Card Set Information
What type of cells are the anterior horn cells?
Nerve cells of the CNS
What type of paralysis do Poliomyelitis patients suffer from?
Describe the condition of a person with poliomyelitis:
Flaccid paralysis of the arms and legs
What is ALS?
Amyotrophic lateral sclerosis
What is Amyotrophic lateral sclerosis?
Serious neurological disease that limits voluntary movement
How does Amyotrophic lateral sclerosis begin?
Muscle twitching/weakness in the arm/leg and slurring of speech
Is there a cure for Amyotrophic lateral sclerosis?
How long do people with Amyotrophic lateral sclerosis live usually?
3-5 years after first symptoms
Describe progressive stages of Amyotrophic lateral sclerosis:
Inability to move muscles needed for eating, speaking, moving and breathing
Last stages = difficulty breathing
Describe Myasthenia Gravis:
AB destroy neuromuscular junctions
What is the presentation of Myasthenia Gravis?
Muscle weakness that increases during activity and improves during rest
What disease is marked by Muscle weakness that increases during activity and improves during rest?
Describe the immune that leads to Myasthenia Gravis:
AB bind (and destroy) ACh receptors on skeletal muscle
AutoABs seen in 90% of patients
Do all Myasthenia Gravis patients have autoantibodies?
No, but 90% do
What type of atrophy is seen with Myasthenia Gravis?
2/3 of Myasthenia Gravis patients have_______ and 15% have _______.
What What specific muscles are characteristically affected in Myasthenia Gravis?
Causes drooping eyelids and double vision
Describe the presentation of Myasthenia Gravis:
Diff. chewing, swallowing
Some respiratory/general skeletal muscles maybe effected
What are the two types of treatment for Myasthenia Gravis?
Increases Ach at neuromuscular junction
Suppress production of abnormal Abs
For Myasthenia Gravis, In what ways can the production of abnormal ABs be thwarted?
What is Plasmapheresis?
What is Thyectomy?
Removal of the Thymus
What is the prognosis for pateints with Myasthenia Gravis?
Describe Polymyositis and Dermomyositis:
Lymphocytic Inflammatory Autoimmune myopathies
Cause symmetrical muscle weakness in large trunk, neck and limbs
What disease is a Lymphocytic inflammatory autoimmune myopathy that effects large muscles of the trunk, neck and extremities?
Dermatomyositis and Polymyositis
What type of inflammation is found in polymyositis and dermatomyositis?
What symptom does dermatomyositis have that polymyositis does not?
Rash on the upper eyelid
What inflammatory muscular disease has a rash on the upprer eyelid?
What symptoms of polymyositis and dermatomyositis be seen on a lab report?
Lymphocytic inflammation of the muscle
Antinuclear antibodies in the serum
Elevated creatine kinase due to muscle injury
Are there lesions of the muscle tissue with dermatomyositis or polymyositis?
Inflammatory myopathies can be caused by dermatomyositis, polymyositis and what else?
: HIV, Influenza
: Trichinosis, Cysticercosis, toxoplasmosis
HIV, Toxoplasmosis, Trichinosis, Cysticercosis and Influenza can all cause what disease?
What are the soft tissues?
What percent of soft tissue tomors are benign?
How do soft tissue tumors present?
As a Mass
At what age to soft tissue tumors present?
What is a malignant soft tissue tumor called?
What is a tumor of the adipose tissue called?
What is a tumor of the smooth muscle called?
What is a tumor of the skeletal muscle called?
What is a tumor of the Fibrous tissue called?
Tumor like conditions
What does Fibrohistiocytic mean?
Having both fibrous and histocytic properties
What is histocytic?
A blood disease characterized by abnormal multiplication of macrophages
What is a common etiology osteosarcoma and fibrosarcoma?
What is a common etiology of Angiosarcoma?
Chemical like PVC
What is a common etiology of Kaposi sarcoma?
Infection like AIDS
What is a common etiology of fibromatosis?
What tumors can be caused by radiation?
What tumors can be caused by AIDS?
What tumors can be caused by PVC?
What tumors can be caused by Genetics?
What is Angiosarcoma?
Blood vessel sarcoma
What age is typical for Rhabdomyosarcoma?
0-15, incidence tapers into the 30s
What is Synovial Sarcoma most common?
What age is typical of Fibrosarcoma?
What age is typical of Liposarcoma?
