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What's the gross feature of an astrocytoma?
Poorly defined, soft, pale expansile mass
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What's the characteristic histology pattern of Anaplastic astrocytoma?
Hipercellularity, pleomorphism, mitoses, cellular atypia
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What's the prognosis for anaplastic astrocytoma?
2 year survival post surgery/therapy
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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
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What's the prognosis for a grade 4 astrocytoma?
Mean survival 15 months
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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
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What are genetic alterations associated with grade 4 astrocytoma?
1/3 p53, 1/3 EGFR, 1/3 neither
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In which astrocytoma is necrosis present?
Type IV
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What are histological characteristics of brain metatsasis?
Multiple lesions, well demarcated, spherical
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What's the gross charactersitic of a gliblastoma?
Ill defined, large, hemorrhagic, necrotic mass
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What are symptoms charactersitic of a uncal herniation?
Fiked and dilated pupil
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What are histological characteristics of glioblastoma?
Hyperceullarity, mitoses, endothelial hyperplasia, coagulatice necrosis surrounded byu pseudopalisading/ serpintine necrosis
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What's the most common primary brain tumor of adults?
Glioblastoma
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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
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What would you suspect if there were multiple meningiomas?
- Von Recklinghausen's neurofibromatosis
- Chromosome 22 mutations (NF2)
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What's the histoilogical pattern seen in meningioma?
Whorled growth patten with psammoma bodies
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What's the demographic for meningioma (spinal)?
- Females 3:2 in mid-late life
- Spinal = 10:1
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In what conditions are Psammoma bodies present?
- Meningiomas
- Papillary carcinoma of thyroid
- Serious cystadenocarcinoma of ovary
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What ares of brain are most vulnerable to infarction?
- Basal ganglia and internal capsule
- Ends of MCA
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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)
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What's the causes of thrombotic vs. Embolic occlusions?
- Thrombotic: atherosclerosis in carotid/vertebrobasila system
- Embolic: mural thrombus --> MCP
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What's most common cause of primary intracebral hemorrhage? (type/location)
- (Rupture of vessel)
- Charcot-Bouchard microaneurysm (HTN) in basal ganglia/thalamus
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What are signs of UMN/LMN injury?
- LMN: muscle atrophy and fasciculations
- UMN: hyperreflexia and Babinski sign
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What are areas of involvement in ALS?
- UMN/LMN symptoms on upper/lower extremities, tongue/facial muscles, chewing/swallowing
- Sensory/ocular/ingelligence maintained
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What's the cause of fasiculations in ALS?
- ACh receptors become distributed over whole muscle fiber surface
- Small amounts of ACh propagate AP
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What's the most common demographic for ALS?
60 year old male (2:1)
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What's the most common from of motor neuron disease in adults?
ALS
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What's the genetic abnormality in ALS?
SOD1 gene on chromosome 21 (10% familial)
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What are gross intracranial characteristics of ALS?
Thinning of precentral gyrus -> widening of central sulcus
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What are characteristics of the spinal cord in ALS?
- Demyelination
- UMN: lateral corticospinal tracts
- LMN: anterior horn
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What are common clinical symptoms of dementia?
Gradual cognitive loss and alteration of behavior
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What's a Neurofibrillary tangle?
- Cytoplasmic bihelical filaments of abnormal proteins
- (tau, ubiquitin)
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What are Neuritic Plaques?
focal collection of tortuous neuritic processes surrounding an amyloid core
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What type of Amyloid is involved in Azheimer's Disease?
B protein from APP (chomosome 21)
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What forms first? Neuritic processes or amyloid core?
Neuritic processes form first
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What are morphological features of alzheimer's disease?
- 1.Cortical atrophy
- 2.Neuronal degeneration/destruction
- 3.Neurofibrillary tangles
- 4.Neuritic plaques
- 5.Amyloid vasculopathy
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What are the areas of atrophic involvement in alzheimer's disease?
Frontal, parietal, temporal
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Where is the most prominent neuronal loss in Alzheimer's disease?
- Cerebral cortex, amygdala, hippocampus and basal
- forebrain (basal nucleus of Meynert).
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What's the normal size of an atrophic alzheimer's brain?
Less than 1100g
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What hemorrhagic condition is associated with cortial atrophy?
- Chronic subdural hematoma
- Increased range of motion for bridging vein rupture
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What are charactersitics of Pick Disease?
- Less frequent
- Frontal/anterior 1/3 temporal lobe atrophy
- Pick's bodies
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What are pick's bodies?
bsophilic cytoplasmic inclusions of tau/ubiquitin protein
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