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PLE Review > Patho-PNSCNS > Flashcards

Patho-PNSCNS Flashcards

1
Q

Most common cause of peripheral neuropathy

A

DM

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2
Q

Most common inherited peripheral neuropathy

A

Charcot-Marie Tooth disease

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3
Q

Symmetric ascending demyelinating polyradiculoneuropathy

Associated infections
Most prominent lesion of demyelination

A

GBS
Lymphoplasmacytic perivenjlar Nd endoneurial infiltrate

C. Jejuni, M. Pneumonia
CMV, EBV

Segmental demyelination

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4
Q

Most common form of Diabetic Neuropathy

Histology:
Axonal neuropathy
Hyaline arteriosclerosis
Regenerative axonal clusters

A

Distal sensorimotor polyneuropathy

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5
Q

2nd decade of life

Progressive distal sensorimotor neuropathy

Most common form

A

CHARCOT-MARIE-TOOTH DISEASE

Most common: CM1
Axonal: CM2, severe
Demyelinating: the rest

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6
Q

Differentiate Myasthenia Gravis and Lambert Eaton Myasthenic Syndrome in

Autoantibodies
Weakness with exertion
Muscle groups

A

Both are antibody mediated Type II

MG

  • Postsynaptic AcH receptor
  • fatigable weakness
  • EOMs

LEMS

  • presynaptic Ca channel
  • improves with repetitive exertion
  • extremities
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7
Q

Start with myalgia, then proximal weakness and eventually distal weakness

Differentiate dermatomyositis and polymyositis

Age
Skin changes
Pathogenesis
Mononuclear infiltrate

A

Dermatomyositis

  • juvenile
  • heliotrope rash - periorbital lilac discoloration
  • gottron papules - dusky res patches over knuckles, knees and elbows
  • CD4 mediated, INF-1

Polymyositis

  • adult
  • no skin changes
  • CD8 mediated
  • endomysial
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8
Q

Pelvic girdle weakness up to shoulders

Pseudohypertrophy of lower leg muscles

Arrhythmia, cardiomyopathy, mental retardation

Differentiate these 2 types in

  • defect
  • onset
  • immunostaining
A

Duchenne

  • total absence of dystrophin
  • early, severe

Becker

  • reduced activity of dystrophin
  • late, mild

Early: segmental myofiber degeneration and regeneration
Late: Fatty replacement

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9
Q

PERIPHERAL NERVE SHEATH TUMORS

Identify:

  1. Plexiform (bag of worms), NF-1 associated, CD34 spindle cells in loose collagen stroma (shredded carrot)
  2. NF-2 associated, vestibular, Anton A (cellular, spindle cells in fascicles), Anton B (hypocellular, spindle cells in myxoid stroma), Verocay bodies, S100+
A
  1. Neurofibroma

2. Schwannoma

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10
Q

Differentiate herniation syndromes in

Herniating part
Herniation through
Compressed structure
Clinical manifestation

A

Subfalcine
-cingulate to falx cerebri, compressing ACA causing focal neurologic defecits

Transtentorial
-medial temporal to tentorium cerebelli compressing CNIII causing pupillary dilatation

Tonsillar
-cerebral tonsil to foramen magnum compressing the brainstem causing cardiac and respiratory depression

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11
Q

Cerebellar vermis hypoplasia
Cystic dilatation of 4th ventricle
Hydrocephalus

A

Dandy Walker malformation

Posterior fossa anomaly

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12
Q

Small posterior fossa with misshapen cerebellar tonsils
Aqueductal stenosis
Noncommunicating hydrocephalus

Low lying cerebellar tonsils
Clinically silent or hydrocephalus

A

ARNOLD CHIARI MALFORMATION

Chiari I

Chiari II

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13
Q

Rapidly evolving neurologic symptoms with lucid intervals

CT scan: biconvex, cross the midline, does not cross sutures

Dx?
Most common vessel involved

A

Epidural hematoma

Middle meningeal artery (usually from pterion fx)

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14
Q

Slowly evolving neurologic symptoms

CT scan: crescent shaped, can’t cross falx and tentorium

Dx?
Most common vessel involved

A

SUBDURAL HEMATOMA

Bridging veins

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15
Q

Worst headache of my life
Syncope
From ruptured saccular berry aneurysm

Dx?
Most common location?

