Transcript Central Nervous System Pathology Review

Central Nervous System
Pathology Review
RT 91
SPRING 2011
1) Meningitis and Encephalitis fall into
which disease classification?
A. Neoplastic
B. Inflammatory
C. Degenerative
D. Metabolic
Meningitis and Encephalitis fall into
which disease classification?
A. Neoplastic
Oops!
Neoplastic diseases result in a new or abnormal
growth. Lets try again:
HOME
Meningitis and Encephalitis fall into
which disease classification?
B. Inflammatory
SUCH DEDICATION!
Question #2
Meningitis and Encephalitis fall into
which disease classification?
C. Degenerative
Uh oh, hmm lets think about this again.
Degenerative disease are caused by a
deterioration of the body. Try again:
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Meningitis and Encephalitis fall into
which disease classification?
D. Metabolic
Lets get back our minds back on school. Try
again:
HOME
2) Meningitis is more servere
than Encephalitis ?
1)Yes
2) No
YES
Hmmm, I am sure you were just kidding…right?
Encephalitis is more severe than meningitis.
WHY?
NO
You are right on!
Now, do you know why?
Is Meningitis or Encephalitis more
severe?
Encephalitis is more severe than meningitis
because individuals that acquire encephalitis
more frequently develop permanent
neurologic disabilities.
Question #3
3) Meningitis can be caused by many
pathogenic microorganisms. Which type of
most commonly causes meningitis?
1)
2)
3)
4)
Protozoa
Viruses
Bacteria
Fungi
3) Meningitis can be caused by many
pathogenic microorganisms. Which type of
most commonly causes meningitis?
1) Protozoa
I think you should think about it again.
HOME
2) Viruses
Viruses can cause meningitis but it is not the
most common cause.
HOME
3) Bacteria
WAY TO GO!
Pathogens responsbilbe for acute mengingitis include 3
pyogenic (pus forming) types of bacteria. They are
usually carried via the middle ear or frontal sinus.
Can you name the 3?
4) FUNGI
Well, you are ½ right.
FUNGI does cause meningitis. But it is the most
common cause of CHRONIC meningitis.
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Acute Bacterial Meningitis
Meningococcal Meningitis
• Most common in infants
Streptococcal Meningitis
• Most comon in children
Pneumococcal
• Most common in adults
Question # 4
4) How is meningitis treated?
1)
2)
3)
4)
Amphotericin B
Antibiotics
Neosporin
Steroids
4) How is meningitis treated?
1) Amphotericin B
You are correct!
This medication is used to treat acute or chronic
meningitis?
4) How is meningitis treated?
2) Antibiotics
Excellent!
Antibiotics are used to treat acute or chronic
meningitis?
WRONGO!
3)Neosporin
4) Steroids
Ok, now you know these two are incorrect.
You got 50/50 chance, try again.
HOME
AMPHOTERICIN B
This medication treats fungal meningitis which is
most commonly is a chronic form of meningitis.
But one other answer in one the 4 is correct..
Which one?
Question #5
ANTIBIOTICS
Are used to treat bacterial meningitis, which is
usual acute in nature.
But there is still one more correct
answer…which one?
Question #5
5) What is the primary contributing
pathogenic microogranism in
Encephalitis?
1)
2)
3)
4)
Protozoa
Bacteria
Fungi
Virus
5) What is the primary contributing
pathogenic microogranism in
Encephalitis?
1) Protozoa
Not quite….try again.
5) What is the primary contributing
pathogenic microogranism in
Encephalitis?
2) Bacteria
Bacteria usually is the primary cause for ACUTE
meningitis.
Hmmm, I know you can do this. Try again.
5) What is the primary contributing
pathogenic microogranism in
Encephalitis?
3) Fungi
Wow, some studying may be in
order….maybe???
Try again
4) VIRUS
Is usually secondary to other conditions such as
chickenpox, influenza, measles and herples simplex
Question #6
6) Acyclovir is an anti-viral medication
that is used to treat which type of
encephalitis?
1)
2)
3)
4)
Chickenpox related
Herpes simplex related
Measles related
Influenza related
6) Acyclovir is an anti-viral medication
that is used to treat which type of
encephalitis?
1) Chickenpox related
Oh no!
Better luck next time.
6) Acyclovir is an anti-viral medication
that is used to treat which type of
encephalitis?
2) Herpes simplex related
RIGHT ON!!
6) Acyclovir is an anti-viral medication
that is used to treat which type of
encephalitis?
3) Measles related
Better luck next time!
6) Acyclovir is an anti-viral medication
that is used to treat which type of
encephalitis?
4) Influenza related
Oops, does your book have dust on it??
What are the 3 types of spinal
bifida?
Spinal Bifida
1)Meningocele
2) Myelomeningocele
3) Myelocele
Of the 3 types of Spinal Bifida which is
most severe?
1) Meningocele
2) Myelomeningocele
3) Myelocele
Not this time!
• Meningocele
• Only the meninges protrude with this form
• Treated surgically withot difficulty
• Have an excellent prognosis
• HOME
Oh yeah!
2) Myelomeningocele
Both meninges and spinal cord protrude into
skin of back.
Usually have severe neuorological deficits such
as: paraplegia, diminished control of limbs,
bladder and bowel and hydrocephalus
Question # 8
Need more studying time or too well
rested?
• Myelocele
• Protrusion of the spinal cord
• Treated surgically
• HOME
8) Non comunicating and
Communicating Hydrocephalus both
cause an interruption in CSF
circulation.
Which one caused by an obstruction?
1) Non communicating
2) Communicating
Non Communicating Hydrocephalus
• A blockage occurs
with CSF flow from
ventricles to
subarachnoid space.
