Pathology: Nervous System
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| Difference between intracellular and extracellular edema? Common causes? | show 🗑
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| Why is a patient with head trauma made to hyperventilate? | show 🗑
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| 1. What is Pseudotumor cerebri 2. What is the most common demographic affected? 3. Most likely cause | show 🗑
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| Herniation sites: 1. Subfalcine 2. Uncal 3. Tonsillar | show 🗑
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| Complications of: 1. Subfalcine 2. Uncal 3. Tonsillar | show 🗑
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| Presentation of uncal herniation | show 🗑
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| 1. Communicating hydrocephalus causes 2. Noncommunicating hydrocephalus | show 🗑
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| show | 1. hydrocephalus and paralysis of upward gaze
2. blockage of the aqueduct of Sylvius
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| show | 1. ventricles appear dilated secondary to brain atrophy (i.e. Alzheimer's)
2. medulla and cerebellar vermis displaced through foramen magnum; can cause noncommunicating hydrocephalus
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| 1. Neutrophils in the CSF 2. Lymphocytes in the CSF 3. Lymphocytes & monocytes in the CSF | show 🗑
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| 1. Spina bifida occulta 2. Meningocele 3. Meningomyelocele | show 🗑
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| 1. Dandy-Walker malformation 2. Syringomyelia 3. Which long tract is first affected? | show 🗑
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| show | 1. NF1 - mutation in gene coding for neurofibromin; NF2 - merlin
2. both proteins act as tumor suppressors
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| show | 1. Cafe au lait colored macules (100%)
2. Lisch nodules (>90%)
3. axillary and inguinal freckling (70%)
4. optic glioma (2-5%)
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| Common manifestation of Neurofibromatosis 2? | show 🗑
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| show | 1. seizures
2. mental retardation
3. hamartomas in CNS, skin
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| show | 1. tuberous sclerosis
2. 1% to 2% of head injuries (very low)
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| show | 1. AD disorder
2. Fracture of the temporoparietal bone (at the pterion) causing severance of the middle meningeal artery
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| show | tearing of bridging veins that run through the subarachnoid space to connect the brain witht he dural sinuses
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| 1. What are the symptoms of Horner's Syndrome? 2. Where must the spinal cord lesion be to have Horner's Syndrome? | show 🗑
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| What is autonomic dysreflexia and what is it caused by? | show 🗑
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| show | 1. loss of sympathetic innervation to the vascular smooth muscle
2. vasodilation → hypotension
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| show | 1. contralateral paralysis of lower face and tongue (contains corticobulbar fibers so motor deficit to face)
2. Middle Cerebral Artery
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| show | 1. lesion below the red nucleus (intact red nucleus causes flexion of upper extremities)
2. extension of both upper and lower extremities
dEcErEbratE = E for extension
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| show | 1. lesion above the red nucleus
2. flexion of upper extremities and extension of lower extremities
deCORticate = arms protect CORE
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| show | 1. involuntary muscle contractions due to sudden stretching of the muscle; UMN lesion
2. flaccid paralysis because it is where LMNs come out
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| show | 1. paralysis or weakness of an ocular muscle
2. improper alignment of the eyes
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| show | 1. medial deviation of the eye results from abducens lesion
2. superior oblique function → looking down
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| show | Conductive - external auditory canal or middle ear
Sensorineural - cochlea or CN VIII
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| show | 1. cold water = fast phase of nystagmus to opposite side
2. warm water = fast phase of nystagmus to same side
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| show | slow drift off target followed by a quick corrective saccade
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| show | 1. sudden, wild flailing of 1 arm and/or 1 leg
2. sudden, jerky movements
3. slow, writhing movements
4. involuntary muscle contractions
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| show | 1. subthalamic nucleus
2. basal ganglia
3. basal ganglia
4. upper motor neuron
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| show | 1. lack of will or initiative
2. inability to recognize faces
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| 4 Main symptoms of Parkinson's | show 🗑
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| show | inability to suppress blinking when the forehead is tapped. Found in Parkinson's
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| show | 1. alpha-synuclein
2. dopamine neurons in the substantia nigra pars compacta
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| What is the difference between aphasia and dysarthria? | show 🗑
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| show | 1. nonfluent aphasia with intact comprehension
2. fluent aphasia with impaired comprehension
3. nonfluent aphasia with impaired comprehension
4. poor repetition but fluent speech, intact comprehension
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| show | 1. during severe hypotension (cardiac arrest, shock)
2. junction between anterior and middle cerebral arteries
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| 1. Open-angle glaucoma is due to.. 2. Closed-angle glaucoma is due to... 3. Which type of glaucoma is more chronic in its onset? | show 🗑
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| What are the 4 main symptoms of Gerstmann's syndrome? | show 🗑
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| show | ideomotor apraxia
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| 1. Lack of awareness of part of one's body 2. It typically results from a lesions to | show 🗑
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| Patient cannot execute command to move their left arm. Patient is able to execute command to move right arm. | show 🗑
