CNS II

Question 1

signs and symptoms of bacterial meningitis (5)

Answer 1

• headache
• photaphobia
• fever
• meningismus (stiff neck)
• obtundation (reduced level of alertness)

Question 2

How is bacterial meningitis diagnosed?

Answer 2

• suspicious clinical signs and symptoms
• lumbar puncture
• cultures of CSF and blood

Question 3

What does a lumbar puncture test for to diagnosis bacterial meningitis?

Answer 3

• neutrophils (pus)
• elevated protein
• reduced glucose
• increased pressure

Question 4

Bacterial meningitis: microorganism that affects dorsal vs basal surface

Answer 4

Dorsal = Streptococcus 
Basal = M. tuberculosis

Question 5

CNS infections seen commonly in immunocompromised patients

Answer 5

fungal infections

Question 6

method of action of fungal infections of the CNS and what it causes

Answer 6

microorganisms often invade/clog small vessels and result in hemorrhagic infarcts

Question 7

fungal infection characteristically seen in patients with uncontrolled diabetes

Answer 7

Mucormycosis

Question 8

most common CNS fungal infection

Answer 8

Cryptococcosis

Question 9

structure seen in cells that indicate a viral infection (give examples)

Answer 9

inclusion bodies

• Cowdry bodies for HSV1
• Negri bodies for rabies

Question 10

infections by these organisms can cause a rapidly fatal necrotizing encephalitis

Answer 10

Naegleria fowleri (amoeba)

Question 11

method of action of Naegleria fowleri

Answer 11

• Free living in soil and fresh warm water
• Inhaled into olfactory epithelium and migrate up olfactory nerve
• Spread via subarachnoid space

Question 12

most common cause of brain hemorrhage

Answer 12

hypertension

Question 13

Tumors of astrocytes in increasing malignancy (grade II-IV):

Answer 13

II –> astrocytoma
III –> anaplastic glioma
IV –> glioblastoma

Question 14

Name the astrocyte tumor: location is cerebral hemispheres

Answer 14

astrocytoma and anaplastic glioma

Question 15

Name the astrocyte tumor: 60% p53 mutation

Answer 15

astrocytoma

Question 16

Name the astrocyte tumor: >90% p53 mutation

Answer 16

anaplastic glioma

Question 17

Name the astrocyte tumor: histology = well differentiated fibrillary or gemistocytic astrocytes

Answer 17

astrocytoma

Question 18

Name the astrocyte tumor: histology = increased cellularity (nucelar atypia, mitotic activity)

Answer 18

anaplastic glioma

Question 19

Name the astrocyte tumor: most common

Answer 19

glioblastoma

Question 20

Name the astrocyte tumor: separates itself by the presence of necrosis

Answer 20

glioblastoma

Question 21

peak incidence of glioblastoma

Answer 21

45-70 yo (mean = 53 yo)

Question 22

location = posterior fossa, 75% vermis

Answer 22

medulloblastoma

Question 23

histology = classily presents as densely packed cells (round/oval to “carrot-shaped” nuceli)

Answer 23

medulloblastoma

Question 24

pediatric brain tumor

Answer 24

medulloblastoma

Question 25

malignant, but responds well to chemo and radiation

Answer 25

medulloblastoma

Question 26

benign neoplasms that affect peripheral nerves of the head and neck

Answer 26

schwannoma

Question 27

Where do schwannomas occur in the skull?

Answer 27

8th cranial nerve (vestibulocochlear nerve)

Question 28

histology = spindle-shaped interdigitating cells

Answer 28

schwannoma