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Clinical Neuro Microbio > Chapter 24 > Flashcards

Chapter 24 Flashcards

0
Q

Septic vs. Aseptic causes

CSF

A

Septic: Bacteria (cloudy csf)
Aseptic: Virus (clear csf)

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1
Q

Septic vs. Aseptic

Meningitis

A

Septic: 200-20000 neuts, high protein >100 mg, low glucose <45

Aseptic: 100-1000 monos, 50-100 mg, normal glucose

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2
Q

How does the host response to Herpes Simplex and Varicella Zoster contribute to bug transmission?

A

Invades drg. Establishes latency, allowing for reactivation and infection via shedding

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3
Q

How does the host response to Rabies contribute to bug transmission?

A

Affects limbic system, causing changes in behavior, more aggressive = more likely to bite-spread

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4
Q

Neisseria Menigitidis

Gram
Morph
Growth
Fermenting
Clinical Present
Virulence
A 
Gram negative
Diplococcus
Choclate blood agar, thayer-martin
Maltose positive
Petechiae rash
POICE
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5
Q

Haemophilus Meningitidis (influenzae)

Gram
Morph
Growth
Virulence

A

Gram negative
Coccobacillus
Chocolate agar
POICE

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6
Q

Strep pneumo

Gram
Hemo
Morph
Virulence
Vaccine
Populations
A 
Gram positive
A
Coccus
CI
Pneumovax
Sickle/head trauma/splenectomy
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7
Q

E Coli

Gram
Morph
Virulence
Pops

A

Gram negative
Anaerobic rods
Adhesins, exotoxins
Newborn, 1-12 weeks

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8
Q

Group B Strep

Gram
Morph
Virulence

A

Gram positive
Cocci in chains
Capsule
Same pop/clin as e coli

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9
Q

Listeria Monocytogenes

Gram
Morph
Hemo
Growth
Virulence
Pop
A 
Gram positive
Coccbacillus
Weak B
Facultative intracellular
Immunocompromised
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10
Q

Mycobacterium TB

Gram
Morph
Virulence
Pops
Clin
A 
Weak gram positive
Acid fast aerobic rods
Lipid cell wall (disenfectant resistant)
0-4 years
Infection elsewhere, miliary TB
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11
Q

Cryptococcus neoformans

Morph
Preparations
Virulence
Pops

A

Spherical/oval
Indian ink-stained CSF
Polysacc capsule
Immunosuppressed

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12
Q

Herpes Simplex Virus

Characteristics
Pop
Transmission

A 
dsDNA
Enveloped
Icosahedral
Replicate in nucleus
Neonates
Saliva, fluids
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13
Q

Mumps

Characteristics
Transmission
Clin

A 
ssRNA
Enveloped
-sense
Replicate in cytoplasm
Transmitted via respiratory drops
Parotitis, aseptic meningitis
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14
Q

Lymphocytic Chorieningitis

Characteristics
Pops
Transmission

A 
ssRNA
Enveloped
-sense
Replicates in cytoplasm
Immunocompromised
Transmission urine of mice/hamsters
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15
Q

Enterovirus (coxsackievirus, echovirus, poliovirus)

Characteristics
Pops
Transmission
Clins

A 
ssRNA
\+sense
Naked
Icosahedra
Replicates in cytoplasm
Under 5 years
Coxsackievirus: respiratory drops
Echo/polio: fecal-oral
Paralysis
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16
Q

Rabies

Characteristics
Transmission
Clin

A

ssRNA, -sense, enveloped, Bullet-shaped, replicates in cytoplasm
Bite from dog, cat, skunk, raccoon, bat
Seizures, paralysis, incubation period

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17
Q

Japanese encephalitis

Characteristics
Pops
Transmission
Clin

A

ssRNA, +sense, spherical, replicates in cytoplasm
SE asia
Mosquito-borne
50% mortality

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18
Q

Eastern/Western equine encephalitis

Characteristics
Pops
Transmission

A

ssRNA, +sense, enveloped, spherical, replicates in cytoplasm
E/W US
Mosquito-borne

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19
Q

Louping lll

Characteristics
Pops
Transmission

A

ssRNA, +sense, enveloped, replicates in cytoplasm
Scotland
Tick-borne

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20
Q

HIV

Characteristics
Transmission
Clins

A

ds/ssRNA, +sense, enveloped, replicates in cytoplasm
Transmits via blood, sex fluids
Encephalitis/dementia, inc cells in csf, macrophage and microglia damage

