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Pathophys Exam 1 > Review Questions 3 > Flashcards

Review Questions 3 Flashcards

1
Q

What are the most common tumors that metastasize to the brain?

A
  • Disseminated Melanoma (50% of metastasis)
  • Breast and lung (35%)
  • Kidney and colon (5%)

**Prostate, liver and sarcomas rarely spread

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2
Q
  • A chronic demyelinating disease of the CNS in which there are numerous patches of demyelination throughout gray or white matter?
  • Which disease?
A
  • White matter
  • Multiple Sclerosis (MS)
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3
Q
  • Disease which affects both sensory and motor functions
  • Characterized by exacerbations/remissions over period of several years
A

MS

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4
Q
  • MS is commonly found in which climates? Which climate is it rare in?
  • MS is acquired at which age? Rare in which ages?
A
  • Common: temperate climates
  • Rare: Tropics
  • Acquired: age 30
  • Rare before 14 yrs, rare after 60 yrs
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5
Q

Which sex is most affected by MS?

A

Women, twice as often!

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6
Q

Etiology of MS

A

Idiopathic. But, experimental/clinical studies point to:

  • genetic
  • immune
  • infectious
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7
Q

Plaques are the hallmark of this diease

A

MS

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8
Q
  • Describe plaques of MS.
  • Where are they most commonly located?
A
  • Variable size w/ smooth rounded contour
  • Usually in white matter, but occasionally breech the gray-white junction
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9
Q

With MS, where do the plaques prefer to be?

A

Optic nerves and chiasm, uniformly localized to periventricular white matter

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10
Q

What are plaques in MS?

A

Areas of demylenation

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11
Q

Clinically, when does MS onset?

A

3rd or 4th decades

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12
Q

When a patient with MS has an “exacerbation,” what does this mean?

A

There is a formation of new plaques of demylenation

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13
Q

What are the initial sxs of MS?

A
  • Sxs related to lesions of optic nerves, brainstem, or spinal cord.
  • Blurred vision or loss of vision in one eye is common
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14
Q

With MS, if the initial lesion is in the brainstem, what are the 2 most troubling early sxs?

A
  • Double vision
  • Vertigo
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15
Q

W/ MS, plaques within the spinal cord show which sxs?

A
  • Weakness of one or both legs
  • Sensory sxs (numbness in LE)
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16
Q

Are sxs of MS reversible?

A

Yes, many sxs are “partially reversible” within a few months, but in most patients the course of the disease is chronic relapse/remitting

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17
Q
  • MS patients range from minor disability to severe incapacity (paralysis, dysarthria (slurred/slow speech), severe visual defects, incontinence, dementia.
  • Patients w/ MS usually die of which 2 things?
A
  • Respiratory paralysis
  • UTIs (as most are women)

*When they are in a terminal coma*

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18
Q

An Intracranial Schwannoma (acoustic neuroma) is restricted to which cranial nerve, located where?

A

8th CN in the cerebellar pontine angle (CPA)

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19
Q

Causes tinnitus, deafness, and if large enough can compress cranial nerves.

A

Intracranial Schwannoma (acoustic neuroma)

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20
Q

Are acoustic neuromas (Intracranial Schwannoma) malignant?

A

Rarely, although they can recur with incomplete excision

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21
Q

What is an example of pseudomembranous infammation?

A

C. difficile causing pseudomembranous colitis caused by a bacterial overgrowth secondary to intake of broad spectrum abx.

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22
Q

A complication of wound healing from lack of sufficient tensile strength resulting in separation of wound margins.

A

Dehiscence

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23
Q
  • Deficient scar formation occurs in DM patients due to ischemia and metabolic disturbances. These patients have higher levels of experiencing wound dehiscence due to what?
  • What substance is not produced as much in patients tx w/ corticosteroid hormones which lead to dehiscence?
A
  • DM: Sluggish formation of granulation tissue
  • Cortico: Collagen
24
Q

Excess scar formation w/ defective remodeling of scar tissue/results in immature scar

  • What is an example of this?
  • What are they composed of?
A
  • Keloid
  • Type 3 Collagen
25
Q

Etiology of keloids?

A

Genetic

26
Q

Vascularized connective tissue that is rich in macrophages + (myofibroblasts, angioblasts, fibroblasts). What is this called?