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| show | 1. severing the splenium of the corpus callosum from a left PCA infarct
2. cerebellar vermis
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| What is the result of a lesion at each area? 1. Amygdala 2. Mammillary bodies 3. Paramedian pontine reticular formation | show 🗑
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| What is the result of a lesion at each area? 1. Frontal eye fields 2. subthalamic nucleus 3. cerebellar vermis 4. cerebellar hemisphere | show 🗑
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| show | 1. pupils that react to accomodation but do not constrict to light
2. Tabes Dorsalis
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| show | 1. ventral horns & corticospinal tract
2. dorsal columns, spinocerebellar tracts, & corticospinal tract
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| 1. Disease characterized by abrupt attacks of vertigo, tinnitus and hearing loss? 2. What is the cause? | show 🗑
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| show | 1. Anterior Spinal Artery
2. PICA
3. Basilar Artery
4. AICA
5. PCA
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| show | 1. corticospinal tract and DCML
2. spinothalamic tract
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| Name the syndrome: contralateral paresis, contralateral tactile loss and ipsilateral tongue paralysis | show 🗑
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| hydrocephalus with paralysis of upward gaze | show 🗑
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| show | 1. trinucleotide repeat on chromosome 4
2. mutant Huntingtin (mHtt) protein produced and binds Rhes in caudate leading to cytotoxicity
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| show | 1. thiamine deficiency
2. confusion ophthalmoplegia, ataxia
3. anterograde amnesia, confabulation, personality change
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| 1. Amyloid precursor protein is found on which chromosome? 2. Its chromosomal location makes which patient population vulnerable to Alzheimers? | show 🗑
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| What symptoms do individuals with Pick's disease exhibit that are not seen in Alzheimer's? | show 🗑
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| Most likely cause of a subarachnoid hemorrhage? | show 🗑
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| show | 1. eye looks down and out
2. eye drifts up
3. medially directed eye
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| show | 1. parasympathetic is on the outside
2. motor component
3. parasympathetic component
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| show | 1. Middle Cerebral Artery
2. MCA will have hemiparesis and sensory loss of face and upper extremities while ACA will be in lower extremities
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| show | 1. junctions of communicating branches with main cerebral artery
2. junctions lack internal elastic lamina and smooth muscle
3. anterior cerebral artery and anterior communicating artery
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| What are the relative CSF levels in bacterial meningitis: 1. protein 2. leukocytes 3. glucose | show 🗑
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| show | 1. ↑
2. ↑ (lymphocytes)
3. normal
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| show | 1. Enteroviruses (Coxsackievirus)
2. Strep B (agalactiae)
3. Stept. pneumoniae
4. Strep. pneumoniae
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| show | 1. CD4 T cells react against self antigens in myelin sheath
2. cytokines activate macrophages that destroy myelin and oligodendrocytes
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| show | 1. Subacute sclerosing panencephalitis
2. Rabies
3. JC virus → progressive multifocal leukencephalopathy
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| show | 1. medial longitudinal fasciculus damage leading to impaired adduction
2. Multiple Sclerosis
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| 1. Demyelination disorder caused by rapid IV correction of hyponatremia 2. Most common fungal CNS infection in AIDS? | show 🗑
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| show | 1. presenilin-1, presenilin-2
2. ApoE4
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| Pathogenesis of neurofibrillary tangles in Alzheimer's diseases | show 🗑
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| show | medial temporal lobe and frontal cortex especially entorhinal cortex and hippocampus
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| 1. Parkinsonism with dementia and visual hallucination 2. Acute muscle weakness in lower extremities following gastroenteritis | show 🗑
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| Charcot's triad of Multiple Sclerosis | show 🗑
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| Hereditary disorder associated with sensory and motor neuropathy | show 🗑
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| Difference between partial and generalized seizures | show 🗑
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| 1. Where do Partial seizures commonly originate from? 2. Difference between simple partial and complex partial | show 🗑
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| 1. Extracellular edema due to increased vessel permeability 2. Autosomal dominant trinucleotide repeat disorder leading to chorea | show 🗑
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| show | trinucleotide repeat disorder → Frataxin deficiency → impaired mitochondrial iron homeostasis → free radical damage and apoptosis
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| show | 1. dorsal root ganglia and posterior columns
2. spinocerebellar tracts
3. lateral corticospinal tracts
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| 1. Familial cases of amyotrophic lateral sclerosis involve.. 2. Inherited lower motor neuron disease of children manifesting within the first few months of life | show 🗑
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| 1. What is the abnormality of Wilson's disease 2. Which spinal cord long tracts are affected by vitamin B12 deficiency? | show 🗑
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| show | 1. Acute intermittent prophyria
2. teenagers (always present before 20)
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| How does the location of primary brain tumors differ in adults and in children? | show 🗑
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| show | Both astrocytomas
1. glioblastoma multiforme
2. pilocytic astrocytoma
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| 1. Which CNS tumor characteristically crosses the corpus callosum? 2. Common site for medulloblastoma? 3. Common site for ependymoma | show 🗑
