Part II: Pathoma

Question 1

poliomyelitis babinski?

Answer 1

negative

Question 2

Friedreich Ataxia autosomal _______ with unstable trinucelotide repeat in _______ gene?

Answer 2

Auso recessive

Frataxin gene: mitochondiral iron regulation (increased free radicals from fentin reaction)

Question 3

Friedreich ataxia is degeneration of the ________ and is associated with

Answer 3

Degeneration of the cerebellum and spinal cord tracts

Associated with hypertrophic cardiomyopathy

Question 4

Causes of Global Cerebral Ischemia

Answer 4

Low Perfusion (atherosclerosis)

Acute decrease in blood flow (shock)

Chronic hypoxia (anemia)

Repeated Episodes of hypoglycemia (insulinoma)

Question 5

Severe Global Ischemia due to

Answer 5

vegetative state

Question 6

Moderate Global ischemia due to

Answer 6

infarcts to watershed areas (end of ACA, end of MCA)

Damage to highly vulnerable regionszzz

Question 7

What happens to the brain in moderate global ischemia?

Answer 7

Pyramidal layers areas 3,5,6 create a line of necrosis know as cortical laminar necrosis

Question 8

What are other highly vulnerable regions in moderate global ischemia?

Answer 8

Pyramidal neurons of the hippocampus

Purkinje neurons of the cerebellum

Question 9

Regional ischemia that results in focal neurologic deficits for >24hours is called

Answer 9

Ischemic stroke

Question 10

Regional ischemia that results in focal neurologic deficits for <24hours is called

Answer 10

Transient Ischemic Attack

Question 11

Ischemic stroke can result from

Answer 11

1. ) Thrombus formation (rupture of an atherosclerotic plaque which develop commonly at branch points; pale infarction at the periphery)
2. )Embolic Stroke (thrombo embolus lodges in the blood vessel classically w/ A Fib, then hemorrhagic infarction in the periphery)
3. ) Lacunar Stroke (secondary to hyaline arteriosclerosis, commonly in the lenticulostriate vessels, lake like areas of infarction)

Question 12

Where are the lacunar strokes commonly found?

Answer 12

deep structures of the brain

Question 13

What is the earliest change with ischemic stroke?

Answer 13

Red neurons found, then liquefactive necrosis

Question 14

When Charcot-Bouchard microaneurysms (a complication of HTN) rupture, what type of hemorrhage is seen and where?

Answer 14

Bleeding into the brain parenchyma

seen commonly in the basal ganglia