25-55, usually 40+
What age is typical of Malignant schwannoma?
What age is typical of malignant fibrous histcytoma?
What is the incidence of soft tissue tumors of the lower limbs and girdle?
What is the incidence of soft tissue tumors of the upper libs and girdle?
What is the incidence of soft tissue retroperitoneal or intraperitoneal tumors?
What is the incidence of soft tissue tumors of the trunk?
What is the incidence of soft tissue tumors of the Head and neck?
What is the most common soft tussue tumor?
How common is lipoma?
Most common soft tissue tumor
Usually trunk and neck (can be anywhere)
Histologically, what do lipomas look like?
Bright yellow mature adipose tissue with a fine fibrous capsule
Where are Liposarcomas usually found?
Deeply seated in soft tissue
What is the most common soft tissue sarcoma?
What are the subtypes of Liposarcoma?
What is the pathology of a liposarcoma?
A well circumscribed, non-encapsulated tumor that contains lipoblasts is most likely what?
What is the prognosis for liposarcoma?
What subtype of liposarcoma has the best prognosis?
Well-differntiated, myoxoid liposarcoma
What two “tumor like conditions” of the fibrous tissue were discussed in class?
What age group is affected by nodular fasciitis?
What is Nodular fasciitis commonly misdiagnosed as?
Why is Nodular fasciitis commonly misdiagnosed as sarcomas?
What is a nodular fasciitis composed of?
Plump immature fibroblasts or Myofibroblasts
Where do Nodular fasciitis tumors usually present?
How can the growth of nodular fasciitis be characterized?
Are the masses of nodular fasciitis painful?
Benign proliferation of fibroblast and myofibroblasts
What types of Fibromatosis are there?
Where is superficial fibromatosis found?
On the palms and penis
Where are deep type fibromatoses found?
Describe histology/pathology of a fibromatosis:
White cut surface
What is the treatment of fibromatosis?
Surgery, often reoccurring
Describe the aggressiveness of fibromatosis:
Locally aggressive, does not metastasize distantly
What does Fibromatosis resemble?
What is a desmoid tumor?
A deep type fibromatosis
When does deep type fibromatosis of the abdominal wall often occur?
How common is Fibrosarcoma?
What is the reoccurrence rate of Fibrosarcoma?
What percent of Fibrosarcomas metastasize?
Where do Fibrosarcomas often develop?
What does a Fibrosarcoma look like histologically?
Herringbone Fibroblast growth
What type of tumor shows Herringbone fibroblastic growth patterns?
What are the three type of Fibohistiocytytic tumors?
Dermatofibrosarcoma protuberans (DFSP)
Malignant fibrous histiocytoma
Is Fibrous histiocytoma malignant?
Is Dermatofibrosarcoma protuberans malignant (DFSP)?
What type of Fibrohistiocytic tumor is Malignant?
FMalignancy fibrous histiocytoma
What type of Fibrohistiocytic tumor is benign?
What type of Fibrous histiocytic tumor is borderline Malignant?
Dermatofibrosarcoma protuberans (DFSP)
How do most benign fibrous histiocytomas usually present initially?
Mobile subcutaneous nodule on the extremities
What does a Benign Fibrous histiocytoma look like histologically?
Tuton giant cells
What disease has a histological appearance of foamy macrophages/storiform pattern/Tuton giant cells?
Benign Fibrous histiocytoma
What does Storiform pattern of cells look like?
Star like clustering
Can Dermatofibrosarcoma protuberans metastasize?
Can, but rarely
Where are Dermatofibrosarcoma protuberans usually found?
Trunk and proximal extremities
What characteristically happens with Dermatofibrosarcoma protuberans after excision?
Describe Dermatofibrosarcoma protuberans histology:
Similar to Benign fibrous histiocytoma
More mitotic activity
Usually, how old are patients with malignant fibrous histiocytoma?
How often do malignant fibrous histiocytomas metastasize?
50% of cases
Where are malignant fibrous histiocytomas usually located?
Soft tissues of the extremities
Describe the histology of malignant fibrous histiocytoma:
Highly pleomorphic and atypical cells
What is aRhabdomyoma?
Benign tumor of skeletal muscle
How common is Rhabdomyoma?
What other disease can rhabdomyoma occur with?
At what stage in life does Rhabdomyosarcoma occur?
Infancy through first decade
What is the most common sarcoma in children?
Children from 2-8 usually develop Rhabdomyosarcoma in what body areas?
