Pathoma (HIGH YIELD) Flashcards by Charles Shirley

Anencephaly presentation

‘Frog-like’ appearance (prominence of eyes)

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Anencephaly sequelae

Maternal polyhydramnios

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Dandy-Walker malformation

Dilated 4th ventricle (with absent cerebellum)

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Arnold-Chiari malformation may be associated with what?

Meningomyelocele and syringomyelia

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Familial ALS can be associated with what mutation?

Zinc-copper superoxide dismutase

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Freidreich’s ataxia gene and its function

Frataxin gene; essential for mitochondrial iron regulation (results in incr. potential for free radical damage to neurons)

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Neurologic disease associated with Hypertrophic cardiomyopathy

Freidreich’s ataxia

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Common meninigitis pathogen(s) in neonates

Group B Strep, E coli, L monocytogenes

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Common meningitis pathogen(s) in children and teenagers

N meningitidis

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Common meningitis pathogen(s) in adults and elderly

Strep pneumo

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Common meningitis pathogen(s) in unvaccinated infants

Haemophilus influenzae

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Common meningitis pathogen(s) in immunocompromised

Fungi

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Lumbar puncture needle placement

Between L4 and L5 (because spinal cord ends at L2)

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What meningeal layers are spared in an LP

Pia mater

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What form of meningitis often leads to complications? What are they?

Bacterial meningitis; death, hydrocephalus, hearing loss, seizures

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Possible causes of global cerebral ischemia

Repeated episodes of hypoglycemia (d/t insulinoma, highest yield), chronic hypoxia (ischemia), low blood flow, reduced perfusion (atherosclerosis)

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Thrombotic focal ischemic stroke appearance

Pale infarct at periphery of the cortex

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Embolic focal ischemic stroke appearance

Hemorrhagic infarct at periphery of the cortex

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Early finding in ischemic stroke

Red neurons (ischemic stroke leads to liquefactive necrosis)

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Most common cause of subarachnoid hemorrhage? Why does this occur?

Berry aneurysm; saccular outpouching lacks a media layer

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Most common location of berry aneurysm

Anterior circle of Willis (branch points of ACA)

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Most common cause of epidural hematoma

Fracture of temporal bone with rupture of middle meningeal artery

Most common cause of subdural hematoma

Rupture of bridging veins

Multiple Sclerosis pathophysiology

Autoimmune destruction of CNS myelin and oligodenrocytes (higher yield)

Geographic distribution of Multiple Sclerosis

More common away from the equator

Vision sx characteristic of Multiple Sclerosis

Internuclear Ophthalmoplegia

Subacute sclerosing panencephalitis etiology

Slowly progressing, persistent infection of the brain by measles

Central Pontine Myelinolysis classic presentation

Acute paralysis ('locked-in' syndrome: all patient can move is their eyes)

Alzheimer notable genes

E4 allele of apolipoprotein E is associated with higher risk; E2 allele associated with lower risk

Down syndrome incr. risk for what neurologic disease

Alzheimer's (b/c APP is present on chromosome 21; \3 copies in Down syndrome)

Alzheimer's angiopathy?

Cerebral amyloid angiopathy (A-B amyloid deposits around blood vessels)

Notable contents of Neurofibrilliary tangles in Alzheimer's

Hyperphosphorylated tau protein

Pick Disease pathologic findings

Round aggregates of tau protein in neurons of cortex

Parkinson's disease pathologic finding

Lewy bodies (contain alpha synuclein)

Difference between Parkinson's and Lewy body dementia

Dementia is only a feature if late-stage Parkinson's; early dementia suggests Lewy body dementia (dementia, hallucinations and Parkinsonian features)

What causes anticipation in Huntington's Disease?

Further expansion of trinucleotide repeats during spermatogenesis

Normal pressure hydrocephalus pathophysiology?

Incr. CSF causes stretching of corona radiata, leading to dilated ventricles

Normal pressure hydrocephalus treatment?

LP relieves sx; tx is VP shunt

What causes spongiform encephalopathy?

Pathologic protein in a beta pleated sheet conformation

Creutzfeld Jacob Disease presentation

Progressive dementia with ataxia and startle myoclonus

Pilocytic astrocytoma appearance on imaging

Cystic lesion with mural nodule

Pilocytic astrocytoma pathologic findings

Astrocytes with Rosenthal fibers (thick eosinophilic processes)

What type of neurologic tumor crosses the corpus callosum?

Glioblastoma multiforme

Intermediate filament associated with glioblastoma multiforme

GFAP

Oligodendroglioma usual location

Frontal lobe

Oligodendroglioma classic presentation

Seizures

Oligodendroglioma pathologic findings

"Fried egg" appearance

What type of neurologic tumor spreads via CSF?

Medulloblastoma ("drop metastases" when it involves spinal cord)

Meningioma IHC profile

Expresses estrogen receptors

Pathologic appearance of meningioma

"Whirled" appearance of cells

Schwannoma IHC profile

S100 positive

What type(s) of neurologic tumors are seen in NF2

Bilateral Schwannomas

Location of CNS tumor in adults vs children

Tumors in adults usually arise above the tentorium, tumors in kids usually arise below the tentorium