Neuropathology 4-15

Front 1

name two diseases that affect the CEREBRAL CORTEX

Back 1

1) Alzheimer's disease 2) Pick's disease

Front 2

name two diseases that affect BASAL GANGLIA & BRAIN STEM:

Back 2

1) Huntington's disease 2) Parkinson disease

Front 3

in the spinal cord:

name 3 degenerative MOTOR NEURON diseases

Name 3 degenerative SPINOCEREBELLAR diseases

Back 3

1)ALS = amyotrophic lateral sclerosis 2)Werdnig-Hoffmann disease 3) Polio

1) Olivo-ponto-cerebellar atrophy 2) Friedreich's ataxia 3) subacute combined degeneration [B12 deficiency]

Front 4

what is the most common cause of elderly dementia?

Back 4

Alzheimer's

Front 5

name two pathological findings characteristic of Alzheimer's

Back 5

1) senile plaques = intracytoplasmic inclusion bodies 2) neurofibrillary tangles (abnormally phosphorylated tau protein)

Front 6

what is the 2nd most common cause of dementia in elderly?

Back 6

multi-infarct dementia in elderly\

Front 7

How can Alzheimer also affect intracranial vasculature?

Back 7

amyloid angiopathy --> intracranial hemorrhage

Front 8

The familial form of Alzheimer's is associated with what chromosomes and (name the allele's name in 2 of the 4)

Back 8

chromosome 1, 14, 19 (APO-E4 allele), 21 (p-App gene)

Front 9

What is pathognemomic with Pick's disease upon histology?

Back 9

Pick bodies = intra-cytoplasmic inclusion bodies

Front 10

What cortical areas does Pick's disease affect

Back 10

Frontal and temporal lobes (remember; sharp, atrophic appearance of gross specimen)

Front 11

What is the inheritance pattern of Huntington's

Back 11

Auto Dominant

Front 12

What are some symptoms of Huntingtons?

Back 12

1) chorea 2) dementia

Front 13

Huntington's is due to atrophy of _____ what?

Back 13

atrophy of caudate nucleus = loss of GABA-nergic neurons

Front 14

what is the genetic abnormality of Huntington's?

Back 14

1) Chr. 4 - expansion of CAG repeats

Front 15

Parkinson disease is associated with what pathology findings?

Back 15

1) Lewy bodies 2) depigmentation of substantia nigra (loss of dopaminergic neurons)

Front 16

rare cases of Parkinson's have been linked to what contaminant of certain illicit drugs?

Back 16

MPTP = contaminant to street drug

Front 17

Parkinson's can make you feel in a "TRAP" = ?

Back 17

T = tremor at rest; R = cogwheel rigidity; A = akinesia ; Postural instability

Front 18

ALS = Lou Gehrig's disease (the Iron Horse of the Yankees, hero of Joe DiMaggio) = what signs is ALS associated with?

Back 18

Both UMN and LMN deficits

Front 19

Werdnig-Hoffman disease - presents as birth as?

Back 19

1) floppy baby syndrome 2) note tongue fasciculations as well (also seen in ALS)

Front 20

for Polio, what kind of signs to you see?

Back 20

predominantly LMN deficits.

Front 21

name 4 types of cranial related hemorrhages (think of layers that could possibly be involved)

Back 21

1) epidural hemorrhage 2) subdural h 3) subarachnoid h 4) parenchymal h

Front 22

what is a common site of epidural hematoma/hemorrhage

Back 22

1) rupture of MMA: middle meningeal artery, often 2ndary to fracture of temporal bone

Front 23

what does CT show for epidural h?

Back 23

biconcave disc NOT crossing suture lines

Front 24

what else do you see in epidural hematoma?

Back 24

lucid interval

Front 25

How do subdural h. most often occur?

Back 25

rupture of bridging veins (think, elderly being jolted in roller coaster)

Front 26

subdural hematoma is venous bleeding so how would this influence symptomatic findings?

Back 26

venous = less pressure = delayed onset of symptoms

Front 27

what types of people do you see subdural h.?

Back 27

1) elderly, 2) alcoholics 3) blunt trauma/sudden change in velocity injuries

Front 28

for SUBDURALs what do you see upon CT?

Back 28

1) crescent-shaped hemorrhage instead 2) YES IT does cross the suture lines

Front 29

subarachnoid hemorrhage is often seen where (name 2 types

Back 29

rupture of 1) aneurysm (usually Berry aneurysm) or an 2)AVM

Front 30

symptoms of subarachnoid hemorrhage?

Back 30

the worst headache of my life

Front 31

since its subarachnoid (hemorrhage), what do you see on what test?

