Pathology Flashcards

1
Q

two process that can occur as a result of damage to nerve cells

A
  1. rapid necrosis and sudden failure (stroke)

2. slow atrophy with gradual dysfunction (cerebral atrophy)

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2
Q

neuron reaction to hypoxia

A

red

irreversible cell death

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3
Q

axons reaction to hypoxia

A

increase protein synthesis and swell

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4
Q

oligodendrocyte reaction to hypoxia

A

demyelintion

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5
Q

astrocyte response to hypoxia

A

gliosis

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6
Q

microglial response to hypoxia

A

proliferate and recruit inflammatory mediators

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7
Q

define cerebrovascular disease

A

abnormality of the brain caused by pathological blood vessels

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8
Q

two types of cerebral ischaemia

A
  1. global

2. focal

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9
Q

define stroke

A

sudden disturbance in cerebral function of vascular origin that lasts >24 hours

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10
Q

types of stroke

A
  1. infarction

2. haemorrhage

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11
Q

causes of infarction stroke

A

thrombus
emboli
dissection?

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12
Q

risk factors for ischaemic stroke

A
>70
male 
hypertension
hyperlipidaemia
DM
smoking
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13
Q

causes of haemorrhagic stroke

A

BBB disruption

can be caused by thrombolysis

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14
Q

carotid artery lesion presentation

A

contralateral weakness or sensory loss

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15
Q

MCA presentation

A

weakness in contralateral face and arm

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16
Q

ACA presentation

A

weakness in contralateral leg

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17
Q

PCA presentation

A

pure sensory loss

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18
Q

vertebra-basilar artery presentation

A

vertigo
ataxia
dysarthria
dysplasia

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19
Q

lacunar presentation

A

sensory or motor symptoms only to one side of the body with 2/3 areas involved (face, arm, leg)

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20
Q

examples of vascular malformations

A

arteriovenous malformation
cavernous angiomas
venous angiomas
capillary telangectases

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21
Q

define hydrocephalus

A

accumulation of CSF in ventricular system

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22
Q

mechanisms of the causes of hydrocephalus

A
obstruction
decreased resorption (SAH, meningitis)
overproduction
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23
Q

classification of hydrocephalus

A
  1. non-communicating

2. communicating

24
Q

define non-communicating hydrocephalus

A

obstruction occurs within the ventricular system

in children tends to be due to aqueduct stenosis

25
define communicating hydrocephalus
outside ventricular system
26
what happens if hydrocephalus occurs before closure of cranial sutures?
cranial enlargement
27
what is hydrocephalus ex vacuo?
dilation of the ventricles occur due to loss of brain parenchyma
28
presentation of normal pressure hydrocephalus
Parkinson's symptoms
29
causes of raised ICP
``` hydrocephalus SOL oedema increased venous volume physiological (hypoxia, hypercapnia, pain) ```
30
effects of raised ICP
herniations distortion of cranial nerves impaired blood flow reduced consciousness
31
presentation of raised ICP
papilloedema vomiting HA
32
what is a medulloblastoma
primary tumour often in children in the cerebellum (embryonal)
33
why does a medulloblastoma cause hydrocephalus?
commonly in the midline so disrupts CSF causing hydrocephalus
34
management of medulloblastoma
radiosensitive
35
two types of head truma
1. penetrating (missile) | 2. blunt (non-missile)
36
what is a contra-coup injury?
damage to the opposite side of impact due to brain moving in the cranial cavity
37
when does diffuse axonal injury (DAI) occur?
at the moment of injury (balloon axons)
38
describe extradural haematoma
usually middle meningeal artery | immediate brain damage minimal but untreated causes midline shift
39
two types of subdural haematoma
1. acute | 2. chronic
40
describe acute subdural haematoma
clear history of trauma elderly cerebral bridging veins?
41
describe chronic subdural haematoma
associated with brain atrophy | composed of liquefied blood/yellow- tinged fluid
42
classification of demyelinating disorders
1. primary | 2. secondary
43
primary causes of demyelination
MS ADEM AHL
44
secondary causes of demyelination
viral (JC virus) metabolic (central pontine myelinosis) toxic (CO, cyanide)
45
examples of presentations for MS
optic nerve lesions= unilateral visual impairment spinal cord lesions= motor or sensory deficit, spasticity, bladder control brainstem= ataxia, nystagmus, internuclear ophthalmoplegia
46
pathology specimen for MS
well circumscribed plaques
47
primary causes of dementia
alzheimer's LBD Pick's disease (FTD) Huntington's
48
secondary causes of dementia
vascular infection (HIV, syphilis) trauma metabolic
49
implicated genes in Alzheimer's
amyloid precursor protein (APP) presenilin 1 presenilin 2
50
why is there higher incidence of Alzheimer's in trisomy 21?
APP gene on chromosome 21
51
pathological specimen features of Alzheimer's
gliosis neurofibrillary tangles (TAU protein) neuritic plaques= Abeta amyloid plaques amyloid angiopathy
52
what is amyloid angiopathy?
stiffening and thickening of blood vessel walls due to eosinophil accumulation
53
diagnosis of amyloid angiopathy
stains with congo red
54
what produces Parkinsonism symptoms?
conditions that affect the nigro-striatal dopaminergic pathway
55
examples of parkinsonism causes
``` PD LBD drugs (phenothiazine) trauma multisystem atrophy ```
56
what happens in Hungtinton's disease?
atrophy of the basal ganglia (caudate nucleus) with expansion of ventricles degeneration of neurones leads to loss of inhibition activity
57
FTD pathological features
atrophy Pick's cells (swollen neurones) Pick bodies (inclusion)