A

SUBARACHNOID HEMORRHAGE

ACA-ACoA junction

May lead ti

  • ischemic injury
  • meningeal fibrosis > CSF outflow obstruction
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16
Q

CSF findings:
Dec sugar, inc protein, +culture

Dx
Common cause

A

ACUTE PYOGENIC MENINGITIS

infants: E. Coli > GBS > L. Monocytogenes

Adolescents: N. Meningitides

Adults: S. Pneumonia, L. Monocytogenes

17
Q

CSF findings:
Normal sugar, inc protein, -culture

Dx
Common cause

A

ACUTE ASEPTIC MENINGITIS

Enteroviruses

18
Q

Localized focus of necrosis of brain tissue with accompanying inflammation

Central liquefactivd necrosis surrounded by granulation tissue

Dx
Common cause

A

BRAIN ABSCESS

Staph and Strep: immunocompetent

19
Q

Exudate on basal cister s and around cranial nerves

Present with tuberculomas

Obliterative endarteritis of vessels in SAS

Adhesive arachnoiditis

CSF: lymphocytic pleocytosis with markedly elevated protein

A

TUBERCULOIS MENINGIENCEPHALITIS

20
Q

Cytoplasmic, round to oval, eosinophilic inclusions in pyramidal neurons of the hippocampus and Purkinje cells of the cerebellum

Widespread neuronal degeneration most severe in brainstem

A

RABIES

21
Q

Microglial nodules, multinucleated giant cells

With microglial affectation that expresses CD4

Increased incidence of CNS lymphomas

A

HIV

22
Q

Central foci of necrosis surrounded by tachyzoites and bradyzoites

CT scan: ring enhancing lesions

Brain abscess near the gray-white junction (cerebral cortex)

A

TOXOPLASMA

23
Q

Gelatinous material within the subarachnoid space and small cysts in basal ganglia

Expanded perivascular (Virchow-Robin) spaces containing aggregates organisms

A

CRYPTOCOCCUS

24
Q

Spongiform transformation in cerebral cortex and deep gray matter structures
-pathognomonic finding

A

CREUTZFELD-JAKOB DISEASE

25
Q

Initial manifestation: unilaterL involvement of optic nerve

CSF: Increased IgG (oligoclonal)

Type IV hypersensitivity to myelin sheath

TRIAD: nystagmus, intention tremor, scanning speech

A

MULTIPLE SCLEROSIS

Charcot triad of MS

26
Q

Neuritic plaques
Neurofibrillary tangles

Lewy body, alpha synuclein aggregates

A

Alzheimers

Parkinsons

27
Q
  1. Ataxia
    Confusion
    Ophthalmoplegia

Acute
Can be reversed with thiamine

  1. Confabulation
    Hallucinations
    Amnesia

Chronic
Hemosiderin laden, dorsomedial nucleus

A

WERNICKE ENCEPHALOPATHY

KORSAKOFF SYNDROME

28
Q

Rosenthal fibers
-eosinophilic granular bodies

Fried egg appearance
-round tumor cells with cytoplasmic halos

Perivascular Pseudorosettes
-regular, round to ovoid nuclei with abundant granular chromatin

A

Astrocytomas
-children: cerebellum, adults: cerebral cortex

Oligodendroglioma
-cerebral cortex

Ependymoma

  • 1st 2 decades: cerebellum
  • adults: spinal cord
29
Q

Homer-Wright rosettes
Small, round, blue cells

Drop metastases

Most common poorly differentiated tumor

A

MEDULLOBLASTOMA

-radiosensitive

30
Q

Most common CNS neoplasm in immunocompromised individuals

A

PRIMARY CNS LYMPHOMA

31
Q

CNS tumor

-Psammoma bodies

A

MENINGIOMA

PLE Review (9 decks)

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