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| show | 1. lung
2. oligodendrocytoma
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| show | 1. Bell's Palsy
2. herpes simplex virus
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| 1. Periventricular plaques of demyelination 2. ↑ α-fetoprotein | show 🗑
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| show | Normal pressure hydrocephalus
(wet, wacky and wobbly)
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| 1. Lack of which vitamin results in Wernicke-Korsakoff? 2. If the brainstem is intact in a comatose patient, which direction would the eyes deviate ofter introducing cold water in the ear? | show 🗑
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| Brief, irregular foot contractions in a child with rheumatic fever | show 🗑
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| 1. What is constructional apraxia 2. It is from a lesion to.. | show 🗑
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| show | 1. absence of the skull and brain
2. symptoms of stroke last < 24 hours
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| show | 1. pyramidal neurons in cortical layers 3, 5 and 6
2. pyramidal neurons of the hippocampus
3. Purkinje layer of cerebellum
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| 1. Subtype of stroke resulting in pale infarct 2. Subtype of stroke resulting in hemorrhagic infarct 3. What are lacunar stroke due to? | show 🗑
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| show | 1. hypertension leads to hyaline arteriosclerosis which weakens vessel walls
2. Charcot-Bouchard microaneurysms rupture
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| show | 1. Epidural hematoma
2. Subdural hematoma
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| show | 1. Metachromatic leukodystrophy
2. Arylsulfatase
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| 1. Which human leukocyte antigen is associated with multiple sclerosis? 2. Which T helper cell is involved in multiple sclerosis? | show 🗑
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| 1. First sign of Alzheimer's disease 2. Cowdry Type A Inclusion | show 🗑
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| 1. Most common cause of dementia 2. Second most common cause of dementia 3. Second most common neurodegenerative cause of dementia | show 🗑
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| 1. Parkinsonism with impaired autonomic function. 2. Cause of hemiballismus. What is the role of this structure? | show 🗑
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| show | 1. vitamin B12 deficiency
2. vitamin E deficiency
3. Friedreich's ataxia
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| Which conditions present as destruction of anterior horn of spinal cord alone? | show 🗑
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| show | 1. Creutzfeldt-Jakob disease
2. Sturge-Weber syndrome may have leptomeningeal angioma
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| show | 1. unilateral; aura, nausea, photophobia
2. bilateral; no aura, no photophobia
3. unilateral; Horner's syndrome
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| Brain tumor with 1. psammoma bodies 2. GFAP staining 3. pseudorosettes 4. fried egg appearance and calcifications 5. Rosenthal fibers 6. S-100 positive 7. synaptophysin staining 8. Pseudopallisading | show 🗑
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| show | 1. mutation in gene encoding α-synuclein (can't degrade with ubiquitin)
2. Mutaiton in 'Parkin" gene which encodes a ubiquitin ligase
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| 1. Headache with male predominance 2. What is the penetrance and expressivity of neurofibromatosis? | show 🗑
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| Inheritance pattern of : 1. Neurofibromatosis 2. Tuberous sclerosis? 3. Wilson's disease 4. Sturge-Weber | show 🗑
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| show | copper carrying protein found in plasma
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| show | 1. Alzheimer's disease
2. 12-48 hours (red neurons)
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| 1. Which disease is known as frontotemporal dementia? 2. Which type of dementia exhibits loss of executive function and may preserve memory? 3. Which type of dementia presents with myoclonus? | show 🗑
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| What is the sequence of tissue pathology following ischemic stroke | show 🗑
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| Which neurocutaneous disorder is associated with: 1. hamartomas, cardiac rhabdomyoma 2. bilateral renal cell carcinoma 3. subependymal giant cell astrocytoma 4. retinal angiomatosis | show 🗑
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| New onset confusion with right arm and leg 5 days after a Subarachnoid hemorrhage. What is the problem? | show 🗑
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| DDx for ring-enhacing lesion | show 🗑
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| Ring enhanced lesion on MRI. Biopsy reveals polymorphonuclear aggregation with adjacent collagenization, gliosis and edema. | show 🗑
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| show | 1. Streptococcus pneumonia
2. Neisseria meningitis
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| 1. Atrophy of the caudate nucleus is seen in 2. Child with ataxia and hypertrophic cardiomyopathy | show 🗑
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| show | 1. craniopharyngioma
2. pituitary adenoma
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| show | 1. NF-1
2. NF-2
3. NF-1
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| What is the cause of the two Age-Related Macular Degenerations: 1. Dry 2. Wet | show 🗑
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| show | MRI to exclude vascular malformation
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| Headache worse when lying down at night. | show 🗑
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| show | associated with intracranial mass lesion, since brain edema increases overnight from the effects of gravity in the reclining position
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| show | 1. hypertension
2. bradycardia
3. abnormal respirations
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| Aneurysm of which artery can cause a third-nerve palsy? | show 🗑
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| What is the difference between a saccular and fusiform aneurysm? | show 🗑
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| show | 1. intraparenchymal
2. subarachnoid
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