Neuropathy

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Author:
bigfootedbertha
ID:
85499
Filename:
Neuropathy
Updated:
2011-05-12 18:19:24
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Neurology pathology
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path exam
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  1. Integrity of blood brain barrier is disrupted
    causing interstitial edema
    Vasogenic edema
  2. increase in intracellular fluid from
    hypoxic-ischemic insult
    Cytotoxic edema
  3. medial aspect of the temporal lobe compressed
    against the tentorum, third nerve compressed resulting in pupillary dilation on
    the side of the lesion
    Transtentorial(uncal hernitation):
  4. unilateral expansion of cerebral hemisphere displaces the cingulate gyrus under the falx cerebri
    Cingulate gyrus herniation
  5. Cerebellar tonsil displaces through the foramen magnum, brain stem compression of respiratory centers
    • Tonsillar herniation
    • Most life threatening
    • Prevent by medicine, holes in skulls
  6. Midline and pons, due to brain herniation thru
    the foramen magnum. Vessels tear, almost always lethal, also VERY serious.
    Duret's Hemorrhage
  7. Causes of Duret's hemorrhage
    Subdural hematoma, tumor, trauma
  8. Most common cause of CVA
    infarct
  9. Most common populatino for an infarct
    Males,7th decade
  10. Most common cause of an infarct
    Cerebral atherosclerosis
  11. Type of necrosis involved with an infarct
    Liquefactive
  12. Vessel most commonly causing an infarct
    MCA
  13. What type of reactions occur at the MCA?
    Gliotic reactions, NOT fibrosis
  14. Most common cause of primary brain parenchymal hemorrhage
    HTN
  15. minute aneurysms in basal ganglia from
    hypertension
    Charcot-Bouchard microaneurysms; seen in primary brain parenchymal hemorrhage
  16. Most common location for a parenchymal hemorrhage
    Basal ganglia (particularly putamen)
  17. Parenchymal hemorrhage sx
    N,V,HA,LOC, speech problems
  18. Most common cause of SAH
    rupture of a saccular aneurysm
  19. Where are most berry aneurysms located and when is the greatest risk of rupture?
    • most commonly found at arterial bifurcations, such as junction of anterior cerebral and anterior communication arteries
    • Greatest risk of rupture 4-7 cm in diameter
  20. Who is at an increased risk for developing renal aneurysms?
    Adult PCKD
  21. What are the most common vascular malformations?
    AV malformations
  22. AV malformations are most commonly found where?
    The cerebral hemisphere, typically temporal lobe
  23. haphazardly arranged blood vessels
    AV malformation
  24. Most common areas of bleeding in the brain
    SAH, epidural, subdural
  25. Most common cause of epidural hematoma
    trauma
  26. Hematoma associated with skull fracture
    Epidural
  27. Hematoma associated with MMA
    epidural hematoma
  28. Hematoma with venous blood
    Subdural
  29. MOA of subdural hematoma
    Brain bouncing around and pulling on BRIDGING veins
  30. Brain injury associated with rapid deceleration and retraction and shearing of axons
    Diffuse axonal injury
  31. What is the difference between the two types of brain contusions?
    Coup-injury to vein directly beneath and impact sight. Usu. Stationary head being hit by a moving object