Teenagers from 14-18 usually develop Rhabdomyosarcoma in what areas of the body?
What are the three subtypes of Rhabdomyosarcoma?
What characteristic indicates Aveolar Rhabdomyosarcoma?
Chromosomal translocation t(2, 13)
What disease typically shows chromostomal translocation t(2,13)
What are long thin cells associated with Rhabdomyosarcoma called?
What cells are often seen on a slide of Rhabdomyosarcoma?
What is the name for a benign smooth muscle tumor?
Where are Leiomyomas usually found?
What is the most common neoplasm in women?
What is the histology of Leiomyoma?
Blunt ended, elongated nuclei
No coagulative tumor necrosis
What type of tumor would you expect to have blunt ended, elongated nuclei, little atypia and mitosis and no coagulative necrosis factor?
What percent of adult soft tissue sarcomas are Leiomyosarcoma?
What sex is more likely to develop Leiomyosarcoma?
Where is a common site for metastasis of Leiomyosarcoma?
What are common sites for Leiomyosarcoma?
Lumen of vessels (inferior vena cava, saphenous vein)
What would you expect to see on a slide of Leiomyosarcoma?
High mitotic activity
Tumor cell necrosis
What is synovial sarcoma?
Deep seated tumor around large joints, usually in young adults
Where are most synovial sarcomas located?
80% at the knee or ankle
What age range is typical for synovial sarcoma?
How often does synovial sarcoma metastasize?
Where does synovial sarcoma metastasize to?
Regional lymph nodes
What usually causes Synovial sarcoma?
Chromosomal translocation t(X;18), (p11.2; q11)
What percent of people with synovial sarcoma also have chromosomal translocation?
What is characteristic of the histology of synovial sarcoma?
Spindle cells stroma and Round epithelial cells that form glands
What type of tumor has a biphasic histological appearance with spindle cells and round epithelial cells mixed as glands?
What are the important cell types of the epidermis?
Squamous epithelial cells
What is another name for squamous epithelial cells of the epidermis?
What are the major components of the dermis?
Describe a Papule:
Elevated solid area (plaque)
What is an elevated solid area on the skin?
What is a Macule?
Flat area of coloration on the skin
What is the term for a flat area of coloration on the skin?
What is a Nodule?
A solid area larger than a papule
What is a Weal?
An itchy, transiently elevated area with variable blanching and erythema
What is the term for an itchy transiently elevated area of the skin with variable blanching and erythema?
What is a vesicle?
(Bulla), fluid filled raised area
What is the term for a fluid filled raised area?
What is a Pustule?
Discrete pus filled raised area
What is the term for a discrete raised pus filled area?
Vesicle or Bulla
What is another term for hives?
What is another term for Uticaria?
What are Utricaria?
Red edematous itchy plaques appearing within minutes
What are the common ages to develop uticaria?
What areas are utricaria found?
Trunk and distal extremities
How long does Uticaria usually last?
What are Uticaria usually from?
Hypersensitivity Type I (IgE dependant)
What skin disease is usually caused by a type I hypersensitivity (IgE dependant)?
What is an IGE independent cause of Uticaria?
What would you expect to see in a cross section of skin with uticaria?
Eiosinophils and mast cells
What disease accounts for 1/3 of dermatology visits?
What causes dermatitis or eczema?
What is Dermatitis/Eczema?
General term for variety of inflammatory skin conditions
What is the term for a general inflammatory skin condition?
Dermatitis or Eczema
What is a complication of Dermatitis/Eczema?
Secondary skin infections
What does a typical dermatitis or eczema lesion look like?
Oozing, crusting, scaling
What type of dermatitis were covered in class?
Allergic contact dermatitis
Primary irritant dermatitis
What is Allergic contact dermatitis?
Type IV hypersensitivity reaction
Poison IVY, jewelry, cosmetics, etc.
What is Atopic dermatitis?
Associated with a personal or family history of eczema, hay fever or asthma
Begins in infancy on face and scalp
What type of dermatitis is a Type IV hypersensitivity (i.e. cosmetics, poison ivy, etc.)?
Allergic contact dermatitis
What type of dermatitis is associated with a personal of family history of hay fever, asthma or eczema and begins at infancy with a face and scalp rash?
What type of dermatitis disappears when a drugs is removed?
What is Photoeczematous eruption?
Dermatitis on exposed skin
What is Primary irritant dermatitis?
