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76 Cards in this Set
- Front
- Back
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Possible clinical presentations of concussion
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loss of consciousness loss of reflexes, respiratory arrest at time of injury, event amnesia, nausea, vomiting. no permanent damage
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Most common cause of aseptic meningitis
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enterovirus
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Types of Neural tube defects
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Spina Bifida Occulta (caudal), Meningocele, myelomeningocele, anencephaly (worst, lethal)
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Parkinson's Disease
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loss of pigmented dopaminergic neurons of the substantia nigra, resulting in pill rolling tremors, cogwheel rigidity and shuffling gait
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Multiple Sclerosis (MS)
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Autoimmune, relapsing chronic disease, causes demyelination of the CNS, Brain, Optic nerve, etc. causes
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What% of CNS tumors are metastatic? where are they found?
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50% multiple lesions, found mostly at gray/white matter junction
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Types of contusions
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Coup: injury to the area of impact
Contra Coup: injury to opposite side of impact. (seen in sudden stops) |
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Different leukocyte findings (in CSF) between aseptic and septic meningitis
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in aseptic (viral) will be mostly lymphocytes, in septic (bacterial) will be mostly neutrophils
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What do you look for in the amniotic fluid to confirm neural tube defects
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very high levels of alpha fetoprotien
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Exposure to which chemical can cause parkinson's disease
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MPTP, biproduct of meperidine synthesis
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Main Genetic association with Multiple Sclerosis (MS)
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HLA-DR2
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What are the two main primary CNS tumors?
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meningiomas and glioblastoma multiforma. Primary, invasive, and large single tumors.
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Signs and symptoms of CNS tumors
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late night or early morning headaches, seizures, mental status changes, focal neurologic deficits
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Gross appearance of contusions to brain
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hemorrhage, liquifactive necrosis, yellow plaque area (scar)
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Most common cause of septic meningitis in newborns, and treatment
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Group B Strep: Treatment
Ceftriaxone and amoxicillin. Could also treat with Penicillin G. also prednisone to reduce inflammation and scarring |
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What supplement should be taken prior to pregnancy to reduce risk of NTD's
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Folate, or folic acid
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What is the mechanism of the tremors, rigidity, and akinesia in Parkinsons?
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the loss of the inhibition of the inhibitory pathways to the thalamus
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CSF finding for people with MS
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oligoclonal bands of IgG, and oligoclonal CD-4 lymphocytes
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Astrocytomas
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have fibrillary background, stain with GFAP, ill defined border.
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Diffuse axonal injury
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Injury to white matter, seen in acceleration/deceleration injury. axon damage at nodes of ranvier (corpus callosum, peduncles)
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Most common cause of meningitis in the 3 month old through adolescence, with up to date immunizations
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Neisseria gonorrhoeae: Treatment
Ceftriaxone. Could also treat with Penicillin G also prednisone to reduce inflammation and scarring |
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What is Arnold-Chiari Malformation type 2
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posterior fossa is too small, the cerebellum is moved downward compressing 4th ventricle or spine, causing hydrocephalus or syringomyelia
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What will we see microscopically in the remaining dopaminergic neuronal cytoplasm in the patient with parkinsons?
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Lewy bodies, pink inclusions, composed of A synuclein
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Acute lesion seen in patients with MS
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well circumscribed plaque, area of demyelination of white matter. periventriclular. looks like gray matter in white matter
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two types of astrocytomas
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fibrillary: and pilocytic
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Spinal cord injury above what level could cause respiratory paralysis and death
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C4
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Most common cause of meningitis in the 3 month old through adolescence, without up to date immunizations
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Haemophilus influenzae:
Ceftriaxone and amoxicillin. Could also treat with Penicillin G |
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What is syringomyelia? and what does it cause?
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defect of the central tube causing cavitation, damaging pain and temperature crossing fibers. cape like distribution loss of sensation
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Mainstay treatment for parkinsons
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Levodopa and carbadopa
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Pathology of the peri-ventricular plaques seen in MS
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destruction of the myelin sheaths of the axons, axons are not affected, so after resolution of flare up, symptoms will go away
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Grades of astrocytomas
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grade 1,2 well differentiated grade 3. anaplastic, aggressive grade 4: glioblastoma multiforma most common, and most lethal
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3 types of brain herniations
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sub falcine: compresses ACA
uncal: impinges 3d CN, and PCA tonsilar: compresses medulla oblongata, causes resp arrest |
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Most common cause of septic meningitis in the elderly
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Strep pneumococcus and Listeria monocytogenes
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Perinatal brain injury
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injury to brain during prenatal and immediate post natal period.major cause of cerebral palsy. bleeding in germinal matrix
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Huntingtons disease
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autosomal dominant, loss of gabanergic neurons in the caudate, causes dementia, chorea, and personality changes. anticipation makes it worse and earlier each generation
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Clinical presentation of MS
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weakness or loss of sensation in extremities. optic neuritis, visual loss, internuclear opthamoplegia. hemi paresis
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Gross and microscopic morphology of glioblastoma multiforma
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occur in white matter, ill defined, often crosses corpus callosum, ring enhancing on CT/MRI. butterfly shape. hyperchromatic, anaplastic, central necrosis,marked vessel proliferation pseudopallisading cells
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CSF findings for septic (bacterial) meningitis
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very high neutrophil count, low glucose level, high protein, very high opening pressure
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Gene implicated in Huntingtons disease,
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HD Gene on Chromosome 4, makes huntington protien. is a triplet nucleotide repeating gene (CAG).
