CNS: Robbins Pathology Chapter 28 EXAM||ACTUAL
COMPLETE REAL EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ /NEWEST EXAM / JUST
RELEASED!!
What is the response of oligodendrocytes and ependymal cells to
injury?
- A feature of acquired demyelinating disease and leukodystrophies
- May harbor viral inclusions in progressive multifocal
leukoencephalopathy (degenerative white matter changes)
- Glial cytoplasmic inclusions (mostly a-synuclein) in oligodendrocytes
in multiple system atrophy (MAS)
- No specific patters of reaction in ependymal cells; ependymal
granulations
- Neither cells mediate a significant response to most forms of injury
in the CNS
What are the characteristics of vasogenic edema?
- Results from a disruption in the BBB; inflammation and neoplasm
- Increased ECF in the brain from BBB disruption and increased vascular
permeability allows fluid to shift from intravascular to intercellular
spaces
- Paucity of the lymphatics in the brain impairs resorption of the excess
ECF
- Localized: adjacent to inflammation or neoplasms
- Generalized can follow ischemic injury
,What are the characteristics of cytotoxic edema?
- BBB is intact, the Na/K ATPase is compromised leading to retention
of Na (and H2O); due to global processes like ischemia
- Increased in ICF from neuronal, glial, or endothelial cell membrane
injury
- Global processes or with a metabolic derangement that prevents
maintenance of the normal membrane ionic gradient
If a patient presents with signs of increased ICP and the CSF fluid
sample reveals RBCs, what is the most likely mechanism?
Edema adjacent to a primary neoplasms; Vasogenic edema
What are the characteristics of hydrocephalus in infants?
- before sutures close: enlargement of the head and increased cranial
circumference
- The most common cause of noncommunicating hydrocephalus in the
neonate/infant is aqueductal stenosis
What are the characteristics of *noncommunicating hydrocephalus?
- The ventricular system is obstructed and does not communicate with
subarachnoid space
- Both aqueductal stenosis and Dandy-Walker malformation are
congenital conditions causing ventricular system obstruction
,What are the characteristics of communicating hydrocephalus?
- Ventricular system is in communication with the subarachnoid space
- Enlargement of the entire ventricular system - symmetric dilation
- Pneumococcal meningitis in adults often invaded the vertex, where the
arachnid granulations that reabsorb CSF are found
- Chronic pneumococcal meningitis may give rise to chronic adhesive
arachnoiditis - hydrocephalus due to failure of CSF resorption
What are the characteristics of hydrocephalus ex vacuo?
- refers to a compensatory increase in ventricular volume secondary to
a loss of brain parenchyma (atrophy)
- This is a type of communicating hydrocephalus
- There is no pressure effect
What are the characteristics of subfalcine (cingulate) herniation?
- Unilateral or asymmetric expansion of the cerebral hemisphere
displaces the cingulate gyrus under the falx
- This can lead to compression of the ACA and its branches -
contralateral LE weakness is a consequence of subfalcine herniation
with compression of the ipsilateral ACA
, What are the characteristics of a transtentorial (uncinate, medial
temporal) herniation?*
- Mass effect of a medial temporal lobe -> compression of CN III palsy
= down and out eye, pupillary dilation
- Medial aspect of the temporal lobe is compressed against the free
margin of the tentorium
- CN III palsy is ipsilateral
- PCA can become compressed -> ischemia of the visual cortex
- If large enough, contralateral cerebral peduncle can also become
compressed that results in hemiparesis ipsilateral to the side of
herniation - in this setting it is known as Kernohan notch
What are duret hemorrhages?
- Secondary hemorrhagic linear or flame-shaped lesions in the midbrain
and pons that often accompany transtentorial herniation
- Usually occur in the midline and paramedian regions
- Believed to be due to distortion or tearing of penetration veins and
arteries supplying the upper brainstem
- Midline hemorrhages into the pons (mesencephalon) that
accompany transtentorial herniation
What are the characteristics of tonsillar herniations?
- Displacement of the cerebellar tonsils through the foramen magnum
- Life-threatening because it compresses the brainstem and the
corresponding vital respiratory and cardiac centers in the brain
Is alpha-fetoprotein elevated in spina bifida occulta?
no
COMPLETE REAL EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ /NEWEST EXAM / JUST
RELEASED!!
