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Neuro II > CNS infections > Flashcards

CNS infections Flashcards

1
Q

subdural abscess

A

infection may spread to subdural space from air sinuses or middle ear
traversed by brr aa, but these will not deliver abx
must be drained
IV abx

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2
Q

normal CSF pressure

A

<200mm

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3
Q

normal CSF protein

A

14-45mg

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4
Q

normal CSF glucose

A

50% of serum

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5
Q

normal CSF WBCs

A

0-10

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6
Q

CSF pressure with bacterial meningitis

A

high&raquo_space;200

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7
Q

CSF protein with bacterial meningitis

A

high

45-200

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8
Q

CSF glucose with bacterial meningitis

A

very low, maybe 0

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9
Q

CSF WBCs with bacterial meningitis

A

polys in 1000s

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10
Q

CSF pressure w/viral meningitis

A

normal-slightly high

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11
Q

CSF protein w/viral meningitis

A

normal-slightly high

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12
Q

CSF glucose w/viral meningitis

A

normal

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13
Q

CSF WBCs w/viral meningitis

A

monos 10-100s

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14
Q

most common infectious agent of CNS

A

leptomenigitis

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15
Q

common cause of bacterial meningitis in birth-2months

A

E.coli
Grp B strep
listeria

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16
Q

common cause of bacterial meningitis in 2months-5yrs

A

strep pneumoniae
meningococcus
H. influenza (before vaccine)

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17
Q

common cause of bacterial meningitis in older child/adult

A

Strep pneumoniae

N. meningitdis (epidemics)

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18
Q

common cause of bacterial meningitis in elderly

A

S. penumoniae
E. coli
group B strep
listeria

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19
Q

common viruses which cause encephalitis

A

arboviruses
CMV
herpes
HIV

20
Q

rare viral causes of encephalitis

A

rabies
Progressive Multifocal Leukoencephalopathy
Subacutre Sclerosing Panencephalitis

21
Q

herpes encephalitis clinical

A

HA, fever, stiff neck, drowsy, coma, neuro symptoms
fatal w/o rapid Tx
25-50% fatal w/Tx
long term sequel in survivors common

22
Q

neonatal vs adult herpes encephalitis

A

adults show predilection for frontal and temporal lobes, neonatal global

23
Q

rabies

A

variable incubation 10days-year
centripetal axonal transport to CNS
HAs, fever, malaise, dysphagia , stupor, coma, death

24
Q

rabies histo

A

negri bodies

inclusions of proteins made by virus in cytoplasm

25
Q

progressive multifocal leukoencephalopathy (PML)

A
  • caused by polyomavirus (JC and BK)
  • latent in kidneys and B-cells in tonsils of most adults and sometimes the brain
  • reactivation w/in CNS or in peripheral tissues -> white matter damage
  • infects/destroys oligodendrocytes
26
Q

PML clinical

A
  • infection in humans in generally asymptomatic
  • focal neurologic deficits that progress to cognitive impairment
  • fatal
  • Tx immunosuppression can lead to remission
27
Q

subacute sclerosing panencephalitis (SSPE)

A

rare
in kids and adolescents several years after measles which usually occurs before 2 yrs of age
present with school and behavioral issues -> seizures and motor problems -> to coma and death
CSF increased IgG
affects grey and white matter

28
Q

cryptococcosis

A 
hematogenous dissemination from lung
usually immunosupressed pts 
menigitis w/or w/o parenchymal cysts
abscesses
India ink CSF
bird droppings
29
Q

TB

A 
meningeal signs and cranial nn palsies
basal meningitis
granular meningeal surface
granulomas in 10%
vasculitis 
like herpes inflammatory response more common in base of brain
30
Q

bacterial cerebral abscesses

A 
pts with infective endocarditis
wound infection (post-op)
31
Q

cerebral absesses

A

HA, fever, seizures, focal signs
mortality 10-30% w/Tx
50% have sequele

32
Q

aspergillosis

A 
one of more common mycotic infections of nervous system
spores, pulmonary entry 
hematogeneous spread
immunosuppressed
hemorrhagic infarcts and abscesses
very high mortality even w/Tx
33
Q

neurocysticercosis

A

commonest parasitic infection of CNS leading cause of epilepsy worldwide
pork meat
can be asymptomatic
become calcified

34
Q

toxoplasmosis in AIDs

A

CD4 <100
form abscesses
usually subacute variable presentation
Dx with imaging, CSF PCR

35
Q

cryptococcus in AIDs

A

CD4 <50
spreads from lungs
chronic HA, fever, malaise
Dx with CSF- increased ICP, culture, Ag+

36
Q

primary lymphoma in AIDs

A 
CD4<100
DLBCL
chronic decreased mental status
HA, no fever, localizing signs
Dx: imaging, Bx
37
Q

PML in AIDs

A

CD4 demyelination
progession of multifocal symptoms in wks
Dx with CT

38
Q

HIV dementia

A

CD4 <200
infection of neural cells w/direct and immune damage
broad neuropsychiatric and motor deficits
clinical Dx, imaging supportive

39
Q

CJD

A

subacute progressive dementia with EEG changes and CSF finding (increased protein 14-3-3)
very long latent period
no Tx- fatal
can be sporadic, familial, iatrogenic, or variant
Dx- western blot

40
Q

prions

A

porteinaceous infectious agents
no nucleic acid
not inactivated by typical steralization procedures

41
Q

PrPc

A

normal protein

alpha pleated sheet

42
Q

PrPsc

A

abnormal
beta pleated sheet
EXTREMELY protease resistant

43
Q

CJD histo

A

spongioform degeneration with axonal and neuronal death

gliosis

44
Q

Kuru histo

A

PAS stain

plaque formation

45
Q

autoimmune encepalitis

A

anti-NMDA R encephalitis

usually pts have tumor elsewhere that produces neural tissue -> Ab generation -> cross BBB attack self

Neuro II (22 decks)

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