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SP16- Gen Path Exam 3 > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

True or False: Benign tumors can be as destructive as malignant tumors.

A

True, if it’s in a bad place…like the brain

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2
Q

What are the four routes of entry for CNS infections?

A
  1. Hematogenous
  2. Direct Implantation (blunt force trauma)
  3. Peripheral Nerves (rabies)
  4. Local extension of infections (dental, ear, sinus)
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3
Q

Which route of CNS infectious spread is most common?

A

hematogenous dissemination

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4
Q

What are three common brain infections?

A
  • acute bacterial meningitis
  • cerebral abscess
  • encephalitis
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5
Q

Acute bacterial meningitis is an infection that results in inflammation of the _______ and _______.

A

leptomeninges (arachnoid & pia mater) and subarachnoid space

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6
Q

What causes Acute purulent meningitis?

A

pyogenic bacteria

“PP: purulent = pyogenic”

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7
Q

What causes Leptomeningitis?

A
  • viruses
  • pyogenic bacteria
  • mycobacteria and fungi
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8
Q

What are the risk factors for acute bacterial meningitis?

A

age extremes
debilitated state
poor hygiene
crowded living conditions

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9
Q

What are the common symptoms presented by acute bacterial meningitis?

A

fever
headache
stiff neck
photophobia (sensitive to light)

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10
Q

True or False: Acute bacterial meningitis causes a thick layer of purulent exudate to coat the cerebral hemispheres within the ventricles.

A

True

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11
Q

True or False: It is difficult for antibiotics to reach the bacteria within the meninges.

A

True

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12
Q

Brain abscesses (focal suppurative infections) are usually caused by ______.

A

bacteria (strep, staph, S.milleri)

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13
Q

Brain abscesses will spread either ______ or ______.

A 
hematogenously
contiguously (adjacent areas =50% i.e. dental root or ear infection)
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14
Q

True or False: Abscesses usually occur in clusters.

A

False, usually its solitary

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15
Q

What are the clinical symptoms of brain abscess?

A

fever

focal neurologic deficits

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16
Q

________ is the result of a disseminated mycobacterial disease.

A

Tuberculous meningitis (chronic)

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17
Q

______ weeks of headache, lethargy, nausea and vomiting would indicate a possible Tuberculous meningitis infection.

A

more than 2-3 weeks

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18
Q

What type of stain would reveal mycobacterium?

A

acid fast

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19
Q

Cryptococcal meningitis is caused by ______ found in _____.

A

spherical budding yeast
soil

(“crypt = the dead are buried in the dirt and soil”)

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20
Q

What is encephalitis?

A

diffuse inflammation of brain parenchyma

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21
Q

What is the most common cause of encephalitis?

A

herpesvirus

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22
Q

True or False: Herpesvirus shows Cowdry type A inclusions on staining.

A

True

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23
Q

What are three common microscopic features of encephalitis?

A
  1. perivascular lymphocytosis
  2. microglial nodules (hive of activity)
  3. neuronophagia (attack on neuron)
24
Q

Myelin is derived from _________.