What is the response of oligodendrocytes and ependymal cells to
injury?
- A feature of acquired demyelinating disease and leukodystrophies
- May harbor viral inclusions in progressive multifocal
leukoencephalopathy (degenerative white matter changes)
- Glial cytoplasmic inclusions (mostly a-synuclein) in oligodendrocytes
in multiple system atrophy (MAS)
- No specific patters of reaction in ependymal cells; ependymal
granulations
- Neither cells mediate a significant response to most forms of injury
in the CNS
What are the characteristics of vasogenic edema?
- Results from a disruption in the BBB; inflammation and neoplasm
- Increased ECF in the brain from BBB disruption and increased vascular
permeability allows fluid to shift from intravascular to intercellular
spaces
- Paucity of the lymphatics in the brain impairs resorption of the excess
ECF
- Localized: adjacent to inflammation or neoplasms
- Generalized can follow ischemic injury
,What are the characteristics of cytotoxic edema?
- BBB is intact, the Na/K ATPase is compromised leading to retention
of Na (and H2O); due to global processes like ischemia
- Increased in ICF from neuronal, glial, or endothelial cell membrane
injury
- Global processes or with a metabolic derangement that prevents
maintenance of the normal membrane ionic gradient
If a patient presents with signs of increased ICP and the CSF fluid
sample reveals RBCs, what is the most likely mechanism?
Edema adjacent to a primary neoplasms; Vasogenic edema
What are the characteristics of hydrocephalus in infants?
- before sutures close: enlargement of the head and increased cranial
circumference
- The most common cause of noncommunicating hydrocephalus in the
neonate/infant is aqueductal stenosis
What are the characteristics of *noncommunicating hydrocephalus?
- The ventricular system is obstructed and does not communicate with
subarachnoid space
- Both aqueductal stenosis and Dandy-Walker malformation are
congenital conditions causing ventricular system obstruction
,What are the characteristics of communicating hydrocephalus?
- Ventricular system is in communication with the subarachnoid space
- Enlargement of the entire ventricular system - symmetric dilation
- Pneumococcal meningitis in adults often invaded the vertex, where the
arachnid granulations that reabsorb CSF are found
- Chronic pneumococcal meningitis may give rise to chronic adhesive
arachnoiditis - hydrocephalus due to failure of CSF resorption
What are the characteristics of hydrocephalus ex vacuo?
- refers to a compensatory increase in ventricular volume secondary to
a loss of brain parenchyma (atrophy)
- This is a type of communicating hydrocephalus
- There is no pressure effect
What are the characteristics of subfalcine (cingulate) herniation?
- Unilateral or asymmetric expansion of the cerebral hemisphere
displaces the cingulate gyrus under the falx
- This can lead to compression of the ACA and its branches -
contralateral LE weakness is a consequence of subfalcine herniation
with compression of the ipsilateral ACA
, What are the characteristics of a transtentorial (uncinate, medial
temporal) herniation?*
- Mass effect of a medial temporal lobe -> compression of CN III palsy
= down and out eye, pupillary dilation
- Medial aspect of the temporal lobe is compressed against the free
margin of the tentorium
- CN III palsy is ipsilateral
- PCA can become compressed -> ischemia of the visual cortex
- If large enough, contralateral cerebral peduncle can also become
compressed that results in hemiparesis ipsilateral to the side of
herniation - in this setting it is known as Kernohan notch
What are duret hemorrhages?
- Secondary hemorrhagic linear or flame-shaped lesions in the midbrain
and pons that often accompany transtentorial herniation
- Usually occur in the midline and paramedian regions
- Believed to be due to distortion or tearing of penetration veins and
arteries supplying the upper brainstem
- Midline hemorrhages into the pons (mesencephalon) that
accompany transtentorial herniation
What are the characteristics of tonsillar herniations?
- Displacement of the cerebellar tonsils through the foramen magnum
- Life-threatening because it compresses the brainstem and the
corresponding vital respiratory and cardiac centers in the brain
Is alpha-fetoprotein elevated in spina bifida occulta?
no
