11-18 NeuroPATH I.D. Flashcards
Gerstmann-Straussler
autosomal dominant prion disease
—ataxia—>dementia—>death
PrP^sc
the bad version of the prion gene (sc for scrapie, je crois)
—PrP^c = constitutive/normal version
CJD presentation
involuntary myoclonic jerks
—classic EEG findings
—“spongiform encephalitis” —> neuropil fills w/ vacuoles, neurons die in large numbers —> astrocytosis
—may also have Kuru-like amyloid plaques
CSF in viral encephalitis
lymphocytosis
—glucose ~nl
—prot a little elev
Herpes encephalitis usually sets up shop where?
temporal lobe
what type of inflammation do you see with viral CNS infx?
lymphocytic w/ MOs
—perivascular lymphocytic cuffs
polio attacks?
anterior horn cells
neuronophagia
microglial digestion of neurons
—microglial make nodules
Cowdry bodies
inclusion body of HERPES
—kind of fried egg-like
What organ is #2 affected by HIV?
le cerveau!
Path appearance of HIV-encephalitis
—microglial nodule comme toujours
—giant cells
most important 4 AIDS-assoc’d disease
- Toxoplasma gondii
- Cryptococcal
- PML (JC virus +immunosupp —> deadly WM dz
- B-cell lymphoma - cerebral or disseminated (EBV dormant in neurons + HIV-immunosupp —> CNS B-lymphoma)
PML
JC Virus (dsDNA polyomavirus)
—most people infected in renal tubule and oligodendrocytes
—extensive myelin loss —> starts multifocal WM lesions that all grow together
—present w/ sx of encephalopathy (clouding of mentation), but more slowly than viral
toxoplasmosis
—cats!
—intracellular parasite forms pseudocy
—NBD if you have a competent immune system
—BAD if you are preg (destroys fetal neurons) or immunocompromised
—might see intracranial calcifications
CSF findings with bacterial infection
—neutrophilia
—low glucose
—high protein
Bacterial meningitis: Causative agents in 0-2months
E.coli, GBS, Listeria monocytogenes
Bacterial meningitis: Causative agents in 2mo-5y/o
completely diff from neonates: Pneumococcus, Meningococcus, M.tb, Haemophilus (way less now w/ vaccine)
Bacterial meningitis: Causative agents in >5 y/o
Lose Haemophilus (Pneumococcus, Meningococcus, M.tb)
Bacterial meningitis: Causative agents in elderly
—Listeria and haemophilus back;
—pneumococcus and M. tb still there
—meningococcus gone
What space does pus collect in bacterial meningitis?
subarachnoid space (does not invade parenchyma) —however cytokines do—>inflamm —> herniation
What actually kills kids w/ bacterial meningitis?
Herniation from inflammation from swelling from pro-inflamm cytokines
—i.e. NOT the bacteria themselves
post-meningitis infarct
dx—>abx—>fine
—later return w/ “catastrophic CNS event
—Type III hypersensitivity rxn centered on BVs in subarachnoid space
