CNS1

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eschott
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81613
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CNS1
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2011-04-25 04:33:06
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CNS Lab Notes Exam4
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  1. What's the gross feature of an astrocytoma?
    Poorly defined, soft, pale expansile mass
  2. What's the characteristic histology pattern of Anaplastic astrocytoma?
    Hipercellularity, pleomorphism, mitoses, cellular atypia
  3. What's the prognosis for anaplastic astrocytoma?
    2 year survival post surgery/therapy
  4. What are the characteristic features of a pilocytic astrocytoma? What's the demographic/prognosis?
    • Non-infiltrative growth in posterior fossa
    • Most common in kids
    • Excellent prognosis
  5. What's the prognosis for a grade 4 astrocytoma?
    Mean survival 15 months
  6. What genetic alterations are associated with astrocytomas? (Low/High Grade)
    • Low: Inactivation of p53, overexpression of PDGF-A
    • High: Disruption of RB, p16/CDKNZA, chromosome 19
  7. What are genetic alterations associated with grade 4 astrocytoma?
    1/3 p53, 1/3 EGFR, 1/3 neither
  8. In which astrocytoma is necrosis present?
    Type IV
  9. What are histological characteristics of brain metatsasis?
    Multiple lesions, well demarcated, spherical
  10. What's the gross charactersitic of a gliblastoma?
    Ill defined, large, hemorrhagic, necrotic mass
  11. What are symptoms charactersitic of a uncal herniation?
    Fiked and dilated pupil
  12. What are histological characteristics of glioblastoma?
    Hyperceullarity, mitoses, endothelial hyperplasia, coagulatice necrosis surrounded byu pseudopalisading/ serpintine necrosis
  13. What's the most common primary brain tumor of adults?
    Glioblastoma
  14. What's the gross features of a meningioma? Where's their typical location?
    Mass projecting from inner surface of dura; usually found in the parasagittal sinus
  15. What would you suspect if there were multiple meningiomas?
    • Von Recklinghausen's neurofibromatosis
    • Chromosome 22 mutations (NF2)
  16. What's the histoilogical pattern seen in meningioma?
    Whorled growth patten with psammoma bodies
  17. What's the demographic for meningioma (spinal)?
    • Females 3:2 in mid-late life
    • Spinal = 10:1
  18. In what conditions are Psammoma bodies present?
    • Meningiomas
    • Papillary carcinoma of thyroid
    • Serious cystadenocarcinoma of ovary
  19. What ares of brain are most vulnerable to infarction?
    • Basal ganglia and internal capsule
    • Ends of MCA
  20. What are recent/old sings of brain infrarction?
    • Recent infarct: dead reds --> gitter cells
    • Old infarct: cystic with scattered macrophages and vessels (areas of gliosis)
  21. What's the causes of thrombotic vs. Embolic occlusions?
    • Thrombotic: atherosclerosis in carotid/vertebrobasila system
    • Embolic: mural thrombus --> MCP
  22. What's most common cause of primary intracebral hemorrhage? (type/location)
    • (Rupture of vessel)
    • Charcot-Bouchard microaneurysm (HTN) in basal ganglia/thalamus
  23. What are signs of UMN/LMN injury?
    • LMN: muscle atrophy and fasciculations
    • UMN: hyperreflexia and Babinski sign
  24. What are areas of involvement in ALS?
    • UMN/LMN symptoms on upper/lower extremities, tongue/facial muscles, chewing/swallowing
    • Sensory/ocular/ingelligence maintained
  25. What's the cause of fasiculations in ALS?
    • ACh receptors become distributed over whole muscle fiber surface
    • Small amounts of ACh propagate AP
  26. What's the most common demographic for ALS?
    60 year old male (2:1)
  27. What's the most common from of motor neuron disease in adults?
    ALS
  28. What's the genetic abnormality in ALS?
    SOD1 gene on chromosome 21 (10% familial)
  29. What are gross intracranial characteristics of ALS?
    Thinning of precentral gyrus -> widening of central sulcus
  30. What are characteristics of the spinal cord in ALS?
    • Demyelination
    • UMN: lateral corticospinal tracts
    • LMN: anterior horn
  31. What are common clinical symptoms of dementia?
    Gradual cognitive loss and alteration of behavior
  32. What's a Neurofibrillary tangle?
    • Cytoplasmic bihelical filaments of abnormal proteins
    • (tau, ubiquitin)
  33. What are Neuritic Plaques?
    focal collection of tortuous neuritic processes surrounding an amyloid core
  34. What type of Amyloid is involved in Azheimer's Disease?
    B protein from APP (chomosome 21)
  35. What forms first? Neuritic processes or amyloid core?
    Neuritic processes form first
  36. What are morphological features of alzheimer's disease?
    • 1.Cortical atrophy
    • 2.Neuronal degeneration/destruction
    • 3.Neurofibrillary tangles
    • 4.Neuritic plaques
    • 5.Amyloid vasculopathy
  37. What are the areas of atrophic involvement in alzheimer's disease?
    Frontal, parietal, temporal
  38. Where is the most prominent neuronal loss in Alzheimer's disease?
    • Cerebral cortex, amygdala, hippocampus and basal
    • forebrain (basal nucleus of Meynert).
  39. What's the normal size of an atrophic alzheimer's brain?
    Less than 1100g
  40. What hemorrhagic condition is associated with cortial atrophy?
    • Chronic subdural hematoma
    • Increased range of motion for bridging vein rupture
  41. What are charactersitics of Pick Disease?
    • Less frequent
    • Frontal/anterior 1/3 temporal lobe atrophy
    • Pick's bodies
  42. What are pick's bodies?
    bsophilic cytoplasmic inclusions of tau/ubiquitin protein

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