Dermatitis following repeated trauma like rubbing
What type of dermatitis follows repeated trauma like rubbing?
Primary irritant dermatitis
What is Impetigo?
Superficial bacterial infection of the face
What is usually the cause of impetigo?
Staph or strep infection
Is impetigo infectious?
Yes, especially children in crowded spaces
What part of the body is usually infected by impetigo?
What does Impetigo look like?
Oozing, crusting and pus forming blister on the face (usually)
How is Impetigo treated?
What is Acne?
Nodules and pustules on the face and upper back
When is Acne most common?
Puberty through adulthood
What causes Acne?
Blockage of sebaceous glands and hair follicle by lipids and keratin
What is the etiology of Acne (6)?
What causes inflammation associated with acne?
What bacteria can live in a plugged hair follicle?
What are the possible treatments for Ance?
What antibiotics would you use to treat acna with?
What must be done to cause Erythema Multiforme to heal?
What is Erythema multiforme?
Multiple forms of lesions on the skin (macules, papules,etc.)
What is the characteristic lesion of Erythema multiforme?
What disease is indicated by targetoid lesiosn?
What type of skin lesion would you expect with herpes simplex?
What etiologies does Erythemia Multiforms have?
: Sulfonamides, penicillin
Collagen vascular disease
What type of skin lesion is found with Sulfonamide and penicillins?
What type of skin lesion is found with Collagen vascular disease?
What type of skin lesion is associated with malignant diseases?
What is Stevens-Johnson syndrome?
Erythemia Multiform of the the entire body and mucus membranes
Extensive and febrile EM
What is the name for an extensive and febrile form of Erythemia Multiforme?
What are two chronic inflammatory skin conditions?
What type skin of diseases are Lichen planus and Psoriasis?
Chronic inflammatory diseases
What is Psoriasis?
Demarcated pink plaques with silver scales on knees, elbows, scalp and glans penis
Probably an immune disorder
What is the etiology of Psoriasis?
What percent of psoriasis sufferers have nail issues as well?
What areas of the body does psoriasis usually affect?
The elbow, knees, nails, skin, scalp and glans penis
What is the term for new Psoriasis lesions developing at the site of trauma?
What is Koebner phenomenon?
New lesions of psoriasis developing at a site of trauma
What percent of the population of affected by Psoriasis?
What ages are most effected by psoriasis?
What do psoriasis lesions look like?
Pink demarcated plaques covered in shiny, silvery scales that bleed when they break away
What is the Auspitz sign?
Bleeding points of psoriasis plaques when the scales pull away
What type of nail changes would you expect with psoriasis?
What is Lichen Planus?
Itchy purple papules of the skin and mucus membranes, usually symetrically distributed
Where are Lichen planus lesions located?
Skin = knee, write and elbow
What percent of Lichen Planus patients have oral lesions?
What is the etiology of Lichen Planus?
Linked to Hep C
What is the most distressing symptoms of Lichen planus?
What skin disease includes itchy purple papules an skin and mucus membranes?
If a person has Lichen planus on one hand, where else would you expect to find it?
On the other hand (lichen planus = symmetrical)
What is Seborrheic Keratosis?
Benign dark colored plaques (keratin cysts) that appear "stuck on"
What age group usually gets Seborrheic Keratosis?
Middle aged to older
Where are Seborrheic Keratosis lesions found?
Head, neck, trunk and extremities
What disease is characterized by keratin cysts that appear stuck on to the skin?
What is a Keratoacanthoma?
Dome shaped Benign proliferation of the keratanocytes
What other disease does Keratoacanthoma mimic?
Squamous cell carcinoma
Why does Keratoacanthoma mimic squamous cell carcinoma?
It is fast growing
What group is Keratoacanthoma common in?
Men over 50
What areas of the body is Keratoacanthoma common?
Face, sun exposed areas
What is a Keratoacynthoma composed of?
Dome shaped nodule with keratin filled plug
What disease presents as a domed shaped nodule with a keratin filled plug?
What is another term for Verrucae?
What is another term for warts?
What group is Verrucae common in?
Children/adolescents (though any age)
What causes Verrucae?
DNA virus =HPV
What does a Verrucae look like?
raised horny lesions
How is Keratoacanthoma treated?
Is not, because it is self limiting
How are Verrucae treated?
What are the four types of Verrucae?
What is Verruca vulgaris?
