Path 3 CNS

Question 1

Insulinoma

Answer 1

Causes chronic hypoglycemia

Global cerebral ischemia

Question 2

Moderate global cerebral ischemia effect

Answer 2

Watershed infarction

Question 3

12-24 hours after ischemia

Answer 3

Red neurons

Neutrophilic infiltration

Question 4

24hrs-2 weeks after ischemia

Answer 4

Necrosis
Reactive gliosis (astrocyte hyperplasia)
Macrophages
Vascular proliferation

Question 5

> 2 weeks after ischemia

Answer 5

Gliosis (reparative)
Pseudolaminar necrosis (susceptible layers)

Question 6

3 most vulnerable neurons

Answer 6

Hippocampal pyramidal (CA1)
Neocortical pyramidal (layers 3,5,6)
Purkinje cells

Question 7

Korsakoff’s amnesia

Answer 7

Bilateral hippocampal damage

Anterograde amnesia

Question 8

Hemorrhagic emboli of white matter

Answer 8

Bone marrow emboli post trauma

Question 9

Embolisms cause

Answer 9

Hemorrhagic infarctions (reperfusion after plaque dissolution)

Question 10

Thrombosis causes

Answer 10

Nonhemorrhagic infarcts

Question 11

Hyaline arteriolar sclerosis

Answer 11

HTN leads to intracerebral hemorrhage

Question 12

Charcot-Bouchard microaneurysms

Answer 12

Lenticulostriate HTN microvascular hemorrhage (<1mm)

Question 13

Slit hemorrhage

Answer 13

Small HTN hemorrhage, leaves slit when reabsorbed

Question 14

Lacunar infarct

Answer 14

Occlusion of deep brain arteries (0.2-15mm)

Question 15

Acute hypertensive encephalopathy

Answer 15

Increased ICP due to DBP>130

Fibrinoid necrosis of vessel wall

Question 16

Cerebral Amyloid Angiopathy

Answer 16

• Amyloid deposits destroy vessels
• Large hemorrhages with lobar distribution (not in thalamus/BG)
• Dementia via microinfarcts and diffuse leukoencephalopathy

Question 17

Saccular/Berry aneurysms

Answer 17

• Congenitive absence of tunica media and elastic lamina and CoW bifurcations
• Worst headache of my life

Question 18

Berry aneurysm associations

Answer 18

Ehlers-Danlos
Marfans
Polycystic kidney disease
Neurofibromatosis1

Question 19

Multiple Arteriovenous malformations

Answer 19

Hereditary Hemorrhagic Telangiectasia

Question 20

1 cause of adult meningitis

Answer 20

Strep pneumoniae

Question 21

Teen causes of meningitis

Answer 21

Nisseria meningitidis

Coxsakievirus

Question 22

Brain abscess lab values

Answer 22

WBC high
Protein high
Glucose normal

Question 23

Bacterial meningitis lab values

Answer 23

WBC high
Protein high
Glucose low

Question 24

Rabies

Answer 24

Violent convulsions and CNS excitability

Negri bodies

Question 25

Herpes encephalitis

Answer 25

HSV-1 - frontal & temporal lobes | Eosinophilic intranuclear inclusions

Question 26

Herpes inclusions

Answer 26

Cowdry type A bodies

Question 27

CMV encephalitis

Answer 27

Neonates & immunosuppressed | Microcephaly with periventricular calcification

Question 28

HIV

Answer 28

Aseptic meningitis | Increased risk of CNS lymphoma

Question 29

Transmissible spongiform encephalopathy mechanism

Answer 29

PrPc -> PrPSc or PrPTSE

Question 30

Creutzfeldt-Jakob Disease

Answer 30

Can be sporadic or familial Vacuoles within neuropil No inflammatory infiltrate

Question 31

Kuru

Answer 31

Prion disease from eating brains

Question 32

GSS

Answer 32

Gerstmann-Straussler-Scheinker syndrome Autosomal dominant prion disease Progressive ataxia and dementia

Question 33

Fatal Familial Insomnia

Answer 33

Autosomal dominant prion sleep disorder | Thalamus lesions