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Pathology II Exam 3 > 10 Neuropathology (CNS infections) > Flashcards

10 Neuropathology (CNS infections) Flashcards

1
Q

Name the 4 routes via which infectious agents can enter the CNS

A
  • hematogenous
  • direct implantation
  • local extension from adjacent site of infection
  • axoplasmic transport along peripheral nerve axons
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2
Q

Bacteria and yeast most often cause what type of meningitis?

A

pyogenic or granulomatous

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3
Q

Hyphal forms of fungi most often cause ____ and _____

A

cerebritis

abscesses

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4
Q

T/F- bacterial is the most common type of CNS infection and results in meningitis more frequently than abscess

A

true

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5
Q

Viral infections usually cause what?

A

encephalitis, meningoencephalitis

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6
Q

Describe the CSF findings in bacterial pyogenic meningitis

A

many neutrophils
high protein
low glucose

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7
Q

Describe the clinical symptoms of bacterial pyogenic meningitis

A

headache
altered mental state-encephalopathy
increased intracranial pressure
seizures

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8
Q

What 2 organisms cause acute (purulent) meningitis in neonates

A

Group B strep

Listeria Monocytogenes

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9
Q

What 3 organisms cause acute meningitis in young children

A

N. meningitidis
Strep pneumoniae
H. influenzae (unvaccinated)

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10
Q

What 2 organisms cause acute meningitis in older children/adults?

A

Strep. pneumoniae

Neisseria meningitidis

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11
Q

T/F- in bacterial meningitis you’ll likely see pmns in leptomeninges

A

true

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12
Q

Name 2 complications of meningitis

A

infarcts

chronic hydrocephalus

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13
Q

Lymphocytic meningitis (aka aseptic/viral) is usually self limited. What will you see in the CSF?

A

lymphocytes
moderately high protein
Normal glucose

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14
Q

Name 2 most common causes of lymphocytic/aseptic meningitis

A

echovirus

coxsackie virus

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15
Q

Name 3 causes of chronic (granulomatous) meningitis

A
  1. M. tuberculosis/avium
  2. Yeast forms of fungi (cryptococcus, coccidioides, blastomyces)
  3. rarely sarcoidosis
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16
Q

What is a feared complication of chronic meningitis?

A

obliterative endarteritis leading to infarction of underlying brain

17
Q

chronic meningitis has a predilection for _____

A

base of brain

18
Q

What bacteria commonly cause cerebrates and abscess in the brain?

A

Anaerobic strep
Strep pneumoniae
Staph sp.

19
Q

What fungi cause cerebrates and abscess of the brain?

A

aspergillus
mucor
candida

20
Q

What protozoal infection can cause cerebrates and abscess of the brain?

A

toxoplasma

21
Q

What is the most common method of pathogen “spread” leading to cerebritis and abscess?

A 
Direct spread (50%)
hematogenous spread (25%)
22
Q

Rank the following from most to least common location of brain abscess: parietal, cerebellum, frontal

A

Frontal»parietal>cerebellum

23
Q

What is cerebritis?

A

focal infection/inflammation before an established abscess (with a wall) forms

24
Q

T/F- abscesses present as a ring enhancing lesion on CT

A

true

25
Q

What type of pathogen (virus, bacteria, etc) is most often responsible for encephalitis?

A

viruses

26
Q

Will you see microglial nodules and neuronophagia with viral encephalitis?

A

yes

27
Q

Rabies: ____ body inclusion
Herpes: ____ body inclusion

A

negri body

cowdry type A

28
Q

What virus causes progressive multifocal leukoencephalopathy?

A

JC virus

29
Q

In HIV encephalitis, you’ll often see multinucleated giant cells located where?

A

around vessels

30
Q

in PML you’ll see bizarre, atypical ______ as well as intranuclear inclusions in ______ cells

A
  1. astrocytes (reactive, not neoplastic)

2. oligodendroglial cells

31
Q

Is toxoplasmosis a ring enchancing lesion?

A

yes

32
Q

In spongioform encephalopathy are the vacuoles in the white or gray matter?

A

gray

33
Q

Classic triad of symptoms in prion diseases?

A

rapid dementia
myoclonus
periodic short wave activity on EEG

34
Q

Are most cases of CJD sporadic or familial?

A

most are sporadic

only 10-15% familial

35
Q

What chromosome is the normal gene for protease resistant prion protein on?

A

chrom20

36
Q

Describe the pathogenesis of prion disease

A
  • Disease occurs with conformational change of PrP 3D structure into ß-pleated sheet
  • Single pathogenic PrP can induce further protein conversions of wild type protein creating a chain reaction
  • PrP accumulates in and outside of cells in the form of amyloid
37
Q

Is there a mutation that increase your risk for sporadic CJD?

A

Homozygosity for Met or Val at codon 129 increases risk of sporadic CJD

38
Q

T/F- CJD brain will always show atrophy

A

false, may look normal or may show atrophy

39
Q

Describe the microscopic appearance of CJD

A

Neuronal loss, gliosis, and spongiform change (often patchy), defined by small “punched out” vacuoles in gray matter (cortex ± deep nuclei)

Pathology II Exam 3 (13 decks)

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