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Pathophys Exam 1 > Review Questions 2 > Flashcards

Review Questions 2 Flashcards

1
Q

A neurologic disorder characterized pathologically by loss of neurons in Substantia Nigra

A

Parkinson Disease

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2
Q
  • Tremors AT REST
  • Muscular rigidity
  • Expressionless/Mask-like Face
  • Emotional lability (depression/dementia)
  • Drooling
  • Very little blinking
  • Cog-wheel rigidity
A

Clinical features of Parkinson Disease

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3
Q

Which neurotransmitter is deficient in Parkinson Disease?

A

Dopamine (produced by Substantia Nigra, are responsible for relaying messages that plan/control body movement)

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4
Q

When does Parkinson Disease usually appear?

A
  • 6th decade (50-59 yrs)
  • 8th decade (70-79 yrs)
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5
Q

When does Parkinson Disease incidence decline?

A

After 80 yrs old

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6
Q

What % of N. America will develop Parkinson Disease?

A

More than 2%

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7
Q

Is not genetic, sex, or racial

A

Parkinson Disease

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8
Q

Vast majority of cases of Parkinson Disease are due to which etiology?

A

Idiopathic

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9
Q

Genetic factor of Parkinson Disease

A
  • Rare, autosomal dominant
  • Early onset
  • Point mutation of chromosome 4
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10
Q

What part of the brain is affected by Parkinson Disease?

A
  • Substantia Nigra (relays info to the Basal Glanglia) through dopaminergic synapses
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11
Q

What group of brain tumors account for 60% of primary intracranial neoplasms?

A

Gliomas (tumors of neuroectodermal origin)

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12
Q

Corticol disease (outside of brain affected)

A

Alzheimer Disease

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13
Q
  • Most common cause of dementia in elderly (1/2 of all cases)
  • Before what age is the prevalence 1 - 2%?
  • After what age is prevalence over 10%
A

Alzheimer Disease

  • under 65 yrs
  • over 85 yrs
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14
Q

Which chromosome has the Alzheimer gene?

A

21

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15
Q

Which sex is affected twice as often by Alzheimer Disease?

A

Women

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16
Q

What % of Alzheimer Disease has a familial variant (genetic)

A

5 - 10%

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17
Q

Etiology of Alzheimer Disease

A

Idiopathic, but there is suspicion for viral cause which is not proven

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18
Q

Significant advances of what pathogenesis have been made for Alzheimer Disease?

A

Beta-protein amyloid deposition in senile plaques

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19
Q

located in areas of the cerebral cortex and are linked to intellectual function and are a constant feature of Alzheimer Disease

A

Senile Plaques

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20
Q

What 3 microscopic features are needed to dx Alzheimer Disease?

A
  1. Senile Plaques
  2. Neurofibrillary tangles
  3. Beta-protein Amyloid Angiopathy
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21
Q

Origin of deposits in the brain

A

Beta-protein amyloid (found in walls of cerebral blood vessels)

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22
Q
  • Paired helical filaments
  • abnormal form
  • microtubule protein
  • proper axonal transport
A

Neurofibrillary tangles

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23
Q

What happen to the Gyri and Sulci w/ AD?

A
  • Gyri narrow
  • Sulci widen
24
Q
  • Which parts of the brain are affected by AD?
  • Which part is spared?
A
  • Bilateral cortical atrophy of frontal, temporal, parietal, and hippocampal cortices
  • Spares occiput
25
Q

Brain loses how many grams over how many years?

A
  • 200 grams
  • 3 - 8 years
26
Q

Which part of the brain is the best place to examine for the 3 microscopic findings to dx AD?

A

Hippocampus

27
Q

discrete spherical masses of silver-staining neuritic processes surrounding a central amyloid core. Found predominantly in the hippocampus and amygdala, as well as the cortex.