A

Granulation tissue

27
Q

Precursors of blood vessels that proliferate like sprouts from the several small blood vessels at the margins of the wound. (Development of new blood vessels)

A

Angioblasts/Angiogenesis

28
Q
  • Healing of sterile surgical wounds
  • Incision site initially contains coagulated blood forming a scab
  • PMNs invade scab (scavenge debris), then 2 - 4 days later replaced by macrophages
A

Healing by First Intention

29
Q
  • Composition of the wound matrix changes from Fibronectin and Collagen 3 –> Collagen 1
  • Proliferation of epithelial cells from wound margins cover defect within 3 - 7 days
A

Healing by First Intention

30
Q

Granulation tissue filling a skin defect of a wound healing by primary intention will transform into a scar by when?

A

3 - 6 weeks

31
Q

Wound healing of large defects and all infected wounds

A

Secondary intention

32
Q
  • Granulation tissue exposed to external surface
  • Myofibroblasts cannot accomplish wound contraction
A

Secondary intention

33
Q

Type 3 collagen

Mature or Immature?

A

Immature

34
Q

Type 1 Collagen

Mature or Immature

A

Mature, most common form of collagen in body

35
Q

an antibody or other substance which binds to foreign microorganisms or cells making them more susceptible to phagocytosis.

A

Opsonin

36
Q

2 examples of opsonins

A
  • Immunoglobulins (Fc)
  • Complement (C3)
37
Q

•A special form of chronic inflammation that typically is not preceded by an acute, PMN-mediated inflammation.

A

Granulomatous Inflammation

38
Q

What causes Granulomatous Inflammation?

A
  • antigens that evoke a cell-mediated hypersensitivity reaction
  • antigens that persist at the site of inflammation
39
Q

Oral cavity to esophagus is made of which type of tissue?

A

Stratified squamous

40
Q

Stomach to Anus, which type of tissue?

(pancreas, gallbladder, liver)

A

Glandular

41
Q

When the heart is damaged, this is loss of myocardial cells. How does the heart repair itself? What cells is it made of?

A
  • Fibrous scarring
  • Non-dividing/Permanent cells (do not proliferate under any circumstances)
  • Damage to heart is irreversible
42
Q

Damage to brain results in loss of brain cells. How does the brain repair itself?

What cells?

A
  • Gliosis/Astrogliosis
  • Non-dividing/Permanent cells
  • Irreversible damage
43
Q

What are the 3 cell types that enter the cell cycle?

A
  • Continuously dividing (labile) cells
  • Quiescent (stable) cells
  • Nondividing (permanent) cells
44
Q
  • Stem cells (RBC) , which type of cell?
  • Bone marrow
  • Intestine
A

Continuously dividing (labile cells)

45
Q

Cells of parenchymal organs (solid) : liver and kidneys are made of which cell type?

A

Quiescent cells (stable cells)

46
Q

Neurons and Myocardial cells are which cell type?

A

Nondividing (permanent) cells

47
Q
  • 20% of primary intracranial neoplasms
  • Poorly demarcated, infiltrates cortex, indistinct margin
  • Can be seen in pons and cerebellum of children
  • Can be seen in cervical spinal cord in young adults
A

Grade 1 Astrocytoma

48
Q
  • Life expectancy is 5 years w/ therapy: surgery and radiation
  • Transformation to higher degree anaplasia (GBM) occurs in 10% of cases which shortens life expectancy
A

Grade 1 Astrocytoma

49
Q
  • Greater cellularity
  • Cellular pleomorphism
  • Anaplasia
  • Rapid growth of tumor
  • Life expectancy of 3 years w/ therapy
A

Anaplastic Grade 2 Astrocytoma

50
Q
  • 40% of primary intracranial neoplasms
  • Predominates in later decades of life
  • Life expectancy of 18 months w/ therapy
  • Infiltrates extensively into cortex, frequently crossing corpus callosum
A

Glioblastoma Multiforme (GBM)

51
Q
  • Extends bilaterally into white matter of both hemispheres
  • Has both mottled red (recent hemorrhage) and yellow (remote hemorrhage)
  • Looks like butterfly
A

GBM

52
Q

How does HTN compromise the integrity of cerebral arterioles which leads to HTN associated aneurysms?

A

Through deposition of lipid and hyaline material in the walls (lipohyalinosis)

53
Q

Charcot-Bouchard aneurysms are small fusiform dilatations in the trunk of a vessel as opposed to bifurcation. They are predisposed to rupture and cause which type of hemorrhage?

A

Hypertensive cerebral hemorrhage

54
Q

What may cause death by transtentorial herniation?

A

Hypertensive Intracerebral hemorrhage

55
Q

Etiology of strokes

A

Atherosclerosis predisposes pt to vascular thrombosis and embolic events

(ischemic strokes most common)

Pathophys Exam 1 (14 decks)

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