Back 31

bloody or xanthochromic CSF on spinal tap

Front 32

name 4 risk factors for parenchymal hematoma

Back 32

1) HTN 2) amyloid angiopathy 3) diabetes mellitus 4) tumor

Front 33

most common site for Berry aneurysms

Back 33

bifurcation of the anterior communicating artery (Circle of Willis)

Front 34

berry aneurysms are associated with which genetic diseases

Back 34

adult polycystic disease, Ehlers-Danlos s., and marfan's

Front 35

Classic triad of Multiple Sclerosis

Back 35

SIN: Scanning speech, intention tremor, nystagmus (affect woman 20-30s)

Front 36

Prevalence of MS

Back 36

increase prevalence w/ increased distance from the equator

Front 37

Clinical s/s of MS, labs, pathology.

Back 37

periventricular plaques, preservation of axons, loss of oligodentrocytes, reactive astrocystic gliosis, increased protein in csf(IgG) in CSF, relapsing course, optic neuritis, MLF syndrome, hemiparesis, bladder/bowel incontinence)

Front 38

Progressive multifocal leukoencephalopathy (PML) is associated w/

Back 38

JC virus and seen in 2-4 % of AIDS pts (reactivation or latent infect)

Front 39

pathogenesis of Guillian-Barre syndrome

Back 39

Inflammation and demyelination of peripheral nerves and motor fibers of the ventral roots (sensory effec less severe than motor)

Front 40

s/s of Guillian-Barre syndrome, lab findings

Back 40

symmetrical ascending muscle weakness beginning in the distal lower extremities. Autonomic fxn may be severely affected (eg. Cardiac irregularities, HTN, or hypoTN) Findings: inc. csf protein w/ normal cell count ("albumino-cytologic dissociation") elevated protein may lead to papilledema

Front 41

association between G-B syndrome and…

Back 41

herpesvirus or camplobacter jejuni infection, inoculations, and stress but no definitive link to a pathogen

Front 42

organism causing polio and mechanism of action

Back 42

poliovirus, transmitted via fecal oral route and enters blood stream then into CNS where it causes destruction of the anterior horn of S.C. leading in turn to LMN destruction

Front 43

s/s of polio

Back 43

malaise, HA, fever, nausea, abd. Pain, sore throats, signs of LMN signs

Front 44

lab findings of polio

Back 44

csf w/ lymphocytic pleocytosis w/ slight elevation of protein, virus recovered from stool or throat

Front 45

describe Broca's (expressive) aphasia

Back 45

confluent aphasia w/ intact comprehension broca's is broken speech

Front 46

describe Wernicke's (aphasia)

Back 46

Fluent aphasia w/ impaired concentration Wernick's ="What?" W area located in superior temperal gyrus

Front 47

describe two types of partial seizures

Back 47

1.simple partial (awareness is intact)--motor, sensory, autonomic, psychic 2.Complex partial (impaired awareness)

Front 48

describe types of Generalized seizure ( diffuse)

Back 48

1.absence- blank stare (petit mal) 2.myoclonic- quick repetitive jerks 3.tonic-clonic- alternating stiffening and mvmt (grand mal) 4. Tonic- stiffening 5.atonic-"drop" seizures

Front 49

what are the causes of seizures in children?

Back 49

genetic, infection, trauma, congenital, metabolic

Front 50

what are the causes of seizures in adults?

Back 50

tumors, trauma, stroke, infection

Front 51

what are the causes of seizures in elderly?

Back 51

stroke, tumor, trauma, metabolic, infection

Front 52

what is Horner's syndrome?

Back 52

sympathectomy of face (lesion above T1) 1.Ptosis 2.anhidrosis and flushing of affected side 3.miosis [PAM is horny]

Front 53

Horner's syndrome is associated w/ what type of tumor?

Back 53

pancoast tumor

Front 54

what is syringomyelia?

Back 54

enlargement of the central canal of the S.C. Crossing fibers of spinothalamic tract are damaged.

Front 55

what are the s/s of syringomyelia?

Back 55

b/l loss of pain and temp sensation in the upper extremities w/ the touch sensation. Most common at C8-T1

Front 56

syringomyelia commonly seen in what pts?

Back 56

pts w/ Arnold-Chiari malformation

Front 57

Tabes dorsalis what infection is tabes dorsalis associated w/?

Back 57

teriary syphilis

Front 58

Tabes dorsalis what happens in the CNS?

Back 58

degeneration of dorsal columns and dorsal root

Front 59

Tabes dorsalis dorsalis also is associated with what s/s?

Back 59

charcot's joint, shooting (lightning) pain, Argyll Robertson pupils, and absence of DTRs