neuropathology 4-15
Terms
undefined, object
copy deck
- name two diseases that affect the CEREBRAL CORTEX
- 1) Alzheimer's disease 2) Pick's disease
- name two diseases that affect BASAL GANGLIA & BRAIN STEM:
- 1) Huntington's disease 2) Parkinson disease
-
in the spinal cord:
name 3 degenerative MOTOR NEURON diseases
Name 3 degenerative SPINOCEREBELLAR diseases -
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] - what is the most common cause of elderly dementia?
- Alzheimer's
- name two pathological findings characteristic of Alzheimer's
- 1) senile plaques = intracytoplasmic inclusion bodies 2) neurofibrillary tangles (abnormally phosphorylated tau protein)
- what is the 2nd most common cause of dementia in elderly?
- multi-infarct dementia in elderly\
- How can Alzheimer also affect intracranial vasculature?
- amyloid angiopathy --> intracranial hemorrhage
- The familial form of Alzheimer's is associated with what chromosomes and (name the allele's name in 2 of the 4)
- chromosome 1, 14, 19 (APO-E4 allele), 21 (p-App gene)
- What is pathognemomic with Pick's disease upon histology?
- Pick bodies = intra-cytoplasmic inclusion bodies
- What cortical areas does Pick's disease affect
- Frontal and temporal lobes (remember; sharp, atrophic appearance of gross specimen)
- What is the inheritance pattern of Huntington's
- Auto Dominant
- What are some symptoms of Huntingtons?
- 1) chorea 2) dementia
- Huntington's is due to atrophy of _____ what?
- atrophy of caudate nucleus = loss of GABA-nergic neurons
- what is the genetic abnormality of Huntington's?
- 1) Chr. 4 - expansion of CAG repeats
- Parkinson disease is associated with what pathology findings?
- 1) Lewy bodies 2) depigmentation of substantia nigra (loss of dopaminergic neurons)
- rare cases of Parkinson's have been linked to what contaminant of certain illicit drugs?
- MPTP = contaminant to street drug
- Parkinson's can make you feel in a "TRAP" = ?
- T = tremor at rest; R = cogwheel rigidity; A = akinesia ; Postural instability
- ALS = Lou Gehrig's disease (the Iron Horse of the Yankees, hero of Joe DiMaggio) = what signs is ALS associated with?
- Both UMN and LMN deficits
- Werdnig-Hoffman disease - presents as birth as?
- 1) floppy baby syndrome 2) note tongue fasciculations as well (also seen in ALS)
- for Polio, what kind of signs to you see?
- predominantly LMN deficits.
- name 4 types of cranial related hemorrhages (think of layers that could possibly be involved)
- 1) epidural hemorrhage 2) subdural h 3) subarachnoid h 4) parenchymal h
- what is a common site of epidural hematoma/hemorrhage
- 1) rupture of MMA: middle meningeal artery, often 2ndary to fracture of temporal bone
- what does CT show for epidural h?
- biconcave disc NOT crossing suture lines
- what else do you see in epidural hematoma?
- lucid interval
- How do subdural h. most often occur?
- rupture of bridging veins (think, elderly being jolted in roller coaster)
- subdural hematoma is venous bleeding so how would this influence symptomatic findings?
- venous = less pressure = delayed onset of symptoms
- what types of people do you see subdural h.?
- 1) elderly, 2) alcoholics 3) blunt trauma/sudden change in velocity injuries
- for SUBDURALs what do you see upon CT?
- 1) crescent-shaped hemorrhage instead 2) YES IT does cross the suture lines
- subarachnoid hemorrhage is often seen where (name 2 types
- rupture of 1) aneurysm (usually Berry aneurysm) or an 2)AVM
- symptoms of subarachnoid hemorrhage?
- the worst headache of my life
- since its subarachnoid (hemorrhage), what do you see on what test?
- bloody or xanthochromic CSF on spinal tap
- name 4 risk factors for parenchymal hematoma
- 1) HTN 2) amyloid angiopathy 3) diabetes mellitus 4) tumor
- most common site for Berry aneurysms
- bifurcation of the anterior communicating artery (Circle of Willis)
- berry aneurysms are associated with which genetic diseases
- adult polycystic disease, Ehlers-Danlos s., and marfan's
- Classic triad of Multiple Sclerosis
- SIN: Scanning speech, intention tremor, nystagmus (affect woman 20-30s)
- Prevalence of MS
- increase prevalence w/ increased distance from the equator
- Clinical s/s of MS, labs, pathology.
- 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)
- Progressive multifocal leukoencephalopathy (PML) is associated w/
- JC virus and seen in 2-4 % of AIDS pts (reactivation or latent infect)
- pathogenesis of Guillian-Barre syndrome
- Inflammation and demyelination of peripheral nerves and motor fibers of the ventral roots (sensory effec less severe than motor)
- s/s of Guillian-Barre syndrome, lab findings
- 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
- association between G-B syndrome and⬦
- herpesvirus or camplobacter jejuni infection, inoculations, and stress but no definitive link to a pathogen
- organism causing polio and mechanism of action
- 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
- s/s of polio
- malaise, HA, fever, nausea, abd. Pain, sore throats, signs of LMN signs
- lab findings of polio
- csf w/ lymphocytic pleocytosis w/ slight elevation of protein, virus recovered from stool or throat
- describe Broca's (expressive) aphasia
- confluent aphasia w/ intact comprehension broca's is broken speech
- describe Wernicke's (aphasia)
- Fluent aphasia w/ impaired concentration Wernick's ="What?" W area located in superior temperal gyrus
- describe two types of partial seizures
- 1.simple partial (awareness is intact)--motor, sensory, autonomic, psychic 2.Complex partial (impaired awareness)
- describe types of Generalized seizure ( diffuse)
- 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
- what are the causes of seizures in children?
- genetic, infection, trauma, congenital, metabolic
- what are the causes of seizures in adults?
- tumors, trauma, stroke, infection
- what are the causes of seizures in elderly?
- stroke, tumor, trauma, metabolic, infection
- what is Horner's syndrome?
- sympathectomy of face (lesion above T1) 1.Ptosis 2.anhidrosis and flushing of affected side 3.miosis [PAM is horny]
- Horner's syndrome is associated w/ what type of tumor?
- pancoast tumor
- what is syringomyelia?
- enlargement of the central canal of the S.C. Crossing fibers of spinothalamic tract are damaged.
- what are the s/s of syringomyelia?
- b/l loss of pain and temp sensation in the upper extremities w/ the touch sensation. Most common at C8-T1
- syringomyelia commonly seen in what pts?
- pts w/ Arnold-Chiari malformation
- Tabes dorsalis what infection is tabes dorsalis associated w/?
- teriary syphilis
- Tabes dorsalis what happens in the CNS?
- degeneration of dorsal columns and dorsal root
- Tabes dorsalis dorsalis also is associated with what s/s?
- charcot's joint, shooting (lightning) pain, Argyll Robertson pupils, and absence of DTRs