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21
Q

Maternal exposure to listeria monocytogenes can cause:

A

Neonatal septicemia
Pneumonia (w/ abscess or granuloma)
Abortion or premature delivery

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22
Q

Early vs late onset Strep agalactiae

A

Less than 1 week vs 1-12 weeks
Preterm, prolonged labor, complications seen in early
Early: bacteremia, pneumonia, meningitis
Late: mainly meningitis

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23
Q

At risk population for cryptococcus neoformans and c neoformans variant gattii meningitis?

A

C neoformans: immunocompromised

C neoformans variant gattii: occurs in immunocompetent

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24
Q

When is India ink stain used?

A

Identifies cryptococcus

Polysaccharide capsule excludes ink

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25
Q

Meningitis-causing bacteria

A 
Neisseria meninigitidis
Haemophilus influenzae
Streptococcus pneumonia
E. coli + Group B strep
Listeria monocytogenes
Mycobacterium TB
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26
Q

Meningitis-causing fungi

A

Cryptococcus neoformans

Coccidiosis immitis

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27
Q

Meningitis-causing viruses

A 
Herpes simplex
Mumps
Lymphocytic choriomeningitis
Enteroviruses
Japanese encephalitis
Eastern/western equine encephalitis
Louping Ill
HIV
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28
Q

Meninigitis-causing parasites

A

Naegleria fowleri

Acanthamoeba

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31
Q

Encephalitis-causing viruses (sporadic)

A

Herpes simplex
Mumps
Varicella-zoster (rare complication of ophthalmic zoster)
Cytomegalovirus (in utero, immunosuppressed)
Louping lll (tick)
HIV

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32
Q

Encephalitis-causing viruses (outbreaks)

How acquired?

A

Polio (enteroviruses)

E/W equine, St louis, japanese, californian encephalitis (mosquitoes)

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33
Q

Encephalitis-causing viruses (slow)

A

Rubella (in utero or sspe)
Measles
JC virus (immunocompromised)

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34
Q

Scrapie group causing encephalitis: Prions

A

Creuztfeld-Jakob and kuru have 20 year incubation

Spongiform encephalopathy

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35
Q

Encephalitis-causing protozoa and fungi

A

Toxoplasma gondii
Cryptococcus neoformans
Plasmodium falciparum (cerebral malaria)
Typanosome (africa sleep sickness)

36
Q

Encephalitis-causing bacteria

A

Treponema pallidum
Mycoplasma pneumonia
Borrelia burgdoferi

37
Q

HSV in neonates

A

HSV-2 from mother shedding during delivery

38
Q

Primary amebic meningoencephalitis

A

Caused by Naegleria
Found in stagnant water
Affects immunocompetent

39
Q

Granulomatous amebic encephalitis

A

Caused by Acanthamoeba

Affects immunocompromised

40
Q

HSV encephalitis in children/adults

A

HSV-1 reactivated in trigeminal ganglia, passed back to temporal lobe

41
Q

Poliovirus

A

Fecal-oral (maybe oral-oral)
Eventual paralysis
3 types preventable with vaccination

42
Q

Nipah virus

Transmission, reservoir

A

Aerosol transmission pig to human
Island flying fox is a reservoir
Encephalitis (paramoxyvirus)

43
Q

Rabies

A 
Rhabdovirus
Bullet shape
ssRNA
Saliva of animals
Transmission via bites
Causes cardiac/respiratory arrest
Diagnosed with immunofluorescence or pcr
Negri bodies
44
Q

Togavirus vectors and transmission

A

E equine enceph (aedes, culiesta mosqs)
W equine enceph (culex, culiesta mosqs)
Japan, west nile, st louis enceph (culex mosqs)
Russian enceph (ixodes, dermacentor ticks)

45
Q

West nile virus reservoirs

A

Birds and mosquitoes

humans and horses are incidental

46
Q

West nile at risk pops

A

Blood transfusions
Organ transplants
Standing water, drainage ditches

47
Q

HIV

clinical disease, pathogenesis

A

Invades cns
Dementia; shrunken brain enlarged vents
Subacute encephalitis
Infects macrophages and microglia