Common wart on hands and feet
What is Verruca plana?
What is Verruca plantaris?
Soles of feet
What is Condyloma acuminata?
What is the term for Common wart on hands and feet?
What is the term for Flat wart?
What is the term for Soles of feet?
What is the term for Veneral warts?
What type of wart makes cauliflower like masses on the skin?
What is actinic keratosis?
Age related change due to many years of sun exposure
What group is actinic keratosis found in?
What is the major concern of actinic keratosis?
Pre-malignant and may develop into squamous cell carcinoma
What does Actinic keratosis look like?
Multiple brown lesions on the skin with rough surface
Where is Actinic keratosis most commonly found?
On sun exposed areas
What is the pathology of actinic Keratosis?
Squamous dysplasia with elastasis (sun damage)
Describe Squamous cell carcinoma?
tumor in sun exposed areas that can metastasize
What is the prognosis of squamous cell carcinoma?
Where does squamous cell carcinoma metastasize to?
regional lymph nodes
What are the etiological agents of Squamous cell carcinoma 8?
UV light DNA damage
tar and oils
What is the most common skin cancer?
Basal cell carcinoma
What percentage of skin cancer is basal cell carcinoma?
Does Basal cell carcinoma metastisize?
Where is most basal cell carcinoma found?
What does basal cell carcinoma look like?
Describe the treatment for basal cell carcinoma?
Indolent course, no treatment
How deep does basal cell carcinoma go into the skin?
Usually shallow, can go deep
What is the name for a deep rooting basal cell carcinoma?
What is another term for a Nevi?
What is another term for a Mole?
What is a Nevi/mole?
A benign proliferation of melanocytes in the skin
Do nevi disappear?
When do nevi develop?
What is the relative risk of melanoma from nevi?
What type of nevi is a precursor to malignant melanoma?
What is a Dysplastic nevi?
A nevi with atypia (that may lead to malignant melanoma)
Describe how Nevi grow?
proliferate at dermal-epidermal junction
The grow into dermis
then reside in the dermis only
What is a junctional nevi?
One that resides at the dermal-epidermal junction
What is a compound nevi?
One that has grown from the dermal-epidermal junction into the dermis
What is a intradermal nevi?
One that resides entirely in the dermis
What is a flat or slightly raised pigmented lesion also known as?
Where is the most common site for male melanoma?
Where is the most common site for female melanoma?
What is the most dangerous type of skin cancer?
What percent of malignant melanoma patients die of metastatic disease?
Where does Malignant melanoma metastasize to?
Anywhere...brain, lungs, lymph nodes, et.c
What is an acral melanoma?
How does malignant melanoma grow?
Horizontally within the epidermis
Vertically within the dermis
What type of skin disease grown horizontally in the epidermis and vertically in the dermis?
How is probability of metastases determined in malignant melanoma?
by the length of vertical growth into the dermis
What are the meninges?
The coverings of the brain
How many meninges are there?
What are the three meninges from external to internal?
What is meningitis?
Inflammation of the brain coverings
What are the four types of intracranial bleeding?
What is Cerebrospinal fluid analysis?
culture and gram stain
look for increased antibodies (as for MS)
What is Computerized axial tomography and what is it used for?
Used to see mass lesions
What is magnetic resonance imaging used for?
What is Electrocephalogram used for?
What is Angiography used for?
Vascular lesion (i.e aneurysm)
What is cerebral edema?
Increased water content on the brain
What is the term for increased water on the brain?
What are the two types of cerebral edema?
Vasogenic and Cytotoxic
What is Vasogenic cerebral edema?
Cerebral edema caused by disruption of the cerebral capillaries and blood brain barrier
What type of cerebral edema is caused by disruption of the capillaries and blood brain barrier?
What is Cytotoxic cerebral edema?
Cerebral edema second to brain cell damage
What type of cerebral edema is second to brain cell damage?
Under what conditions would vasogenic cerebral edema be seen?
late stage cerebral ischemia
Under what conditions would you expect to find Cytotoxic cerebral edema?
What types of intoxifications cause Cytotoxic cerebral edema?
How does the Blood brain barrier restrict access to the brain?
tight junctions and metabolic barriers
What is the rate limiting factor in determining permeability of the a drug into the brain?
The blood brain barrier
What is the blood brain barrier?
Specialized network of capillaries that limit what passes into the brain
What is the result of Cerebral edema?
