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ABCN Exam August 2021 > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

studies have found an increased risk for AD in individuals with a history of ___.

A

HSV.

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2
Q

___ can be associated with tumors such as, ___ or ___, but not always.

A

anti-NMDARE, ovarian teratoma, carcinoma

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3
Q

___ is caused by the John Cunningham virus and typically affects individuals who are immunocompromised.

A

PML

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4
Q

___ and ___ most commonly affect females.

A

NMDARE, AMPAR

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5
Q

PNDS are rare and most often occur in ___. anti-NMDARE occurs in ages __ to __.

A

older adults. 23 months to 76 years.

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6
Q

Cardinal acute symptoms of bac men include (3)

A

sudden fever, severe headache, stiff neck

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7
Q

hemispherectomy may be used to treat ____ to slow down neurological deterioration in pediatric cases.

A

Rasmussen’s encephalitis

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8
Q

initial behavioral presentation of aseptic encephalitis

A

initially behavior or psychotic disorder symptoms

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9
Q

Cranial nerve __ is most often impacted in bacterial meningitis, which can result in __.

A

8, sensorineural hearing loss.

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10
Q

Deficits in children who contract HIV perinatally include

A

language, conductive hearing deficits (20%), WM, PSI, EF, visual memory, visuospatial reasoning,mental health problems (depression, conduct)

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11
Q

involves an inflammatory process related to cancers and localized to structures of the limbic system. )___ is most common.

A

paraneoplastic limbic encephalitis. small-cell lung.

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12
Q

Children with NMDARE more commonly present with __, __, ___, and ___. Changes in __, ___, __, and ___ are also more often seen in children.

A

agitation, aggression, hyperactivity, temper tantrums. speech, personality, sleep, movement.

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13
Q

Acute phase complications of bacterial meningitis in children can include (4)

A

prolonged seizures, hemiparesis, coma, bilateral hearing loss

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14
Q

Creutzfeld Jacob disease is __ progressive and ___ (__ to __ months for classic CJD).

A

rapidly progressive, fatal, 4-5

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15
Q

Children with __ encephalitis have long-term neurological impairment, particularly following delayed start of acyclovir.

A

HSV

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16
Q

the most common cause of brain abscess in HIV patients

A

toxoplasmosis

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17
Q

medical treatment for bac men (3)

A

antibiotics, vaccine, corticosteroids (for inflammation)

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18
Q

gradual symptoms of bac men

A

nonspecific “flu-like” symptoms

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19
Q

Individuals with ___ encephalitis have 2-4 times the risk of cog impairment compared to other aseptic encephalitis.

A

HSV

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20
Q

___ remains dominant in the trigeminal ganglia. if activated, it is believed to travel along the nerve into the brain.

A

herpes simplex virus

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21
Q

In ___, recovery is generally slow and can take up to __ months. __ to ___% of patients relapse.

A

anti-NMDARE, 18. 20-25

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22
Q

4 classic stages of anti-NMDARE:

A

prodromal, psychotic, unresponsive, hyperkinetic

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23
Q

symptoms of ___ include rapidly progressive dementia, memory issues, personality changes, hallucinations, speech impairment, ataxia.

A

CJD

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24
Q

__% of childhood survivors of bacterial meningitis have at least 1 negative sequelae more than 5 years after diagnosis. ___ difficulties are the most common.

A

50, cognitive/behavioral

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25
Q

in ADEM, subtle deficits in (3) have been noted

A

attention, info processing, EF

26
Q

The symptoms of ___ appear rapidly, beginning with encephalitis-like symptoms such as fever, fatigue, headache, nausea and vomiting, and in the most severe cases, seizures and coma

A

ADEM

27
Q

Diagnosis of bacterial meningitis is confirmed by

A

presence of bacteria in CSF (lumbar puncture)

28
Q

most viruses reach the CNS through

A

the bloodstream

29
Q

Presenting symptoms of aseptic meningitis (8)

A

48 hours of flu-like symptoms followed by severe headache, fever, irritability, nausea, vomiting, stiff neck, rash, fatigue.

30
Q

___ are by far the most common cause of aseptic meningitis.

A

enteroviruses

31
Q

Eastern equine encephalitis involves lesions in the

A

thalamus, basal ganglia, and midbrain

32
Q

In developed countries, the most common long-term sequelae of bacterial meningitis includes (4)

A

hearing loss, ID, spasticity/paresis, seizure disordesr

33
Q

impairment in motor functioning, verbal learning and memory, and aspects of EF have been associated with this viral meningitis.

