CH32: Viral Infections, Prion Diseases Flashcards
Virus traveling via retrograde axoplasmic transport (p. 763)
HSV, VZV, rabies
Certain viruses depend on cell-surface receptors in ingress into the cell. Which virus uses serotonin receptor? (p. 763)
JC Virus (to go into the oligodentrocytes)
Most frequent symptom of acute aseptic meningitis (p. 763)
Headache
Mild depression of the CSF glucose occurs with meningitis caused by (p. 764)
mumps, HSV2, lymphocytic choriomeningitis, VZV
Most common viral causes of acute aseptic meningitis (p. 764)
echovirus, Coxsackie virus
Underlies many cases of what has been traditionally considered as idiopathic Bell’s palsy (p. 765)
HSV-1
Patients infected by these virus have exanthemata that may be associated with grayish vesicular lesions of oral herpangina (p. 765)
Echovirus, Coxsackie virus
Irritability, febrile, seizures but brachial neuritis in adults. Strokes have also been identified but rare (p. 765)
Parvovirus
Main organisms causing encephalitis in the immunocompromised (p. 765)
HHV6, CMV, VZV
Also associated with HSV2, aseptic meningitis, bladder failure and vaginal or vulvar pain after a bout of genital herpes (p. 767)
Elsberg syndrome
Most common sporadic cause of encephalitis and has no seasonal or geographic predilection (p. 769)
HSV
Incubation period after mosquito or tick bite transmission duration (p. 770)
5 to 15 days
Pathologic finding in Arboviral encephalitis (p. 771)
Perivascular cuffing by lymphocytes and other mononuclear leukocytes and plasma cells, as well as patchy infiltration of the meninges with similar cells
HSV 1 or 2: encephalitis (p. 771)
HSV 1
HSV 1 or 2: aseptic meningitis, polyradiculitis or myelitis (p. 771)
HSV 2
HSV Pathology (p. 771)
intense hemorrhagic necrosis of the inferior and medial temporal lobes and mediorbital parts of the frontal lobes
2 route of entry of HSV into the CNS (p. 771)
- trigeminal ganglia
2. fibers innervating hte leptomeninges of the anerior and middle fossa
EEG finding in HSV encephalitis (p. 772)
lateralized periodic high- voltage sharp waves in the temporal regions and slow- wave complexes at regular to 2-3s intervals
Treatment for HSV (p. 772)
Acyclovir 30mg/kg/day for 14 to 21 days
Virus associated with encephalitis in patients undergoing stem cell transplant (p. 773)
HHV 6
Pathologic finding of Rabies (p. 774)
Cytoplasmic eosinophilic inclusions called Negri bodies
Focal collections of microglia in Rabies patients (p. 774)
Babes nodules
Shown to inactivate the rabies virus. Clean the wounds with this one (p. 774)
Benzyl ammonium chloride
How to give HRIG (p. 774)
20U/kg of body weight; half around the wound, half IM
Cerebellitis most often associated with? (p. 774)
Chicken pox
Herpes Zoster multiplication in epidermal cells causing swelling, vacuolization, lysis of cell boundaries leading to the formation of these vesicles (p. 775)
Lipschutz inclusion bodies
Most common site (dermatome) of varicella zoster (p. 776)
T5- T10
Facial palsy in combination with a herpetic eruption of the external auditory meatus (p. 776)
Ramsay Hunt Syndrome
Acute hemiparesis, hemianesthesia, aphasia, elevated IgG in the CSF in Herpes Zoster (p. 777)
Zoster angitis
When to give treatment for Herpes Zoster? (p. 777)
Acyclovir should begin within approximately 48hours of the appearance of the rash.
Other treatment for Herpes Zoster (p. 777)
Famciclovir and valacyclovir
Severely painful syndrome following chicken pox occurs in how many percent? (p. 778)
5-10 percent
HIV dementia pathology (p. 780)
diffuse and multifocal rarefaction of the cerebral white matter accompanied by scanty perivascular infiltration of lymphocytes and clusters of few foamy macrophages, microglial nodules, and multinucleated giant cells
HIV dementia described as widespread astrocytosis and microglial activation in the cerebral cortex with little recognizable neuronal loss (p. 780)
diffuse poliodystrophy
description of HIV neuropathy (p. 780)
distal, symmetrical, axonal polyneuropathy, predominantly sensory and dysesthetic in type
Treatment of HIV causing myopathy (p. 781)
Zidovidine
Of focal infectious complications, this is the most frequent focal infectious complications (p. 781)
Cerebral toxoplasmosis
Alternative treatment for Toxoplasmosis (p. 781)
Clindamycin
Progressive multifocal leukoencephalopathy found wheen CD4+ counts are below (p. 781)
< 50 cell per microliter
Among the nonfocal neurologic complications of AIDS, the most common are (p. 781)
CMV and cryptococcal
Treatment of CMV (p. 782)
Ganciclovir, Foscarnet
Slowly progressive spastic gait with early sphincter control difficulty and some degree of later proprioceptive loss of Romberg sign (p. 783)
HTLV1 Myelopathy
Agent used in the treatment of T-cell lymphoma which has been found to have activity against the virus and may have been effective in this disease (p. 783)
HTLV 1
Reservoir of poliomyelitis (p. 783)
Human intestinal tract
Bulbar symptoms of poliovirus because this structure is most frequently involved (p. 784)
Nucleus ambiguus
Earliest histopathologic changes in the anterior horn (p. 784)
Central chromatolysis of the nerve cells along with an inflammatory reaction
Progressive Multifocal Leukoencephalopathy occurs in which patients (p. 786)
lymphoma, CML, immunodeficient states
Characteristic feature in pathology of PML (p. 787)
enlargement of oligodendrocytes, some bizarrely shaped with intranuclear inclusions
EEG of SSPE (p. 788)
periodic (every 5 to 8s) bursts of 2 to 3/s high voltage waves followed by a relatively flat pattern
Histopathologic feature of SSPE (p. 788)
Eosinophilic inclusions found in the cytoplasm and nuclei of neurons and glia cells
Most extraordinary feature of this diease is appearance of a parkinsonian syndrome after an internal of weeks or months (p. 789)
Encephalitis lethargica (von Ecomo disease)
Most common type of CJD (p. 791)
MM1 and MV1
CJD wherein cerebellar ataxia precede the mental changes (p. 791)
Brownell- Oppenheimer variant
CJD wherein visual disturbances precede the mental changes (p. 791)
Heidenhain variant
EEG finding in CJD (p. 791)
diffuse and nonspecific slowing to stereotyped high voltage slow (1-2Hz) and sharp-wave complexes on an increasingly slow and low-voltage background
MRI of CJD (p. 791)
hyperintensity of the lenticular nuclei on T2 weighted and diffusion weighted images in the BG and cortex
Difference of SSPE and CJD (p. 793)
SSPE: children, young adults, elevated CSF IgG
CJD: middle age presenile, CSF normal
prion disease wherein: progressive cerebellar ataxia, corticospinal tract signs, dysarthria and nystagmus; less dementia (p. 793)
Gerstmann-Straussler-Scheinker Syndrome
Localization of fatal insomnia (p. 793)
Medial thalamic nuclei
Gene affected in fatal insomnia (p. 793)
prion gene at codon 178, methionine at codon 129 on chromosome 20
laughing sickness (p. 793)
Kuru
