance
  2. Cognitive disturbance
  3. Motor disturbance
50
Q

Chorea, myoclonus, clumsiness, slurred speech, depression, irritability and apathy?

A

Hungtintons disease - develop dementia later

51
Q

What disease has teh microscopic appearance of loss of neurons in caudate nucleus and cerebral cortex accompanied by reactive fibrillary gliosis?

A

Hungtintons disease

52
Q

A progressive dementia commencing in middle life (usually between 50 and 60 years) characterised by slowly progressing changes in character and social deterioration leading to impairment of intellect, memory and language

A

Pick’s disease

53
Q

What two lobes suffer extreme atrophy in picks disease?

A

Frontal and temporal

54
Q

What are the histological hallmarks of Pick’s disease?

A

Pick’s cells (swollen neurons)

Pick’s bodies (intracytoplasmic filamentous inclusions

55
Q

What disease gives personality and behavioural changes, speech and communication problems, changes in eating habits and reduced attention span?

A

Pick’s disease

56
Q

What four things seperate multiinfarct dementia from Alzheimers?

A
  1. Abrupt onset
  2. Stepwise progression
  3. History of hypertension/stroke
  4. Evidence of stroke seen on CT or MRI
57
Q

What is hydrocephalus?

A

Accumulation of excessive CSF within the ventricular system of the brain

58
Q

What is the normal volume of CSF?

A

120 to 150ml

59
Q

Where is CSF produced?

A

In choroid plexus in lateral and fourth ventricles of brain

60
Q

What absorbs CSF?

A

Arachnoid granulations

61
Q

What foramina does CSF travel through to get to the cisterna magna?

A

Foramina of Luschka

Foramina of Magendie

62
Q

Where does non-communicating hydrocephalus occur?

A

Within ventricular system

63
Q

Where does communicating hydrocephalus occur?

A

Outside ventricular system e.g. in SA space or at arachnoid granulations

64
Q

What are the four most common herniation routes due to an increase in ICP?

A
  1. subfalcine
  2. Tentorial
  3. Tonsillar
  4. Transcalvarium
65
Q

What are the most primary intracerebral tumours?

A

Gliomas - most commonly astrocytoma

66
Q

What arteries are usually ruptured in extra dural haemorrahges - usually associated with skull fractures?

A

Meningeal arteries

JL Neurology (12 decks)

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