PATHOLOGY
Neurologic
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Degenerative diseases/cerebral cortex
-?-Alzheimers disease Most common cause of dementia in the elderly; associated with senile plaques (β-amyloid core) & neurofibrillary tangles
-?-Picks disease Associated with intracytoplasmic inclusion bodies & is specific for the frontal & temporal lobes
Degenerative diseases/ basal ganglia & brain stem
-?-Parkinsons disease Associated with Lewy bodies & depigmentation of the substantia nigra; rare cases linked to exposure to MPTP
-?-Huntington disease Autosomal-dominant inheritance, chorea, dementia; atrophy of caudate nucleus
Intracranial hemorrhage
matching (item may be used more than once)| -?-subdural hematoma | crescent-shaped hemorrhage that crosses suture lines |
| -?-epidural hematoma | CT shows "biconcave disk" not crossing suture lines |
| -?-parenchymal hematoma | caused by hypertension, amyloid angiopathy, diabetes mellitus, & tumor |
| -?-subarachnoid hemorrhage | patients complain of "worst headache of my life" |
| -?-epidural hematoma | lucid interval |
| -?-subarachnoid hemorrhage | rupture of aneurysm or an AVM |
| -?-epidural hematoma | rupture of middle meningeal artery, often 2° to fracture of temporal bone |
| -?-subarachnoid hemorrhage | bloody or xanthochromic spinal tap |
| -?-subdural hematoma | seen in elderly individuals, alcoholics, blunt trauma |
| -?-subdural hematoma | venous bleeding (less pressure) with delayed onset of symptoms |
| epidural hematoma subdural hematoma subarachnoid hemorrhage parenchymal hematoma | |
Berry aneurysms:
occur at the -?-bifurcations in the circle of Willis; most common site is bifurcation of the -?-anterior communicating artery; rupture (most common complication) leads to hemorrhagic stroke/subarachnoid hemorrhage; associated with adult polycystic kidney disease, Ehlers-Danlos syndrome, and -?-Marfans syndrome.
Give the classic triad of multiple sclerosis:
S -?-Scanning speechI -?-Intention tremor
N -?-Nystagmus
Demyelinating/dysmyelinating diseases
| -?-PML, progressive multifocal leukoencephalopathy | associated with JC virus & seen in 2-4% of AIDS patients |
| -?-Guillain-Barré syndrome | elevated CSF protein with normal cell count ("albumino-cytologic dissociation") |
| -?-MS | ↑ prevalence with ↑ distance from the equator |
| -?-Guillain-Barré syndrome | facial diplegia in 50% of cases |
| -?-MS | patients can present with optic neuritis (sudden loss of vision), MLF syndrome, hemiparesis, hemisensory symptoms, or bladder/bowel incontinence |
Symptoms of poliomyelitis?
-?-malaise, headache, fever, nausea, abdominal pain, sore throat, signs of LMN lesionsFindings of poliomyelitis?
-?-CSF with lymphocytic pleocytosis with slight elevation of protein; virus recovered from stool or throatSeizures
| -?-simple partial | Partial seizures in which awareness is intact |
| -?-complex partial | Partial seizures in which awareness is impaired |
| -?-absence (petit mal) | Generalized seizures characterized by a blank stare |
| -?-tonic | Generalized seizures characterized by a stiffening |
| -?-myoclonic | Generalized seizures characterized by quick, repetitive jerks |
| -?-atonic | Generalized seizures characterized by "drop" seizures |
| -?-tonic-clonic (grand mal) | Generalized seizures characterized by alternating stiffening & movement |
Aphasia
| -?-Wernickes (receptive) | fluent aphasia with impaired comprehension |
| -?-Brocas (expressive) | nonfluent aphasia with intact comprehension |
| -?-Brocas | inferior frontal gyrus impairment |
| -?-Wernickes | superior temporal gyrus impairment |
Horner's syndrome: sympathectomy of face (lesion above T1):
P -?-Ptosis (slight drooping of eyelid)A -?-Andhidrosis (absence of sweating) & flushing of affected side of face
M -?-Miosis (pupil constriction)
Tabes dorsalis:
degeneration of dorsal columns & dorsal roots due to -?-3° syphilis, resulting in impaired proprioception & locomotor -?-ataxia; associated with Charcot's joints, shooting (lightning) pain, Argyll Robertson pupils, and absence of -?-DTRs.