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3MB Neurology > Pathology > Flashcards

Pathology Flashcards

1
Q

Which component of the CNS is most vulnerable to hypoxia?

A

Neurones

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2
Q

Which cells are the “macrophage cells” of the CNS?

A

Microglia

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3
Q

Axonal injury involves a reaction in which part of the neurone?

A

Reaction within cell body

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4
Q

In which direction does the axon damage in response to injury?

A

Anterograde degeneration of axon distal to site of injury

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5
Q

Which process do astrocytes initiate in response to injury?

A

Reactive proliferation - gliosis - where cells undergo hyperplasia and hypertrophy

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6
Q

Which process if the most important histopathological indicator of CNS injury, regardless of cause?

A

Gliosis

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7
Q

Which cells line the ventricular system?

A

Ependymal cells

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8
Q

The brain receives how much of the cardiac output?

A

15%

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9
Q

What is the response of vasculature to the brain in hypotension and hypertension?

A

Constricts in hypertension
Dilates in hypotension

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10
Q

What are the two main sets of arteries supplying blood to the brain?

A

Branches of internal carotid + vertebral arteries (form anterior + posterior circulations)

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11
Q

Lack of blood supply in the anterior cerebral artery is associated with which dysfunctions?

A

Frontal lobe dysfunction
Contralateral sensory loss in foot + leg
Paresis of arm + foot

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12
Q

Lack of blood supply in the middle cerebral artery is associated with which dysfunctions?

A

Hemiparesis
Hemisensory loss
Aphasia/dysphasia
Apraxia

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13
Q

Lack of blood supply in the posterior cerebral artery (vertebrobasilar) is associated with which cerebellar dysfunctions?

A

Ataxia
Nystagmus
Intention tremor
Pendular reflexes

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14
Q

Lack of blood supply in the posterior cerebral artery (vertebrobasilar) is associated with which occipital lobe dysfunctions?

A

Homonymous hemianopia with macular sparing

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15
Q

When does gliosis occur following a cerebral infarct?

A

1-2 weeks

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16
Q

What is the most common cause of a subarachnoid haemorrhage?

A

Spontaneous rupture of a saccular aneurysm (Berry aneurysm)

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17
Q

List diseases that have increased incidence of Berry aneurysms

A

Polycystic kidney disease
Fibromuscular dysplasia
Coarctation of aorta

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18
Q

Most berry aneurysms occur where?

A

90% = arterial bifurcations near internal carotid cartery
10% = vertebrobasilar circulation

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19
Q

At which diameter do berry aneurysms have greatest risk of rupture?

A

6-10mm
If over 25mm, risk of rupture decreases

20
Q

Lacunar infarcts can be present in hypertensives. What are they?

A

Small cavities up to 10mm in diameter found in basal ganglia and pons

21
Q

What is demyelination?

A

Destruction of myelin sheath surrounding an axon, either due to breakdown or abnormal production

22
Q

What disease comes under primary demyelination?

A

Multiple sclerosis

23
Q

What is the female:male affected ratio for MS?

A

2:1

24
Q

The external appearance of the brain and spinal cord in MS is usually normal. True/False?

A

True

25
Q

MS is a grey matter disease. True/False?

A

False
MS is a white matter disease

26
Q

Describe the morphology of MS

A

Well-demarcated plaques in white matter in a non-anatomical distribution

27
Q

Describe the colour of MS plaques

A

Acute lesions: soft pink
Chronic lesions: firm pearl-grey

28
Q

What structures do MS plaques commonly affect?

A

Optic nerve
Periventricular white matter
Corpus callosum
Brainstem
Spinal cord

29
Q

Where do chronic inactive MS plaques typically occupy?

A

Situated around lateral ventricles

30
Q

Dementia is always pathological. True/False?

A

True
Neurodegenerative disorder, not just part of ageing!

31
Q

List diseases classified as primary dementias

A

Alzheimer’s disease
Huntington’s disease
Pick’s disease
Lewy body dementia

32
Q

What is the female:male ratio for Alzheimer’s disease?

A

2:1

33
Q

List the genes the can be involved in Alzheimer’s disease

A

Amyloid precursor protein (c21)
Presenilin 1 (c14)
Presenilin 2 (c1)
ApoE (allele e4)

34
Q

Describe the morphology of Alzheimer’s disease on the brain

A

Cortical atrophy
Widened sulci
Narrowed gyri
Dilated ventricles

35
Q

Which lobes are particularly affected in Alzheimer’s disease?

A

Frontal
Temporal
Parietal

36
Q

Which protein forms plaques in Alzheimer’s disease?

A

A-beta amyloid plaques

37
Q

What colour does amyloid protein stain?

A

Congo red

38
Q

Which protein in the brain can become tangled and defective in Alzheimer’s disease?

A

Tau protein

39
Q

Which area of the brain is affected in Lewy body dementia (Parkinson’s)?

A

Substantia nigra

40
Q

Which protein, when stained, can help detect Lewy bodies?

A

Ubiquitin

41
Q

What happens to the caudate nucleus in Huntington’s disease?

A

Caudate atrophy with loss of neurons

42
Q

What are the histopathological landmarks of Pick’s disease dementia?

A

Swollen neurons (Pick’s cells)
Filamentous inclusions (Pick’s bodies)

43
Q

Which lobes does Pick’s disease usually affect?

A

Frontal
Temporal

44
Q

What is the most common type of secondary dementia?

A

Vascular (infarct) dementia

45
Q

Examples of acetylcholine esterase inhibitors used to treat dementia?

A

Donepezil
Galantamine
Rivastigmine

46
Q

Name the NMDA receptor antagonist used to treat Alzheimer’s?

A

Memantine

3MB Neurology (17 decks)

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