A

West Nile

34
Q

HSV encephalitis involves

A

temporal lobes and orbitofrontal lobes

35
Q

HIV-1 AIDS dementia complex/HIV associated dementia includes disruption of ___ loops, resulting in deficits in __.

A

fronto-striatal-thalamo-cortical, attention, WM, EF, learning, memory, psychomotor speed.

36
Q

HIV-1 associated minor cognitive/motor disorder is associated with __ to __ SD impairment in at least __ cognitive domains.

A

0.5-1, 2.

37
Q

__ has the highest incidence in early childhood. on MRI, white matter hyperintensities are seen in both hemispheres, subcortical regions, the cerebellum, and the spinal cord.

A

ADEM

38
Q

HIV-associated neurocognitive disorder (HAND) is common (__% of infected individuals) and includes deficits in (5).

A

50, attention, EF, fluency, memory, psychomotor speed.

39
Q

1st and 2nd most common causes of bacterial meningitis:

A

pneumococcal, meningococcal

40
Q

MRI findings of HIV include small areas of bilateral ____ hyperintensity, volume loss and metabolic changes in the ___, large hyperintensities with discrete and generalized lesions, global and diffuse __, isolated focal lesions.

A

subcortical, basal ganglia, atrophy

41
Q

___ infection leads to macrophages and microglia to cause gradual destruction of neuronal integrity.

A

HIV

42
Q

The 2nd most most common autoimmune encephalitis __.

A

Anti-NMDA receptor encephalitis.

43
Q

Brain tissue develops holes that give it a sponge-like appearance. type of prion disease.

A

Creutzfeld-Jacob

44
Q

bilateral lesions to the temporal lobe resulting in sexualized behaviors, hyperorality, visual agnosia, memory loss

A

Kluver-Bucy

45
Q

Intrauterine and intranatal infections (TORCH)

A

Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, HSV-2

46
Q

In limbic encephalitis, __ and ___ often improve rapidly after treatment but persistent deficits are seen in __ and ___.

A

seizures, behavioral issues. memory, new learning.

47
Q

focal or generalized slowing and occasional epileptiform activity is seen in ___.

A

anti-NMDARE.

48
Q

subacute signs of aseptic encephalitis

A

seizures, speech disturbance

49
Q

characterized by a brief but widespread attack of inflammation in the brain and spinal cord that damages myelin.

A

Acute Disseminated Encephalomyelitis (ADEM)

50
Q

With viral meningitis, most people recover with in __ to ___ days and have _____ neurologic defects.

A

7, 10, no residual

51
Q

Encephalitis with a cancer association is called ___.

A

paraneoplastic neurologic disorder (PND)

52
Q

___ is a rare and usually fatal virus disease that results in progressive and multifocal damage of the white matter.

A

progressive multifocal leukoencephalopathy (PML)

53
Q

ADEM typically damages white matter, leading to neurological symptoms such as (3)

A

visual loss (due to inflammation of the optic nerve) in one or both eyes, weakness even to the point of paralysis, and difficulty coordinating voluntary muscle movements (such as those used in walking).

54
Q

The primary cause of brain damage in bacterial meningitis is __, which leads to __, __, and __. Other complications include __ and increased ___, which can lead to ___.

A

inflammation, tissue and vascular injury, septic thrombosis, smaller infarcts. cerebral edema, ICP, hypoxic ischemic encephalopathy.

55
Q

Highest mortality is for ___ (virtually 100%), and ___ if not treated (50%)

A

rabies virus enc., HSV enc.

56
Q

Underlying disease mechanism seems to be an autoimmune reaction that is initiated in response to the tumor and is mediated by cytotoxic T-cell responses.

A

intracellular antibody disorders

57
Q

A small number of ___ encephalitis cases present with symptoms of Kluver-Bucy syndrome due to bilateral damage to the __.

A

HSV, amygdala

58
Q

___ are the most common cause of encephalitis.

A

viruses.

59
Q

__ results in sleep disturbance, anterograde amnesia, depression, anxiety, agitation, hallucinations. HSV and various autoimmune encephalitides have similar characteristics.

A

Paraneoplastic limbic encephalitis

60
Q

Most common presenting symptoms of bac men in children (10)

A

hyperthermia, lethargy, anorexia or vomiting, respiratory distress, convulsions, irritability, jaundice, bulging fontanelle, diarrhea, nuchal rigidity

61
Q

Medical conditions with immunosuppression that increase risk for bacterial meningitis include (5)

A

HIV, cystic fibrosis, DM, hypoparathyroidism, renal/adrenal insufficiency.

ABCN Exam August 2021 (19 decks)

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