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Neurology > Pathology > Flashcards

Pathology Flashcards

1
Q

How does hypoxia affect the CNS?

A

Affects neurones first - most vulnerable

Activates glutmate receptors causing uncontrolled calcium entry into the cell

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2
Q

What is the most important histopathological indicator of CNS injury?

A

Gliosis

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3
Q

What is gliosis?

A

A nonspecific reactive change of glial cells in response to damage to the central nervous system (CNS)

In most cases, gliosisinvolves the proliferation or hypertrophy of several different types of glial cells, including astrocytes, microglia, and oligodendrocytes

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4
Q

What are oligodendrocytes?

A

Cells that wrap around axons of neurons forming myelin sheath

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5
Q

Which cells line the ventricular system?

A

Epyndemal cells

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6
Q

Which cells of the nervous system act as macrophages?

A

Microglia

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7
Q

What lobe is affected and what clinical signs are produced in cerebrovascular disease affecting the anterior cerebral artery?

A

Frontal lobe

Contralateral sensory loss in foot & leg

Paresis of arm and foot

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8
Q

What clinical signs are produced in cerebrovascular disease affecting the middle cerebral artery?

A

Contralateral hemiparesis

Contralateral hemisensory loss

Aphasia/dysphasia

Apraxia

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9
Q

What is an example of a primary demyelination disorder?

A

Multiple sclerosis

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10
Q

What can be seen histologically with small, active MS plaques?

A

Evidence of ongoing myelin breakdown with abundant macrophages

Inflammatory cells, including both lymphocytes and monocytes, mostly as perivascular cuffs

Small active lesions often centred round veins

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11
Q

What is the histological appearance of an inactive MS plaque?

A

Centre contains little or no myelin

Astrocytic proliferation and gliosis are prominent

Reduction in inflammatory cells and macrophages over time

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12
Q

Does MS affect grey or white matter?

A

White

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13
Q

What is the appearance of chronic MS plaques?

A

Well-demarcated grey/brown lesions in white matter, classically situated around lateral ventricles

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14
Q

What are some of the genes involved in Alzheimer’s disease?

A

Amyloid precursor protein (APP) Chromosome 21

Presenilin 1 – Chromosome 14

Presenilin 2 – Chromosome 1

Apolipoprotein E – allele e4

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15
Q

What is the gross appearance of a brain affected by Alzheimers?

A
  • decreased size and weight of brain (cortical atrophy)
  • widening of sulci
  • narrowing of gyri
  • compensatory dilatation ventricles, 2° hydrocephalus
  • frontal, temporal and parietal lobes affected
  • brainstem and cerebellum normal
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16
Q

What are the histological features of Alzheimer’s?

A
  • intracytoplasmic neurofibrillary tangles

– Aß amyloid plaques (extracellular senile or neuritic plaques)

– amyloid angiopathy

– extensive neuronal loss with astrocytosis

17
Q

What stain is used to show up amyloid in histology?

A

Congo red

18
Q

What are the pathological features seen in dementia with Lewy bodies?

A
  • degeneration of the substantia nigra (as seen in Parkinson’s disease)
  • remaining nerve cells contain abnormal structures called Lewy bodies (pathological hallmark)
  • degeneration of the cortical areas of the brain with many or all of the features seen in Alzheimer’s disease
19
Q

What is the histological appearance of Huntington’s disease?

A

Loss of neurons in caudate nucleus and cerebral cortex accompanied by reactive fibrillary gliosis

20
Q

What is Pick’s disease?

A

A progressive dementia commencing in middle life (usually between 50 and 60 years) characterised by slowly progressing changes in character and social deterioration leading to impairment of intellect, memory and language

21
Q

What pathology can be seen in Pick’s disease?

A
  • extreme atrophy of cerebral cortex in frontal and temporal lobes
  • brain weight
  • neuronal loss and astrocytosis
  • histological hallmarks are Pick’s cells (swollen neurons) and intracytoplasmic filamentous inclusions known as Pick’s bodies
22
Q

What signs might be seen with a cerebellar lesion?

A

Ataxia

Wide based gait

Past pointing

Intention tremor

Dysmetria

Dysdiadokineses

Coarse, staccato speech

Horizontal Nystagmus

23
Q

How might tone and reflexes be affected in a cerebellar examination?

A

Hypotonia

Reduced reflexes

Neurology (17 decks)

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