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Treatment of MS
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Treatment of flare ups is with high dose steroids
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Most common and most lethal tumor in adult brain
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glioblastoma multiforma, usually above tentorium cerebelli (70%)
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CSF findings for aseptic (viral) meningitis
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high lymphocytes, normal glucose, high protein, high opening pressure
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Pathology seen in Huntingtons, gross and micro
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gross, visible loss of caudate, making ventricle seem dilated.
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Central Pontine myolenolysis
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malnurished patient with low Na. When Na is corrected too quickly, causes demyelination of basis pontus. causes death
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Pilocytic astrocytomas
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usually bening tumors, occuring in children, found below tentorium cerebelli (70%). gross: cystic masses with a mural nodule. Micro: spindled shaped astrocytes, with rosenthal fibers
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CSF findings for fungal or TB caused meningitis
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high lymphocytes, low glucose, high protein, high opening pressure.
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Cause of Chorea (dancelike movements) in Huntingtons
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Loss of inhibitory gabanergic neurons in caudate
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Oligodendroglioma
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tumor of oligodendrocytes, usually in adults, in frontal lobe white matter. causes seizures. calcified mass on x ray. nucleus is surrounded by a halo, a fried egg appearance. chicken wire vessels
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Common features of encephalitis
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perivascular cuffs of lymphocytes, microglial nodules, neuronophagia
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Treatment for personality disorders associated with Huntingtons
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Haloperidol
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ependymoma
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ependymal cell tumor. in kids, found in 4th ventricle, in adults, found in lateral ventricles or spinal cord. well circumscribed papillary tumors in ventricular cavities
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clinical features of encephalitis
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mental status changes, fever and headache
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Most frequent cause of dementia
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Alzeimers, 60 percent of all cases. percentage of population with alzeimers: 2% at 65, then doubles every 5 years
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clinical presentation of ependymomas
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cause obstructive hydrocephalus, get more aggressive over time, and recur after surgery
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causes of encephalitis
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Herpes simplex type 1(goes to temporal region), Rabies(goes to cerebellum and hippocampus) HIV (aids dementia complex)
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Risk factors for Alzheimers
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aging, head trauma, and aluminum(epiphenomenon)
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meningiomas
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normally found in adults, come from meningothelial cells of the arachnoid. attached to dura. could cause focal neuro signs from pressure. micro: spindle shaped whirling patterns with dystrophic calcifications, called psammoma bodies
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In Rabies caused encephalitis, what will you see microscopically in the cerebellum
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Pink inclusions in the neuronal cell cytoplasm, called negri bodies
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Protective factors for Alzheimers
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use, education. cigarette smoking
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Primitive neuroectodermal Tumors (PNET)
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highly undifferentiated. arise from primordial neural glial precursors. named for where its found. normally in childhood, small round blue tumor cells, all aggressive
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Diagnostic Criteria for AIDS related encephalitis
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multinucleated giant cells in brain, in spinal cord it has vacuolar myopathy.
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genetics implicated in Alzheimers
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(BAP) beta amyloid precursor protein on Chromosome 21 (reason why downs always get it by age 40). presenilin genes 1, 2. get early onset alzeimers. Apolipoprotien E4 gene over representated, E2 is underrepresented
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Schwannomas
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S100+ tumors, normally found on 8th CN, called accoustic neuromas. if bilateral, they are seen with type 2 neurofibromatosis. spindle shaped cells form verocay bodies
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Cause of progressive multifocal leukoencephalopathy (PML)
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JC virus
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Gross Pathology of Alzheimers
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deposition of abnormal Amyloid B proteins inside and outside the cell in the brain. Wasting of brain causes hydrocephalus ex vacuole
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craniopharyngioma
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benign tumors formed from remnants of rathkes pouch in the supracellar region. normally in kids. cystic, can be calcified, can press on optic chiasm
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Alzheimers predisposes to which type of Hematoma?
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due to wasting of brain tissue and stretching of bridging veins, an subdural hematoma is most likely
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Stains used to demonstrate Senile plaques in alzheimers, and what you will see
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H&E stain shows a core of BAPP. Silver stain shows dystrophic neuritic and dendritic processes.
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Other pathologies seen microscopically in alzheimers
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Neurofibrilary tangles composed of twisted Tau protiens. Granulovacular degenerations, and hirano bodies.
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Clinical presentation of alzheimers
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insidious progressive recent memory impairment. Mood and behavior changes, disorientation. ultimately asphasia
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Most common cause of death in alzheimer's patients
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pneumonia
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Only way to truly diagnose Alzheimers
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Autopsy
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Dementia with Lewy bodies
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Lewy bodies (similar to parkinsons, neuronal loss, and dementia. involves limbic system and cingulate gyrus
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ALS Amyotrophic lateral sclerosis (lou Gherig's disease)
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degeneration and loss of both upper and motor neurons. No Sensory problems. causes hyperreflexia, spasticity, weakness
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In genetically predisposed cases of ALS, what is the responsible gene? 5-10 percent of all cases are genetic
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the zync, copper supraoxide dismutase gene
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Friedreich's ataxia
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recessive, affects children, triplet repeat mutations of the frataxin gene, degenerates neurons. causes gait ataxia, disarthrias, vibratory and position sense, loss of DTR's
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