Increased intracranial pressure
Can lead to brain damage
What are symptoms of cerebral edema?
Change in consciousness
Whatis the most catastrophi cevernt associated with cerebral edema?
Where the brain pushes through the base of the skull
What is the treatment for cerebral edema?
Corticosteroids to stabilize the membranes
Osmotherapy to reduce edema (such as mannitol and carbonic anhydrase)
What would you use to reduce a cerebral edema?
Osmotherapy such as mannitol or carbonic anhydrase
Why would you use carbonic anhydrase to treat cerebral edema?
Stabilize the membranes
What does the brain look like after cerebral edema?
Widened Gyri with a flattened surface and narrowed sulci
A brain that has widened gyri, narrowed sulci and a flattened surface most likely suffered from what?
What is Hydrocephalus?
Accumulation of fluid in the Ventricle system of the brain
What are the two main causes of Hydrocephalus?
Overproduction of CSF
Blockage of CSF circulation
What is the most common cause of Hydrocephalus?
Congenital defects in CSF circulatory pathway development
What disease other than congenital defects commonly cause hydrocephalus?
Hemorrhage of tumors (that block CSF)
Where is CSF produced?
In the Ventricles of the brain
What is the purpose of the Ventricle system of the brain?
Protect the brain from impact
How is waste from the Ventricle system eliminated?
Through the blood stream
What are the manifestations of Hydrocephalus?
In babies: increased size of head and mental retardation
What are three vascular disorders that effect the brain?
What is a brain vascular disorder?
Local interruption of the blood flow to the brain
What is the outcome of brain vascular disorders?
Brain death within minutes
What are the risk factors for brain vascular disorders (10)?
What are the main types of stroke?
What is Ischemic stroke?
Loss of blood supply
What is the most common type of stroke?
What are the two type of Ischemic stroke and their relative incidence?
Emboli stroke (35-40%)
What is Hemorrhagic stroke?
Rupture of saccular aneurysm/vasular malformation
What percent of strokes are Hemorrhagic?
What often causes atrial thrombus in an ischemic strok?
What often causes thrombus from the heart in ischemic stroke?
What type of stroke is caused by atrial thrombus or a thrombus from the heart?
Embolic Ischemic stroke
What is a rare stroke type discussed in class?
How common is Hypoperfusion infarct?
What is Hypoperfusion infarct?
Inadequate arterial blood supply due to hypotension
What is the term for inadequate arterial blood supply to the brain due to hypotension?
What is a mini stroke called?
Transient ischemic attacks (TIAs)
Occurs when blood supply is briefly interrupted
What are the manifestations of stroke?
Confusion or loss of conciousness
How is stroke diagnosed?
What are the outcomes and their associated proportions for stroke?
1/3 live with serious defects
What does stroke prognosis depend on?
Amount and site of brain involved
What are the symptoms of stroke?
Sudden numbness or weakness of the face, arms or legs
Sudden inability to see in one or both eyes
Sudden speech issues
Sudden trouble with balance
Sudden severe headache
Which is more common, arterial thrombosis or venous thrombosis of the brain?
What is the best treatment for stroke?
What is the treatment for Ischemic strokes?
Tissue plasminogen activator (t-PA)
What would you treat with tissue plasminogen activator?
What is the window of opportunity to treat a stroke?
What can be done to treat dead brain tissue?
Little, basically just physical therapy
What is a TIA due to?
Atherosclerotic narrowing of the blood vessel
Small emboli that temporarily lodge
How long do TIA attacks last?
minutes to hours
What are symptoms of TIA?
The blood deficit involved in a TIA usually resolves in what time period?
What do TIAs indicate?
Serve as a warning for cerebrovascular accidents
Where is a subarachnoid hemorrhage located?
Beneath the arachnoid and above the pia mater
What is the most common type of brain hemorrhage?
What percent of hemorrhages are subarachnoid, subdural or extradural?
Describe a Saccular aneurysm or a subarachnoid hemorrhage?
Ruptured cerebral aneurysm that causes a stroke
What type of hemorrhage can be described as a ruptured cerebral aneurysm that causes a stroke?
What percent of the population has subarachnoid hemorrhage or saccular aneurysm?
What is a predisposing condition for Saccular aneurysm and Subarachnoid hemorrhage?
Polycystic kidney disease
Can run in families
What are symptoms of Saccular aneurysm and Subarachnoid hemorrhage?
body weakness in certain areas
loss of consciousness
What is the death rate for Saccular Aneurysm and Subarachnoid hemorrhage?
