CNS

Question 1

WNV

Answer 1

Family: Flavivirus
Geography: US, MENA, Asia, Europe
ROS: disorientation
MRI: hyperdensity in basal ganglia, caudate, thalami, brainstem and spinal cord

Question 2

St. Louis Encephalitis Virus

Answer 2

Family:Flavivirus
Geography: America
MRI: substantia nigra involvement

Question 3

Western Equine Encephalitis Virus

Answer 3

Family: Togavirus
Geography: W. US, W. Canada, S. America 
Seasonality: summer
ROS: febrile prodrome then encephalitis
MRI: thalamus, basal ganglia, brainstem

Question 4

Venezuelan Equine Encephalitis Virus

Answer 4

Family: Togavirus
Geography: S. US, Central and S. America

Question 5

California Encephalitis Group

Answer 5

Bunyaviridae
Geography: US (Tahnya virus in Russia)
ROS: focal neuro dz

Question 6

Japanese Encephalitis Virus

Answer 6

Family: Flaviviridae
Geography: Asia, China, Australia
ROS: focal neuro dz

Question 7

Colorado Tick Fever Virus

Answer 7

Family: Reoviridae
Geography: Western US and Canada (mountains)
ROS: nuchal rigidity, photophobia, AMS

Question 8

Polio

Answer 8

Family: Picornaviridae
Eradicated in most countries worldwide
Transmission: fecal-oral
Pathogenesis: invades peyers patches, eventually causes infection/death of anterior horn cells (gray matter)
ROS: assymetric ascending paralysis (usually LEs), aseptic meningitis, leads to respiratory insufficiency bc diaphragmatic paralysis

Question 9

Eastern Equine Encephalitis Virus

Answer 9

Family: Togaviridae
Geography: Eastern US and Canada
Seasonality: summer

Question 10

Most common cause of aseptic meningitis?

Answer 10

Non-polio Enteroviruses (enterovirus D68, echovirus 18, coxsackievirus)
Seasonality: summer/fall

Question 11

1 cause of sporadic encephalitis?

Answer 11

HSV-1 (temporal lobes affected)

Question 12

Rabies

Answer 12

Reservoir: bat, raccoon
Pathogenesis: replication in muscle then retrograde axonal transport to CNS
ROS: hydrophobia
Dx: Negri bodies (intracytoplasmic inclusions in nerve)
Tx: HRIG + 4 doses of vaccine, or 2 boosters of vaccine (if immunized already)

Question 13

SSPE

Answer 13

Etiology: prior measles infection (5-15 yrs previous)
ROS: slow onset behavior change, neuro sx’s
Prevention: vaccine
*pt non-infectious when SSPE sx’s begin

Question 14

Primary Amebic Meningioencephalitis (PAM)

Answer 14

Etiology: Naegleria fowleri
Transmission: freshwater (recreational)
Pathogenesis: travels through cribiform plate along olfactory nerve to brain

Question 15

Neurocystercercosis

Answer 15

Etiology: Taenia solium
Transmission: consumption of infected pork

Question 16

Hydatidiform Dz

Answer 16

Etiology: Echinococcus granulosus
Transmission: sheep to dogs to humans

Question 17

Botulism

Answer 17

Etiology: Clostridium botulinum
Transmission: canned foods (spores found in soil), honey has spores
Pathogenesis: botulinum toxin prevents release of ACh at synapse of NMJ
ROS: flaccid paralysis

Question 18

Trachoma

Answer 18

Etiology: Chlamydia trachomatis (A-C)
ROS: conjunctivitis, trachoma, blindness

Question 19

Ophthalmia Neonatorum

Answer 19

Etiology: N. gonorrhoeae
Transmission: parturition
ROS: suppurative conjunctivitis

Question 20

Fungal Endophthalmitis

Answer 20

Etiology: Fusarium incarnatum and Bipolaris hawaiiensis