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Flashcards in Pathology Deck (79):
1

cellular responses to injury

rapid necrosis
slow atrophy

2

what is Nissl substance

large granular body in neurons - RER

3

when is a red neuron found

in acute neuronal injury

4

how does a red neuron arise

hypoxia/ischaemia

5

when are red neurons visible

12-48 hours after irreversible insult to cell

6

why is a red neuron called what it is

intensely red cytoplasm

7

list other neuronal responses to injury

axonal
chronic degeneration
sub cellular alterations - inclusions

8

What is Wallerian degeneration

axonal response to injury where there is degeneration of myelin and axon distal to site of injury

9

give an example of subcellular alterations / inclusions

neurofibrillary tangles in Alzheimers

10

What is the main cell involved in repair and scar formation

astrocytes

11

what is gliosis

astrocyte damage

12

what are the early stages of gliosis

hyperplasia and hypertrophy of astrocytes

13

what is the most important histopathological indicator of CNS injury regardless of cause

gliosis

14

what does damage to oligodendrocytes result in

demyelination

15

what are oligodendrocytes sensitive to

hypoxia

16

Ependymal cells have a limited response to injury, true or false

true

17

M2 microglia are anti/pro inflammatory

ANTI inflammatory

18

causes of nervous system injury

hypoxia
trauma
toxins
metabolic abnormalities
nutritional deficiencies
infections
genetics
ageing

19

Why is excitotoxicity important

important mediator of neuronal injury

20

what is excitotoxicity

hypoxia leads to reduced ATP production and so reduced energy followed by neuronal depolarisation
glial cells fail to reuptake glutamate resulting in a glutamate storm
this excites post synaptic GluR resulting in rapid Ca2+ accumulation in post synaptic neuron

21

what are the 3 outcomes of Ca2+ accumulation in excitotoxicity

protease activation
mitochondria dysfunction
oxidative stress

22

what is cytotoxic oedema

accumulation of Na and Cl in the CELL resulting in a shift of water to the cell also

23

causes of cytotoxic oedema

alcohol intoxication
Reye's
hypothermia

24

what is ionic/osmotic oedema

movement of Na, Cl and water into interstitium

25

causes of ionic oedema

SIADH
increased water uptake

26

what is vasogenic oedema

disruption of BBB resulting in larger molecules like albumin bringing in water

27

causes of vasogenic oedema

trauma
tumours
inflammation
infection
encephalopathy

28

what is haemorrhagic conversion

BBB is majorly disrupted that RBCs enter

29

in global hypoxic ischaemic damage, what does the MAP fall below

50mmHg

30

define stroke

sudden disturbance of cerebral function of vascular origin that causes symptoms lasting more than 24 hours

31

what can cause cerebral infarction

thrombus from atherosclerosis - commonly MCA
embolus - from internal carotid artery or from the heart

32

what type of necrosis occurs in the brain

liquefactive necrosis

33

consequences of hypertension in the brain

lacunar infarct strokes
vascular dementia
ruptured aneurysms and intra-cerebral haemorrhage
hypertensive encephalopathy

34

what are lacunar infarcts

small infarcts in deep cerebral white matter, basal ganglia or pons

35

what type of necrosis do you get in blood vessels

fibrinoid necrosis

36

what is hypertensive encephalopathy

HTN and raised ICP
brain herniation
global cerebral oedema
petechiae

37

what illicit drugs can cause intra cerebral haemorrhage

cocaine
alcohol

38

what is amyloid angiopathy

accumulation of abnormal B sheet proteins resulting in stiffened vessels and HTN

39

cellular constituents of CSF

clear fluid
No WBC
low protein
no RBCs
glucose >2.2

40

what is hydrocephalus

accumulation of excessive CSF in ventricular system of brain

41

3 main causes of hydrocephalus

obstruction of CSF flow
decreased CSF resorption
CSF overproduction

42

hydrocephalus calssification

communicating
non-communicating

43

what is non-communicating hydrocephalus

obstruction to CSF flow withIN the ventricular system

44

what is communicating hydrocephalus

obstruction to CSF flow OUTwith the ventricular system

45

what is hydrocephalus ex vacuo and in which degenerative condition is it seen in

loss of brain parenchyma resulting in secondary ventricular dilatation and increase in CSF
Alzheimer's disease

46

causes of raised ICP

tumour / SOL
hydrocephalus
oedema

47

consequences of raised ICP

brain herniations
CN palsies
visual distrubances

48

list some causes of SOL

tumour
abscess
haemorrhage
oedema

49

what is the most common primary malignant tumour in:
adults
children

adults - astrocytoma
children astrocytoma and medulloblastoma

50

what is the most common primary benign tumour in:
adults
children

adults - meningioma
children - craniopharyngioma

51

medulloblastoma is radio/chemosensitive

radiosensitive

52

what is demyelination

preferential damage to myelin sheath with relative preservation of axons

53

examples of primary demyelination in the CNS

MS
acute disseminated encephalomyelitis
acute haemorrhagic leukoencephalitis

54

secondary causes of demyelination in CNS

viral - JC virus
metabolic
toxic

55

describe MS plaques

well demarcated
irregularly shaped
vary in size
non-symmetrical distribution

56

commonly affected areas by MS plaques

lateral ventricle area
corpus callosum
optic nerves and chiasm
brainstem
ascending and descending tracts
cerebellum
spinal cord

57

describe the histology of active plaques in MS

perivascular inflammatory cells
microglia
ongoing demyelination

58

describe the histology of inactive plaques in MS

gliosis
little remaining myelinated axons
reduced number of oligodendrocytes and axons

59

macroscopically, what colour are active plaques

yellow/brown
ill defined edge

60

macroscopically, what colour are inactive plaques

grey/brown
well demarcated

61

what is the immunopathology of MS

lymphocytic infiltration
oligoclonal bands in CSF
HLA DRB1
Th1 and Th27 cells

62

is dementia a normal part of the ageing process

no it is always pathological

63

list primary causes of dementia

Alzheimer's
Lewy body dementia
Frontotemporal dementia/Pick's disease
Huntington's disease

64

list secondary causes of dementia

vascular/multi infarct
infection
trauma
metabolic
drugs and toxins
SOLs

65

what is the most common cause of dementia in the elderly

Alzheimer's disease

66

genetics of Alzheimer's disease

APP
presenalin 1+2
trisomy 21
ApoE4

67

macroscopic appearance of Alzheimer's disease

cortical atrophy - frontal, parietal, temporal lobes
widened sulci and narrowed gyri
hydrocephalus ex vacuo

68

microscopic features of Alzheimer's disease

simple neuronal atrophy
gliosis
neurofibrillary tangles
amyloid plaques/neuritic plaques

69

what are neurofibrillary tangles

intracellular bundles of Tau protein

70

what is amyloid angiopathy

extracellular eosinophilic accumulation of Abeta sheets

71

appearance of amyloid with congo red stain

apple green birefringence

72

features of Lewy body dementia DLB

progressive
hallucinations
fluctuating levels of attention

73

all DLB get PD but not all PD get DLB, true or false

true

74

what are lewy bodies

a-synuclein aggregrates + ubiquitin

75

what is frontotemporal dementia FTD also known as

Pick's disease

76

onset of FTD

early <65 yo

77

symptoms of FTD

social disinhibition
personality change
rapidly progressive

78

atrophy of what happens in FTD

frontal and temporal lobes

79

what are Pick's bodies

intracytoplasmic filamentous inclusions seen in Pick's disease