50% within hours to days
How is Subarachnoid hemorrhage or Saccular aneurysm treated?
If caught on time, clip the bleeding vessels surgically
What is Epidural Hematoma?
Hemorrhage between the skull and the top layer of Dura
Due to middle meningeal artery damage
Secondary to skull fracture in temporal area
What type of brain hematoma is secondary to skull trauma in the temporal region?
What is the presentation of Epidural hematoma?
Lucid interval followed by progressive loss of consciousness
What characteristic is special to epidural hematoma?
Describe the "lucid period" associated with Epidural hematoma:
Loss of consciousness or confusion is followed by a temporary improvement in condition then regression
Lasts minutes to hours
How long does the lucid period of an epidural hematoma last?
minutes to hours
What are epidural hematomas caused by?
Tears in the arteries of the brain, usually the middle meningeal arteries
What is a subdural hematoma?
Bleeding between the dura and the arachnoid mater
What is the cause of Subdural Hematoma?
Tears in veins that cross the subdural space
What brain issue is caused by tears in the veins that cross the subdural space?
What are the predisposing factors for Subdural hematoma?
Very young or old
Use of blood thinners like Coumadin
Alzheimer's or narcolepsy
An acute subdural hematoma usually presents with symptoms during what time?
The first 24 hours
A subacute subdural hematoma usually present with symptoms within what time period?
What are the symptoms of Subdural hematoma?
What can be done to treat subdural hematoma?
Respiratory and Circulatory support
What is a Concussion or contusion?
Injury to the brain due to trauma
What is a Concussion?
transient loss of consciousness and widespread paralysis
Usually recover w/o sequelae
What is the most minor and common type of brain injury?
What is a Contusion?
Hemorrhages in superficial brain tissue by blunt trauma
Bruising of the brain
What is Contusion associated with?
What type of injury is baby shaking?
What is a neural tube defect?
Congenital malformation like anencephaly and Spina bifida
What is spina bifida?
Defect in neural tube that allows nerves to protrude
What is the time period for surgical correction of spina bifida?
What are complications of spina bifida?
damaged nerves below the lesion, causing varying degrees of paralysis and incontinence
What is the most severe form of NTD?
What is the life expectancy of Anencephaly?
What is anencephaly?
cephalic/head end of neural tube does not develop and brain, skull and scalp missing
Infants born without the front part of the brain
What causes NTDs?
Not enough folic acid during pregnancy
How many cases of bacterial meningitis per year in the U.S.?
What are the two types of meningitis?
What s acute purulent meningitis?
What are the major bacteria involved in acute purulent memingitis?
What bacteria is associated with epidemic meningitis?
What is the most serious type of meningitis?
What are the other terms for non-bacterial meningitis?
Acute viral meningitis
What is Aseptic meningitis usually due to?
What are the most common viruses to cause meningitis?
What is Meningismus?
Stiffening of the neck associated with meningitis
What is photophobia?
sensitivity to light
What are the symptoms of Meningitis?
Sensitivity to light
Mental status changes
How is Meningitis diagnosed?
What is another name for CSF examination?
What do you look for in the CSF when concerned aboutmeningits?
Increased lymphocytes and neutrophils
What is the treatment for bacterial meningitis?
What is the treatment for Viral meningitis?
Fluid balance and seizure control
What is Encephalitis?
Inflammation of the brain and spinal cord
What is the term for inflammation of the brain and spinal cord?
What is encephalitis usually caused by?
What viruses can cause encephalitis?
Those carried by mosquitos
What two type of encephalitis that are caused by a virus carried by mosquitos and cause epidemics in warm months?
St. Louis and California encephalitis
What time of year has the highest risk of St. Louis and California encephalitis?
How is encephalitis diagnosed?
Presence of viral antigen in CSF
What are the symptoms of Encephalitis?
Can benign brain tumors be fatal?
Yes, due to pressure on the brain
Are primary brain tumors common?
No, metastatic brain tumors are more common
What are the signs of a CNS tumor?
What is a Glioblastoma?
Most common primary brain tumor
What is the most common primary brain tumor?
What is the prognosis for Glioblastoma?
fatal in about one year
What is the second most common primary brain tumor?
Meninioma = tumor of the meninges
Describe the pathology of a Meningoma:
What is a medulloblastoma?
