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Year 2 neuro exam 1 > Path IV > Flashcards

Path IV Flashcards

1
Q

HIE

A

hypoxic ischemic enecephalopathy

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2
Q

HIE initially attacks what part of brain

A

grey matter

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3
Q

why is brain so sensitive to hypoxia

A

no energy stores

O2 and glucose supplied by circulation

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4
Q

what happens with reperfusion of ischemic event in brain

A

intracell edema
vascular injury
interstitial edema
release of intracellular vasoactive matabolites

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5
Q

how long of ischemic event till neuronsbegin to die

A

4-5 minutes

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6
Q

5+ minutes of global ischemia in brain leads to

A

thalamic and brain stem damage

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7
Q

what part of neuro system is more resistant to hypoxia

A

spinal cord

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8
Q

what are anoxic neurons

A

shrunken eosinophilic cytoplasm and pyknotic nuclei

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9
Q

what causes anoxic neurons

A

ischmia more than 4 minutes

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10
Q

what is Tx for anoxic neurons

A

reperfusion

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11
Q

what is neuronophagia

A

anoxic neurons surrounded by microglial cells

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12
Q

what are red neurons

A

dead neurons

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13
Q

if patient dies shortly after ischemia what will micro brain look like

A

normal because the reperfusion causes problems

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14
Q

reperfusion edema can be seen where clinically

A

papilledema

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15
Q

what is gliosis

A

process of CNS scarring from astrocytes

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16
Q

alzheimer type II astrocytes

A

hepatic encephalopathy

large nuclei and large vacuoles on H&E stain

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17
Q

GFAP stain

A

astrocytes

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18
Q

what cells are very sensitive to HIE

A

CA1 of hippocampus

layters 3,5,6 neoCx, purkinje cells, striatal neurons

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19
Q

diffuse cortical thalamic or combine neuronal loss in HIE results in what

A

dementia

vegetative state

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20
Q

damage to brainstem cause what

A

brain death

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21
Q

why are certain ares for susceptible to HIE

A

areas with neurons that produce more glutamate

22
Q

what cells are in CA1 of hippocampus

A

purkinje

23
Q

holzer stain

A

can see hippocampal sclerosis

24
Q

if lose CA1

A

memory problems

25
Q

what supplies CA1

A

anterior temporal branch posterior cerebral artery

26
Q

what occurs in nonperfused brain after HIE

A

cerebral autolysis

blank on radionucletotide scan

27
Q

what else gets damaged in severe HIE

A

glial cells also damaged

28
Q

what converts selective neuronal necrosis to total tissue necrosis in brain

A

lactic acidosis

29
Q

what is cerebral infarction

A

focal brain necrosis from complete and prolonged ischemia that focally affects all tissue elements, neurons, glia and vessels

30
Q

what are the parts of an infarct

A

the core where there is dense ischmia( non revivable)

and the penumbra (moderate ischmia, delayed infarction GIVE O2!)

31
Q

what is a blan infarct

A

swelling and disintegration of area

32
Q

what is a hemorrhagic infarct

A

disintegration of lesion from an embolus/ thrombus with reperfusion of blood into affected area 10% time

33
Q

what are lacunar infarcts

A

cystic cavities from previous hemorrhagic bleeds

34
Q

what are common causes of cerebral infarcts

A

atherosclerosis
atherosclerosis with thrombus formation
small vessel disease
embolism

35
Q

what are the small vessel disesases

A

HTN, DM, age, cerebral amyloid angiopathy

36
Q

if see pink thickening around vessels, do what stain

A

congo red to rule out amyloid

37
Q

small vessel disease usually result in what type cerebral infarcts

A

lacunar and hemorrhagic bleeds

38
Q

what aa supply basal ganglia area

A

lenticulate striate off of middle cerebral

39
Q

what areas does the anterior choroidal a supply

A

medial globus pallidus, post limb internal capsule, tail caudate and optic tract

40
Q

man in barrel syndrome

A

watershed infarcts

41
Q

where are the watershed areas

A

ACA-MCA MCA-PCA

42
Q

what cause watershed infarcts

A

severe drops in BP

hypovolemia like GI bleed

43
Q

what type of watershed is caused by sudden occlusion of internal carotid a or carotid stenosis

A

ACA-MCA

both fed by int carotid

44
Q

clinical Sx watershed infarct

A

proximal arm and leg weakeness

can cause transcortical aphasia synrome

45
Q

when does liquefaction take place after ischemic stroke

A

3 weeks

46
Q

when do you see distinct border for necrosis on gross specimen of ishcmic stroke

A

2-10 days

47
Q

microscopic brain 24 hr post ischemic stroke

A

red neurons

48
Q

48 hrs microscopic post ischemic stroke

A

neutrophils

49
Q

gliosis time frame post ischemic stroke

A

1-2 weeks

50
Q

when does hemorrhagic conversion or evolutions occur after 5-10% ischemic strokes

A

within first week

Year 2 neuro exam 1 (23 decks)

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