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86 Cards in this Set
- Front
- Back
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MCC dementia
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Alzheimer's
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anterior atrophy of the cortex
ventricular system enlarged |
Alzheimer's
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Anatomical site most serverely affected in AD
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hippocampus and adjacent enterhinal system
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area of the hippocamus most sensitive to hypoxia
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CA1
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Neurofibrillary tangles and neuritic plaques
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AD
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2 AD findings in addition to tangles and plaques
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gliosis
amyloid angiopathy |
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spontaneous hemorrhage in basal ganglia
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HTN induced
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accumulation of microtubule associated protein aka perihelical filaments
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neurofibrillary tangles
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what stain is used to see tangles on H&E
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silver
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2 types of plaques and how are they different
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neuritic: Beta amyloid core
diffuse aB42 neuritic plaque is used 4 diagnosis of AD diffuse natural part of aging |
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central amyloid core w/ radiating spicules surrounded by microglia
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neuritic plaque
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amyloid configuration
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B pleated sheet
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spontaneous hemmorrhage in deep white matter
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amyloid angiopathy associated with AD
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rod-like eosinophilic bodies in hippocampus; main consitutent is actin
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Hirano bodies
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where is granulovacuolar degeneration most likely seen
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hippocampal pyramidal cells
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how can you differentiate neurons from astrocytes
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neurons have prominent nucleolus
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genetic risk factors for AD
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early onset: Downs chromosome 21, 14
late: alz precursor protein (21) & ApoE (19) |
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Lewy bodies
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parkinson's
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degen of structures that stain with ubiquitin and alpha synuclein but not silver stains
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lewy body disorders
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which structures show degeneration in lewy body disorders
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pigmented nuclei: substantia nigra, dorsal motor nucleus of vagus, hippocampus, amygdala, locus coeruleus
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Lew body disorder gene
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synuclein gene on 4q
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cognitive decline, visual and nonvisual hallucinations, narcoleptic drug sensitivity. Diagnosis made at autopsy
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diffuse LB disease
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Lew bodies in deep layers of temporal,c ingulate and insular cortex
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diffuse LB disease
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CN in interpeduncular foci
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III
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Progressive supranuclear palsy (PSP) aka
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steele-richardson-olszewski
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man walks with his head back
expressionless face dysphagia |
Progressive supranuclear palsy (PSP)
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how does PSP differ from parkinson's microscopically
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PSP more areas of brain affected
loss of neurons |
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brief focal neurologic infarcts with neurologic deficits; loss of myelin; arteriosclerosis
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Binswanger disease
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Binswanger disease is associated with what types of cells
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foamy macrophages
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degenerative disease that spares the posterior 2/3 of superior temporal gyrus and is associated with atrophy of striatum
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Pick's
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pt neglects of appearance and inappropriate behavior
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frontal lobe dementias eg. Picks
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T/F: Lou Gehrig's disease affects bilateral proximal muscles
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F: bilateral distal muscles
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dark staining brown (silver and ubiquitin)bodies in dentate
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Pick bodies
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when does motor neuron dementia usually present
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6th decade
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inclusions in dentate that are ubiquitin positive
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motor neuron type dementia
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atrophy of ventral root
bunina bodies in anterior horn ballooned neurons and axonal spheroids |
Lou Gehrig's
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Huntington's disease: gene
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4p
trinucleotide repeat: CAG |
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Huntington's: what structues are affected
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atrophy of striatum
neuronal loss and gliosis in striatum and cortex |
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Huntington's histology
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loss of medium GABA+ spiney neurons
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diagnostic of AD
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neuritic plaques
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injury to the myelin sheath, but relative preservation of the axon
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demyelinating diseases
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T/F: There are multifocal lesions In demyelinating diseases
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T
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T/F: myelin loss is most severe around arteries In demyelinating diseases
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F: most severe around the veins (perivenous) and often patchy
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T/F: you see perivascular infiltrates of lymphocytes and plasma cells in demyelinating diseases