A

Senile (neuritic) Plaques

28
Q
  • bundles of paired, helical filaments in the cytoplasm of cortical neurons or hippocampal pyramidal cells that displace or encircle the nucleus (flame cells).
  • Are dramatically demonstrated on silver stains and are commonly found in the cortex, hippocampus, and the amygdala.
A

Neurofibrillary Tangles

29
Q

found within cerebral blood vessels seen with congo red stains.

A

Amyloid Angiopathy

30
Q

Clinical assessment + modern radiologic methods allow acurate dx in what % of cases of AD?

A

80 - 90%

31
Q

What is the usual cause of death of a bedridden patient with late stage AD?

A

Terminal bronchopneumonia

32
Q

What is the most common clinical presentation of someone w/ an ependymoma of the 4th ventricle?

A

Hydrocephalus, secondary to progressive obstruction of the 4th ventricle rather than invasion of the pons or medulla.

33
Q

Arises in white matter, usually in cerebral hemispheres in adults

A

Oligodenroglioma

34
Q

5 - 15% of gliomas are which one?

A

Oligodendroglioma

35
Q
  • Well circumscribed
  • Gelatinous
  • Grey masses
  • often w/ cysts
  • focal hemorrhage
  • calcifications seen in 90% of tumors
A

oligodendroglioma

36
Q
  • Slow growing tumor due to absence of mitotic figures and necrosis
  • Have a better prognosis than patients w/ astrocytomas
  • Several yrs of neuro complaints (seizures)
A

Oligodendroglioma

37
Q
  • Accounts for 20% of all brain tumors in children
  • Arises exclusively in the cerebellum
A

Medulloblastoma

38
Q

Small, round, blue cell tumors of childhood

(neuroblastoma, retinoblastoma, Ewing’s Sarcoma)

A

Medulloblastoma

39
Q

Where do medullosblastomas infiltrate the brain?

A

Vermis of the cerebellum (aggressively and frequently disseminates through CSF)

40
Q

Well circumscribed, gray, friable

A

Medulloblastoma

41
Q

A child with a medulloblastoma will present with which of 2 things?

A
  • Cerebellar dysfunction
  • Hydrocephalus
42
Q

What is the most common genetic alteration of a medulloblastoma?

A

Loss of material from short arm of chromosome 17

43
Q

Highly malignant, but is extremely radiosensitve tumor if dx early enough.

If untreated is rapidly fatal.

A

Medulloblastoma

44
Q

With total excision and radiation of a medulloblastoma, the 10 year survival rate is ___%.

A

only 50%

45
Q

What is the chromosomal abberation seen in meningiomas?

A

Either deletion or mutation of chromosome 22

46
Q
  • Intracranial tumor
  • Arises from arachnoid villi
  • Produces sxs by compressing brain tissue
A

Meningioma

47
Q

Peak incidence of meningiomas is which 2 decades of life?

A
  • 4th (30 - 39 yrs)
  • 5th (40 - 49 yrs)
48
Q

Intracranial tumor most common in:

  • parasagital areas
  • convexities of cerebral hemispheres
  • olfactory groove
  • lateral wing of sphenoid
A

Meningioma

49
Q
  • Has propensity to erode contiguous bone
  • Slightly more common in females (60:40)
  • Benign tumor
A

Meningioma

50
Q
  • Majority arise sporadically
  • Can be induced by cranial radiation w/ latent period of 10 - 15 yrs
  • Well circumscribed, firm, bosselated masses of variable size
  • Gray fibrous patter (when cut)
  • Cause HA
A

Meningioma

51
Q
  • Meningiomas in which location cause anosmia?
  • Meningiomas in which location lead to visual defects?
A
  • Olfactory groove
  • Suprasellar region
52
Q
  • Depending on location of tumor, pt usually has seizures rather than neuro deficits
  • If not completely excised, tend to recur
  • Doubles in size every 2 years
A

Meningioma

53
Q

Pain down back/leg/knee when hip is flexed

A

Kernig’s Sign (sign of bacterial meningitis)

54
Q

Spontaneous flexion of knees and hips when neck is flexed

A

Brudzinski sign (sign of bacterial meningitis)

55
Q
A

Pathophys Exam 1 (14 decks)

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