48
Q

JC virus

A

Polyomavirus
Invades oligodendrocytes
Immunodeficient peeps (aids)
Leads to progressive multifocal leukoencephalopathy (pml)

49
Q

Viral myelopathy

Clinical symptoms, viral agents

A

Myelitis; inflammation of spinal cord
Motor/sensory loss
HTLV-1 (with TSP), HSV, CMV, EBV, VZV, HIV-1

50
Q

Post-vaccinal and post viral encephalitis

Causative agents

A

Measles, rubella, varicella, mycoplasma

51
Q

Prion infections

A

Scrapie (sheep and goats): spongiform encephalopathy
CJ: BSE infected beef
Kuru: cannibalism, decades of incubation

52
Q

Prion diseases

Pathogenesis, transmission, diagnosis

A

Lack nucleic genome
Intraspecies transmission
Creates more stable isoform of protein, resistant to proteolysis
No effective treatment

53
Q

Toxoplasmosis

Clinical, transmission, laboratory, agent

A

Damage to eye, hydrocephalus, intracerebral calc
Congenitally acquired
Serologic profile (tsp), sabin-feldman test IgG, Elisa, diff agglutination
Toxoplasma gondii

54
Q

Cerebral malaria

Clinical, transmission, diagnosis, agent

A

Fever, convulsions, death
Mosquitoes
Blood film
Plasmodium falciparum

55
Q

Toxocara infection

Clinical, transmission, diagnosis, agent

A

Granulomas around larvae in brain, convulsions, eye tumor, blindness
Eggs ingested from pet feces
Elisa, antibody detection
Toxocara cati, canis

56
Q

Hyatid cyst disease

Clinical, transmission, diagnosis, agent

A

Nausea, vomitting, seizures, mental status
Ingested eggs from dogs
Serum antibody to hyatid antigens
Echinococcus granulosus

57
Q

Cysticerosis

Clinical, transmission, diagnosis, agents

A

Hyrdocephalus, convulsions, meningitis, hyperreflexia, visual deficits
Eggs in human feces ingested by pigs, form cyst in pig, eaten by humans
Detected by serum antibody or csf, mri
Taenia solium

58
Q

Clostridium tetani

Clinical, transmission, moa

A

Hyperreflxia, muscle spasms, respiratory failure, tachycardia
Incubates 3-21 days
Spores from feces of domesticated animals enter wound
Blocks release of inhibitory mediators

59
Q

Clostridium Botulinum

Clinical, transmission, moa

A

Descending weakness/paralysis. Floppy baby
Incubate 2-72 hours
Unsterilized canned or preserved food
Blocks release of acetylcholine

60
Q

Strep pneumo

Gram/morph
Lab
Pop
Transmission
Notes
Treatment
A

+, diplococci
A, bac resistant
Meningitis in ped/old, sinus/otitis in old
Respiratory drops (capsule, iga protease, pneumolysin)
Rusty sputum, bateremia, endocarditis
Ceftriaxone + ampicillin, vanco + ceftriaxone

61
Q

Neisseria meningitis

Gram/morph
Lab
Pop
Transmission
Notes
Treatment
A 
-, kidney bean diplococci
Thayer martin, maltose/glucose
Army, freshmen, infants
Resp drops (iga protease, pili, capsule, endotoxin los)
Csf pmns, petechial rash, dic, sepsis
Ceftriaxone, rifampin for close contact
62
Q

Haemophilus influenzae

Gram/morph
Lab
Pop
Transmission
Notes
Treatment
A 
-, rod
Factor V, D, Choc agar
Peds
Resp drops (capsule B)
Meninigitis, pneumonia, sepsis
Ceftriaxone
63
Q

Strep agalactiae

Gram/morph
Lab
Pop
Transmission
Notes
Treatment
A 
\+, cocci
B hemo, bac resistant
Meningitis in neonates, uti in pregs
Birthing (capsule, c5a peptidase)
Sepsis, bacteremia, pneumonia
Penicillin G or ampicillin
64
Q

E coli k1

Gram/morph
Lab
Pop
Transmission
Notes
Treatment
A

-, rods, pmns in stool
Ox -, lactose, indole +
capsule, polysaccharide, flagellar p-pili
Fecal contamination of water
Uti, septicemia, neonate meningitis, gastroenteritis
Ceftriaxone