• Can be congenital,
from a tumor, trauma
or inflammation
Question #9
NO…but I bet you’ll get it next time
Communicating Hydrocephalus
Poor resorption of CSF by arachnoid villi.
HOME
9) Both of the following pathologies
are “pus” accumulated illnesses.
Which of the two occurs between the
dura mater and arachnoid and
requires immediate drainage?
1) Subdural Empyema
2) Brain abscess
Subdural Empyema
• Like a brain abscess it is
diagnosed using CT or
MRI.
• Have similar symptoms
• After drainage
antibiotics are given
Next question
Brain Abscess
• Not this time 
• Antibiotic treatment is 4-8 weeks
• Sometimes it will require a drainage.
• Correct answer
Name 3 degenerative diseases as
described in your book
Name 3 degenerative diseases as
described in your book
• Degenereative Disk disease and Herniated
Nucleus Pulposus
• Cervical Sponydylosis
• Multiple Sclerosis
10) In this disease process a weakened or
torn annulus fibrosus ruptures and allows
nucleus polpusus to protrude and
compress spinal nerve roots.
1) Degenerative disk disease
2) Cervical Spondylosis
3) Multiple Sclerosis
Degenerative Disk Disease
• The most common areas of a “slipped disk”
are:
1) Lumbar and Thoracic
2) Cervical and Thoracic
3) Cervical and Lumbar
Cervical Spondylosis
• Well, better luck next time 
• Osteoarthritic condition that may cause nerve
root compression.
• Diagnosed with oblique C-spine and/ or MRI
HOME
Multiple Sclerosis
• You got to get your head into the books man!
• Degeneration of the myelin sheath covering the
nervous tissue of the spinal cord and white
manner of the brain.
• Impairs nerve conduction
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Degenerative Disk Disease
• The most common areas of a “slipped disk”
are:
1) Lumbar and Thoracic
Well you got part of it.
Want another try
Degenerative Disk Disease
• The most common areas of a “slipped disk”
are:
2) Cervical and Thoracic
Well you are ½ correct.
Try again.
Degenerative Disk Disease
• The most common areas of a “slipped disk”
are:
3) Cervical and Lumbar
Which levels are most common in lumbar
region? Cervical region?
Most common levels of DDD
• Lumbar
– 80% occur at L5-S1
• Cervical
– Most occur at C6-C7
11) What are some of the treatments
for MS?
1)
2)
3)
4)
5)
6)
7)
Rest and limited range of motion
Corticosteroids & Interferon- B
Regular exercise and physical therapy
1&2
2& 3
1&3
All the above
You got to hit the books hard!
• I know you can pull this out from you memory
banks….try again
• HOME
Your chances are getting better.
• Corticosteroids shorten symptomatic periods
• Interferon-B reduces the frequency of
symptomatic periods and may delay the
progression of the disease.
• HOME
Almost there!
• Regular exercise and physical therapy can help
reduce spasticity and improve range of
motion.
• HOME
I knew you could do it!
EXPLANATION
• Corticosteroids shorten symptomatic periods
• Interferion-B reducing the frequency of
symptomatic periods and may delay the
progression of the disease
• Regular exercise and physical therapy can help
reduce spasticity and improve range of
motion.
12) The following depicts:
1)
2)
3)
4)
Multiple Sclerosis
Meningitis
Encephalitis
Hydrocephalus
 Multiple Sclerosis
• Has the classic MS
plaques.
• These are patch areas
of demyeleniation that
are scar tissue
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 Meningitis
• Demonstrattes ring
lesions
• Slightly enlarged
ventricles
HOME
 Enchephalitis
• Causes cerebral edema
• Hemorrrhagic sports
scattered throughout
ceregral hemispheres,
brainstem and
cerebellum
HOME
A++
• Dilated ventricles
• Sulci and gyri are
obliterated and
flattened
Question 13
13) Which CVA is more lethal, has a
sudden onset and is least common
of the two types?
1) Ischemic
2) Hemorrhagic
Not this one……Ischemic Stroke
This is the most common
Mortality rate is 20%
Can be preceded by
Transient ischemic attacks
Symptoms can occur over
hours or days
HOME
Hemorrhagic Stroke
• Least common
• More lethal
– 50% dying within weeks
• Sudden onset
Question 14
14) __________strokes are
treated with antiocoagulants and
thrombolytic agents.
1)
2)
3)
4)
Thrombolytic infarction
Embolism
Subarachnoid
Intracerebral
Ischemic Stroke caused by
Thrombolytic Infarction
• Thrombus is a blood clot
that obstructs a blood
vessel
• You are correct but there is
one more answer….do you
know which one?
• HOME
Ishemic stroke
caused by Embolism
• Embolism is a mass of
undissolved matter:
liquid, solid or gas
• There is one other
answer…do you know
which one?
• HOME
Not quite! Subarachnoid Hemorrhage
Question 15
NOPE! Intracerebral Hemorrhage
Question 15
15) Which of the following is not a
type of glial tumor?
1)
2)
3)
4)
Astrocytoma
Ependymoma
Meningioma
Oligodendrogliomas
Astrocytoma….no, no, no
This is a Glial tumor
It accounts for 1/3 of all gliomas
Star shaped cells that infiltrate
Low grade of malignancy
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Ependymoma……not it!
• Glial tumor
• Arises from ependyma which lines ventricles
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Meningioma
• RIGHT ON DUDE!
• Most common type of non-glial tumors
• Accounts for 15% of ALL intracranila tumors
• More frequent in women than men (40-60
years of age)
Oligodendrogliomas…..think again
• Glial tumor
• Slow growing benign tumor
• HOME