Malignant tumor of the cerebellum
What is the cure rate of medulloblastoma?
What is the treatment for medulloblastoma?
What are the symptoms of medulloblastoma?
Lack of coordination
Where is a medulloblastoma located?
What is the most common malignant CNS tumor of children?
What is the most common demyelinating disease?
what is multiple sclerosis?
Debilitating demyelinating disease of the brain and spinal cord
Inflammation/damage to myelin sheath and eventually the nerves
How many Americans have MS?
What is the etiology of Multiple sclerosis?
What is the outcome of MS?
Slowed or blocked nerves causing muscle coordination issues
What are the symptoms of MS?
Numbness or tingling in face/extremities
What is the prognosis of MS?
Trouble with balance
Paralysis of limbs
wheelchair bound in 15-20 years
How is MS diagnosed?
MRI features in brain
CSF shows increased IgG
What is the treatment for MS?
What type of medication are used to treat MS?
What is indicated by increased IgG antibodies in the CSF and Brain lesions?
Is dementia a specific disease?
What is dementia?
Any progressive loss of nerves in the CNS affecting memory and cognitive function
Does having memory loss mean you have dementia?
No dementia is in two or more areas of brain function
What is the most common dementia disease in elderly?
How many people in the US have Alzheimer's?
What age does Alzheimer's usually begin?
65 and up
What proportion of people over 85 have Alzheimer's?
What is a risk factor for Alzheimer's disease?
What area of the brain does Alzheimer's start with?
The part that controls thought memory and language
What is the rate of onset of Alzheimer's disease?
What is the cure for Alzheimer's?
No known cure
What is the treatment for Alzheimer's?
Aricept may slow progression of symptoms
What does Alzheimer's brain look like?
Brain shrivels up
Plaques and neurofibrous tangles
Where is brain shrinking especially severe in AD patients?
What happens to the ventricles in AD?
They grow larger
What are the most indicative signs of AD?
Plaques and Neurofibrous tangles
What are Neurofibrous tangles and plaques?
Signs of Alzheimer's disease
Abnormal clumps and tangled bundles of nerves
What is Parkinson's disease?
Progressive loss of nerve cell function in brain that controls muscle movement
What is the cause of Parkinson's disease?
Neurons that make dopamine die or stop working
What does dopamine usually do?
Signaler for coordination of body movement
What disease is marked by the death or lack of function of Brain neurons that secrete dopamine?
When does Parkinson's usually begin?
around age 60
What are the signs of Parkinson's disease?
Trembling hands, arms, legs, jaw and face
Stiffness of arms, legs and trunk
What is a characteristic symptom of Parkinson's disease?
How is Parkinson's disease diagnosed?
By symptoms, no specific test
What is the treatment for Parkinson's disease?
L-dopa for symptom relief
What is the pathology of the brain in a parkinson's patient?
loss of pigment in substantia nigra
Intracytoplasmic inclusions called Lewy bodies
If you examined a brain and saw intracytoplasmic inclusions and loss of pigment in the substantia nigra, what would your diagnosis be?
What is vascular dementia?
Multiple cortical infarcts from previous sustained strokes
What is another name for Vascular Dementia?
Mini infarct dementia
What is the second most common form of dementia?
What is the best form of treatment for Vascular dementia?
Prevention and early detection
What are the risk factors for Vascular dementia?
Peripheral arterial disease
What is Huntington's disease?
Autosomal dominant degeneration of basal ganglia causing dementia and involuntary movements
What is an autosomal dominant disease that affects the basal ganglia andleads to dementia and involuntary movements?
What age is Huntington's disease most common?
How is Huntington's disease aquired?
Autosomal dominant inheritance
What type of tretments are there for Huntington's disease?
Only those for signs and symptoms not for prevention of further progression
If one of your parents had huntington's disease, what are your chances of getting it?
What does Chorea mean?
Dance and refers to quick jerky movements
The basal ganglia of the brain (caudate nucleus, putamen, globus pallidus) change in what ways during Huntington's disease?
What is Creutzfeldt-Jakob disease (CJD)?
rapid progressive dementia that is invariably fatal in one year
Mediated by a Prion
How do you get Creutzfeldt-Jacob disease?
By consuming animal products infection with the bovine form of the prion
What is the pathology of Creutzfeldt-Jacob disease?
Spongiform change in brain tissue
What are the symptoms of CJD?