65
Q

Listeria monocytogenes

Gram/morph
Lab
Pop
Transmission
Notes
Treatment
A 
\+, rod
Cat +, b hemo, tumbling, 4'
Babies, crosses bbb placental barrier
Feces food (listeriolysin O lyses phag)
Meningitis, bacteremia, endocarditis, granulomatis infantseptica
Ampicillin, gentamicin
66
Q

Conjuctivitis-causing viruses

A 
Adenovirus
Measles
Herpes simplex
Varicella-zoster
Enterovirus, coxsackivirus
67
Q

Conjunctivitis-causing bacteria

A 
Chlamydia trachomatis
Neisseria gonnorheae
Staph aureus
Strep pneumo
Haemophilus influenzae
68
Q

Chlamydia trachomatis

Adult/Neonatal inclusion conjunctivitis

A

Adult: mucopurulent discharge, dermatitis, corneal infiltrates, corneal vascularization. Preceded by genital infection. 18-30

Neonate: Mucopurulent discharge. Infected birth canal, infected mother

69
Q

Haemophilus aegyptius

Bacterial conjunctivitis

A

Acute purulent conjunctivitis. Epidemics. Warm months

70
Q

Adenovirus

A

MOST COMMON CAUSE OF CONJ
Pharynconjunctival fever
Follicular conj (pebbled, nodular mucosa)
Sporadic or outbreaks

71
Q

Enterovirus 70, coxsackievirus a24

A

Acute hemorrhagic conjunctivitis

72
Q

Blepharitis (eyelid infection)

Etiology, clinical

A

Eti: Staph aureus

Red, irritated, swollen, scaly, burn/itch

73
Q

Stye (eyelid oil gland/follicle)

Etiology, clinical

A

Eti: staph aureus

Red, swollen, tender gland/follicle

74
Q

What serotypes of Chlamydia trachomatis are involved in trachoma?
Acquisition?

A

A, B, Ba, C

Contaminated flies, fingers, towels

75
Q

Trachoma

Path, dx, tx

A

Abundant flies, conj to conj
Dx: conj fluid
Tx: topical or oral antibiotics

76
Q

Acanthamoeba

Clinical, transmission

A

Corneal ulceration

Multiplies in unchanged lens cleaning fluids

77
Q

Herpes simplex

Clincal, path

A

Keratitis w/ dendritic ulcers, corneal scarring, loss of sight
Invades eye via ophthalmic division of trigeminal

78
Q

Adenovirus

Characteristics, clinical, transmission

A

Linear dsDNA, nonenveloped icosadeltahedral capsid
Resp drops, fecal oral (swimming pools)
Pharynconj fev: flu, myalgia, headache. 5-18
Conj: follicular. Public pools

79
Q

Pathogens causing deeper eye infections (transmission, pops)

A

Rubella (utero)
CMV (utero, aids)
P aeruginosa (trauma)
Toxoplasma gondii (utero)
Echinococcus granulosus hyatid (eggs via dogs)
Toxocara canis (eggs via dogs)
Onchocerca volvulus (larva via simulium flies)

80
Q

Most common cause of retinitis in aids

A

CMF

81
Q

Congenital ocular toxoplasmosis

Acquisition, pathogenesis, clinical

A

T gondii swallowed oocysts from cats (can affect fetus via placenta)
Cysts form in retina, continuous proliferation, lesions, choroid - blind
1 or 2 eyes

82
Q

Toxocara canis

Acquisition, progression, clinical

A

Nematode occurs naturally in dog intestine, ingested eggs
Enters eye/cns triggers eosinophilic inflammatory response
Post uveitis, retinal granuloma, traction bands retinal detachment

83
Q

African river blindness

Vector, path, clinical

A

Onchocerca volvulus transmitted by simulium flies
Microfilariae induce inflammatory reactions in skin
Keratitis (punctuate, sclerosing)
Iridocyclitis
Chorioretinitis
Optic atrophy

84
Q

African eye worm (loa loa)

Transmission, area, clinical

A

Chrysops (deer) flies
Africa
1 year after bite: calabar swellings (worms migrate to conj, eyelid edema, worm visible, sight retained

85
Q

Fusarium keratitis

Transmission, clinical, dx

A

Ocular trauma, use of Bausch and Lomb Renu with Moisture Loc
Corneal infection/damage
Dx: positive fusarium culture from cornea

Clinical Neuro Microbio (1 decks)

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