A

oligodendroglial cytoplasmic processes

25
What is the purpose of myelin?
INSULATION | CONDUCTION
26
What is the most common primary demyelinating disorder? What age group is this most common?
multiple sclerosis | young
27
True or False: MS is likely autoimmune in origin.
True (T-cell mediated) *possible genetic component contains HLA gene*
28
Neurodegenerative disease can be ______ or _____.
sporadic | familial
29
What are the three common neurodegenerative diseases? Where does the degeneration occur (in general)?
Alzheimer's, Parkinson's, Huntington's brain and spinal cord
30
What is the most common cause of dementia?
Alzheimer's
31
What is the gross-effect of Alzheimer's disease?
atrophy of the brain (decrease in mass and size) - from the inside = ventricular dilation - from the outside = atrophy
32
What are two microscopic signs of Alzheimer's Disease that help to distinguish it from general dementia?
1. Neuritic Plaques (aggregation of processes with amyloid) | 2. Neurofibrillary Tangles (filamentous aggregates within neuron cytoplasm)
33
Is there a cure for Alzheimer's disease?
No, cholinesterase inhibitors are used for management of symptoms
34
Parkinson's Disease causes degeneration of _______-secreting pigmented neurons of the ________ in the midbrain
dopamine | substantia nigra
35
True or False: Parkinson's typically presents in the 4th decade.
False, the 6th decade (50s)
36
What are the microscopic indications of Parkinson's disease?
eosinophilic inclusions known as LEWY BODIES within the pigmented neurons of the substantia nigra
37
True or False: Huntington's Disease is a commonly occurring disease of the elderly.
FALSE, very rare...period...and patients don't typically live past age 20
38
_______ is the spontaneous, involuntary, dance-like movement associated with Huntington's Disease.
Chorea
39
The Huntingtin Gene is located on chromosome _____ and is transmitted via _____ ______ inheritance.
4 | autosomal dominant
40
Where does atrophy occur in Huntington's Disease?
severe neuronal loss occurs in the basal ganglia (caudate + putamen + globus pallidus)
41
Most brain tumors present with clinical manifestations such as headache/seizure according to their _______ rather than their ________.
site of origin pathologic type (location>>>>type)
42
What is the difference between primary and secondary brain tumors?
Primary: arise from cells of the brain, spinal cord, or their coverings (sheaths, matas, etc) Secondary: arise from metastasis from another site (lung, breast, prostate, etc.)
43
True or False: Brain tumors rapidly metastasize outside the CNS.
FALSE FALSE FALSE!!!!
44
In brain tumors, histologic ______ corresponds to tumor aggressiveness.
GRADE | usually tumors are based on stage, but the brain is different
45
Most ADULT Brain tumors could alternatively be called _______. What are the three types? What is the fourth type of adult brain tumor that does not fall into this label?
Gliomas (tumors of glial cells) 1. Astrocytoma (cerebral hemisphere) 2. Oligodendroglioma (cerebral hemisphere) 3. Ependymoma (ventricular wall) 4. Meningioma (arachnoid matter)
46
Which type of adult brain tumor is most common? Where do they typically occur?
astrocytoma | cerebral hemisphere
47
High grade tumors are more _______.
anaplastic
48
Which adult brain tumor appears histologically like a fried egg?
Oligodendroglioma "DEN HEN....hens lay eggs"
49
Ependymoma (least common adult brain tumor) is a well circumscribed lesion that arises from _______ and is most often ______-growing.
the ventricular wall | slow
50
In what formation are ependymoma cells often seen on histologic evaluation?
Perivascular Pseudorosettes
51
What are the two microscopic characteristics that are specific to menangioma?
1. Cellular Whorls | 2. Psammoma Bodies (calcified, lamellar-looking)
52
True or False: The brain is a common site for metastatic lesions.
True
53
What are the two types of pediatric brain tumors?
1. Pilocytic Astrocytoma | 2. Medulloblastoma
54
Of the two pediatric brain tumors, which tends to be low-grade and which is typically high-grade?
Low: Pilocytic Astrocytoma (pi-LOW-cytic) High: Medulloblastoma
55
Pilocytic Astrocytoma will often be low grade tumors with thin, hair-like processes known as ________. Medulloblastoma will usually be high grade tumors with __________.
Pilocytic Astro. = Rosenthal Fibers Medulloblastoma = Homer-Wright Rosettes
56
Brain tumors are typically ________, eliminated with ______ treatment, or chemotherapy.
``` surgically excised (common) radiation (proton beam radiation) ```
57
Which type of tumors react best to chemotherapy?
UNdifferentiated (the ones that are random and out of control; rather than those that are encapsulated/organized and plotting to take over the whole brain)

SP16- Gen Path Exam 3 (12 decks)

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