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T
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name the only demyelinating disease that does not have multifocal lesions
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central pontine myelinolysis
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MS: etiology
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immune attach on myelin sheath; influenced by environmental and genetic factors
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MS: who
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females. onset 20-40yo
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Name variants of MS
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Acute (Marburg)
Schilder variant concentric sclerosis (Balo) Classic |
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MS variant that mimics neoplastic mass
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marburg
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MS variant seen in peds
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schilder
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MS variant with similar histology, but fatal clinical course
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Concentric
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MS: histology of LP
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oligoclonal bands of immunoglobulin in CSF (caused by proliferation of B cells)
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MS: brain structures
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optic nerve, brainstem, spinal cord
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MS: MRI findings
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periventricular lesions in white matter
well-circumscribed,horseshoe-shaped ring enhancing lesions |
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MS: diagnostic test
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myelin stain highlights trouble spots
slide looks normal with Bielschowsky silver stain |
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30yo female presents with optic neuritis, CN signs, ataxia, spasticity, motor and sensory impairment, loss of voluntary bladder control
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MS
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3 types of plaques in MS
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active chronic
inactive chronic shadow |
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MS-like disease seen in Asians
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Neuromyelitis optica aka devic
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why is Neuromyelitis optica (Devics) in it's own group
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lack of oligoclonal bands
neutrophils and protein in CNS Necrosis |
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Neuromyelitis optica (Devics): prognosis
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rapidly progressive
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monophasic disease which follows a viral infection
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acute disseminated encephalomyelitis
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pt presents with headache, lethargy and coma 3days after URTI
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acute disseminated encephalomyelitis
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diffuse perivenous demyelinating not-well circumscribed lesions
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acute disseminated encephalomyelitis
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acute disseminated encephalomyelitis: early and late findings
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early: PMNs
late: mononuclear cells with lipid-laden macrophages |
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acute disseminated encephalomyelitis: mortality rate
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20-30%
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Acute Hemorrhagic Leukoencephalitis: etiology
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necrosis of small vessels following URTI
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"ball and ring" petechial hemorrhages in white and gray matter (cerebral purpura)
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acute disseminated encephalomyelitis
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perivascular fibrin deposition and fibrinoid necrosis of small vessels
neutrophils |
acute disseminated encephalomyelitis
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histological features of acute disseminated encephalomyelitis may also be seen in ....
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malaria
fat embolism |
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PML: etiology
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JV virus
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white matter pits around junction between white/gray matter
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PML
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bizarre astrocytes
intranuclear viral inclusions in oligodendrocytes |
PML
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cental pontine myelinolysis: who
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alcoholic, malnourished, severe electrolyte or osmolar imbalances, liver transplkant recipients
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cental pontine myelinolysis: why
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too-rapid correction of hyponatremia--> osmotic stress
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cental pontine myelinolysis: presentation
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sudden quadriplegia, fatal course
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diamond-shaped, symmetrical demyelination in central pons at level of CN5
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cental pontine myelinolysis
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cental pontine myelinolysis: which areas are spared
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periventricular and subpial
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cental pontine myelinolysis: what's found in 10% of cases
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extrapontine lesions
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white matter pits around junction between white/gray matter
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PML
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bizarre astrocytes
intranuclear viral inclusions in oligodendrocytes |
PML
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cental pontine myelinolysis: who
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alcoholic, malnourished, severe electrolyte or osmolar imbalances, liver transplkant recipients
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cental pontine myelinolysis: why
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too-rapid correction of hyponatremia--> osmotic stress
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cental pontine myelinolysis: presentation
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sudden quadriplegia, fatal course
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diamond-shaped, symmetrical demyelination in central pons at level of CN5
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cental pontine myelinolysis
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cental pontine myelinolysis: which areas are spared
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periventricular and subpial
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cental pontine myelinolysis: what's found in 10% of cases
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extrapontine lesions
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