    o Contra-coup-opposite, moving head hitting astationary object.
  32. Optic nerve sheath damage and retinal hemorrhage are signs of what?
    Shaken baby syndrome
  33. What brain injury results due to shearing forces, such as being punched in back of head, or karate chop to back of neck?
    Vertebral artery laceration
  34. Most common cause of neonatal meningitis
    Group B Strep, e coli
  35. Most common cause of meningitis in >6mo
    H flu (but not anymore due to vaccination, it's now strep pneumo
  36. Most common cause of meningitis in older children, adolescents, young adults
    Neisseria meningitidis
  37. Most common cause of meningitis in older adults
    strep pneumo
  38. What populations do you find listeria monocytogenes in?
    elderly, neonates, and immunocompromised
  39. Purulent exudate at base of brain in haemophilus influenzae infections obscuring circle of willis
    H flu meningitis
  40. Edematous brain and spinal cord with neutrophils and fibrin
    Bacterial meningitis
  41. Increased protein and decreased glucose in CSF
    Bacterial meningitis
  42. Most common viruses causing viral meningitis
    mumps, echovirus, coxsachievirus
  43. CSF: protein slightly elevated, glucose normal, mostly lymphocytes
    Viral meningitis
  44. Most comon causes of chronic meningitis
    CSF: protein slightly elevated, glucose normal
  45. most common locations for a brain abscess
    Occur usually in the cerebral hemispheres, Temporal lobe, frontal lobes (niddle ear and sinus involvement)
  46. multiple focal lesions in the gray matter
    toxoplasmosis
  47. Perivascular inflammation: lymphocytes, plasma cells
    Viral encephalitis
  48. Microglial nodules
    Viral encephalitis
  49. infects oligodendroglia causing areas of demyelination
    Progressive multifocal leukoencephalopathy
  50. Where in the brain does HSV infect in vira encephalitis?
    Temporal lobes and orbital/frontal areas
  51. Where in the brain does CMV affect in viral encephalitis?
    Ependymal surfaces (lining of the ventricles)
  52. Where in the brain does HIV affect in viral encehpalitis?
    Brain atrophy, involvement of white matter and basal ganglia with multinucleated giant cells
  53. Causes of spongiform encephalopathies
    CJD, kuru, mad cow dz
  54. Vacuoles in gray matter with rapidly progressive dementia, gait abnormalities
    Spongiform encephalopathies
  55. Most common demyelinating disease
    MS
  56. Most common age affected with MS
    18-40 yo
  57. Common sites for plaques in MS
    periventricular white matter, optic nerves, white matter of spinal cord
  58. Visual disturbances, paresthesias, spasticity, speech disturbances, and gait abnormalities
    MS
  59. Butterfly wing-red area
    MS
  60. Thiamine deficiency resulting in peripheral
    neuropathy
    Wernicke Encephalopathy
  61. Rapid onset of confusion, paralysis of
    extraocular muscles and ataxia
    Wernicke encephalopathy
  62. Hemorrhage in mammilary bodies, thalamus, gray matter around the cerebral aqueduct
    Wernickes
  63. What results from untreated Wernickes?
    Korsakoff's Psychosis
  64. Inability to form new memories or retrieve old ones
    Korsakoff's psychosis
  65. Accompanied by confabulation-forget parts of the story and will fill in with s/t else, won’t make sense
    Korsakoff's psychosis
  66. Technically can only be dx after death
    Alzheimers
  67. Most common cause of dementia in elderly
    Alzheimers
  68. Hydrocephalus ex vacuo: dilation of ventricles from loss of parenchyma
    Alzheimers
  69. What brain weight is an indication of Alzheimers?
    1000 g
  70. coarse, tortuous neurites in cerebral cortex with a central amyloid core
    Senile plaques, seen with Alzheimers
  71. filamentous aggregates within cytoplasm of neurons
    Neurofibrillary tangles, seen with Alzheimer's Disease
  72. Substantia nigra and locus ceruleus are depigmented in most cases
    Parkinsons
  73. laminated intracytoplasmic inclusions in some neurons
    Lewy bodies, seen with Parkinsons
  74. Involves extrapyramidal motor system
    Huntington disease
  75. Atrophy of caudate nucleus, putamen, and globus pallidus; Dilation of ventricles; Neuropsychiatric disturbances occur; Increased risk of suicide
    Huntington's Dz
  76. Degenerative disorder involving the upper and lower motor neurons of the pyramidal system
    ALS
  77. Most common cause of death in ALS
    pneumonia, followed by respiratory insufficiency or infections

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