Pathoma Flashcards
1
Q
neural tube defects
A
- associated with low folate levels prior to conception
- elevated AFP in amniotic fluid and maternal blood
- anencephaly: absence of skill and brain (cranial end disruption)
- spin bifida: failure of posterior vertebral arch to close
- occulta: dimple/patch of hair overlying defect
- meningocele: protrusion of meninges
- meningomyelocele: protrustion of meninges and spinal cord
2
Q
cerebral aqueduct stenosis
A
- congenital stenosis of channel that drains CSF from 3rd→ 4th ventricles
- MCC of hydrocephalus in newborns
- presents with enlarging head circumference due to dilation of ventricles; cranial suture lines are not fused
3
Q
dandy-walker malformation
A
- congenital failure of cerebellar vermis to develop
- presents as massively dilated 4th ventricle with an absent cerebellum
- often accompanied by hydrocephalus
4
Q
arnold-chiari malformation
A
- type I: no symptoms; post. fossa forms too shallow for cerebellum
- associated with syringomyelia
-
type II: congenital downward displacement of cerebellar vermis and tonsils through foramen magnum→ obstruction of CSF flow→ hydrocephalus
- associated with meningomyelocele
5
Q
syringomyelia
A
- cystic degeneration of spinal cord
- arises with trauma or in association with arnold-chiari type I
- C8-T1 location; ant. white commisure of spinothalamic tract with sparing of dorsal column
- cape like distribution: loss of pain and temperature, sparing of fine touch and proprioception in upper extremeties
- syrinx expansion→ LMN of ant. horn (muscle atrophy/weakness) and lateral horn of hypothalamospinal tract (horner syndrome)
6
Q
poliomyelitis
A
- damage to ant. motor horn due to poliovirus infection
- LMN signs (flaccid paralysis with muscle atrophy, fascicuations, weakness and decreased tone, impaired relfexes)
7
Q
werdnig-hoffman disease (SMN-1)
A
- AR; degeneration of ant. motor horn
- presents as floppy baby; death in a few years
8
Q
amyotrophic lateral sclerosis (ALS)
A
- degenerative disorder of UMN and LMN of corticospinal tract
- ant. motor horn: LMN signs
- lateral corticospinal tract: UMN signs
- atrophy and weakness of hands is early sign
- lack of sensory impairment (no loss of pain/temp distinguishes from syringomyelia)
- most cases are sporadic; average age is 60yrs
- zinc-copper SOD1 present in some cases (ROS injury neurons)
9
Q
friedreich ataxia
A
- AR; degeneration of cerebellum and spinal cord (post. columns, distal CST, spinocerebellar)
- ataxia
- loss of vibratory sense and proprioception, muscle weakness in lower extremities, loss of deep tendon reflexes
- due to expansion of trinucleotide repeat in frataxin gene (essential for mitochondria Fe regulation; loss results in Fe buildup→ ROS)
- associated with hypertrophic cardiomyopathy
10
Q
meningitis
A
- MC due to infectious agent
- neonates: group B strep, e. coli, listeria
- kids/teens: n. meningitidis, coxsackie
- nonvacc. infants: flu
- adults/elderly: strep pneumo
- immunocompromised: fungi
- headache, nuchal rigidity, fever; photophobia, vomiting, AMS
- diagnosis by LP (between L4&5 at iliac crest; cross skin ligaments, epidural space, dura, and arachnoid NOT pia)
- bacterial: neutrophila with low glucose
- viral: lymphocytes and normal glucose
- fungal: lymphocytes with low glucose
- complications due to bacteria (death due to herniation, sequlae related to fibrosis)
11
Q
global cerebral ischemia
A
- etiologies
- low perfusion (atherosclerosis)
- acute decrease in blood flow (cardiogenic sock)
- chronic hypoxia (anemia)
- repeated episodes of hypoglycemia (insulinoma)
- mild→ transient confusion with prompt recovery
- moderate→ infarcts in watershed areas and damage to vulnerable regions (cerebral cortex 3, 5, 6; hippocampus; purkinje of cerebellum)
- severe→ diffuse necrosis, survival in vegetative state
12
Q
ischemic stroke
A
- regional ischemia→ focal neurologic deficits lasting >24 hrs (<24hrs= transient ischemic attack)
- subtypes: thrombotic, embolic, lacunar
- results in liquefactive necrosis
- red neurons (dead) are early microscopic findings
- necrosis (24 hrs) infiltration by neutrophils (day 1-3), and microglial cells (day 4-7), and gliosis (weeks 2-3)
- fluid filled cystic space surrounded by gliosis
13
Q
thrombotic stroke
A
- due to rupture of atherosclerotic plaque
- results in pale infarct at periphery of cortex
14
Q
embolic stroke
A
- due to thromboemboli (MC source is L heart, e.g., due to afib)
- usually involves middle cerebral artery
- results in hemorrhagic infarct at periphery of cortex
15
Q
lacunar stroke
A
- occur secondary to hyaline arteriolosclerosis (complication of HTN or diabetes)
- MC involves lenticulostriate vessels→ small cystic areas of infarction
- internal capsule: pure motor
- thalamic involvement: pure sensory
16
Q
intracerebral hemorrhage
A
- bleeding into brain parenchyma
- classically due to rupture of charcot-bouchard microaneurysms of lenticulostriate
- complication of HTN
- basal ganglia is MC site
- presents as severe headache, N/V, eventual coma
