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MD4001 Pathology > CNS infections > Flashcards

CNS infections Flashcards

1
Q

what are the symptoms of meningitis

A

headache, sore throat, drowsiness, fever, photophobia, neck stiffness, petechial or pupuric rash, vomiting, shivering

babies: tense/bulging soft spot on head, not feeding, irritable, stiff body with jerky movements, floppy and lifeless

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2
Q

what are the clinical features of meningitis

A

intravascular coagulation, endotoxaemia, shock, organ failure, raised intracranial pressure

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3
Q

what are the endothelial cells supported by in the BBB

A

thin basement membrane

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4
Q

what cells make up the BBB

A

tightly packed endothelial cells lining the blood vessels

breach by infective agent causes encephalitis

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5
Q

what is the blood- CSF barrier

A

barrier at arachnoid membrane and in ventricles

breach causes meningitis

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6
Q

what are the most common bacterial causes of meningitis

A
  • Neisseriameningitidis
  • Haemophilusinfluenzae
  • Streptococcus pneumoniae
  • Mycobacterium tuberculosis
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7
Q

what are the most common viral causes of meningitis

A 
Enteroviruses:
•Echovirus
•Coxsackie virusesA & B
•poliovirus
Herpes viruses:
•Herpes simplex 1 & 2
Paramyxovirus:
•Complication of mumps
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8
Q

what is a common fungal cause of meningitis

A

cryptococcus neoformans

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9
Q

what protozoa can cause meningitis

A
  • Amoebae
  • Naegleria
  • Acanthamoeba
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10
Q

what are the features of neisseria meningitidis

A
  • Meningococcal disease
  • Gram negative
  • Intracellular diplococus
  • Only infects humans
  • Exists as normal flora in nasopharynx
  • Distinct pathogenic serogroups
  • Transmission by droplet spread or direct contact from carriers
  • 5 strains –A, B, C, W135, Y
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11
Q

what are the features of haemophilus influenza

A
  • Gram-negative
  • Coccobacilli
  • Six capsular serotypes (a-f) known to cause disease
  • Most virulent strain is H. influenzaetype b (Hib)
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12
Q

what are the features of Streptococcus pneumoniae

A
  • Pneumococcal disease
  • Chains of cocci
  • Gram positive
  • Exists as normal flora in nasopharynx
  • Also causes pneumonia, otitis media
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13
Q

what are the virulence factors of bacterial meningits

A
  • Anti-phagocytic polysaccharide capsule
  • Endotoxin
  • IgA protease
  • Outer membrane proteins (OMPs)
  • Pili(fimbriae)
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14
Q

what is the most at risk age group for meningitis

A

2-5 months

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15
Q

what are complications of bacterial meningits

A
  • Sepsis
  • Intellectual deficit
  • Deafness
  • Arthritis
  • Skin necrosis
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16
Q

what vaccines can prevent bacterial meningitis

A
  • MenC(meningococcal group C)
  • Hib(Haemophilusinfluenzaetype B)
  • BCG (Mycobacterium tuberculosis)
  • Strep. Pneumoniae (pneumonococcal)
  • MenB(meningococcal group B)
  • Men ACWY (quadrivalent)
17
Q

what are the features of viral meningitis

A
  • Milder disease than bacterial but more common
  • NAAT is a valuable diagnostic tool
  • Identify in faeces, urine, CSF, serology
  • No specific treatment
  • Aciclovir(herpes)
  • Use of vaccination (polio)
18
Q

what are the features of tuberculous meningitis

A
  • Frequently associated with miliaryTB
  • Usually develops when Rich focus discharges contents in sub-arachnoid space
  • Acid-fast bacilli in CSF smear
  • NAAT and culture from CSF
  • Treated with rifampicin, isonazid, pyrazinamide, ethambutol
  • Vaccination with BCG
19
Q

what are the features of encephalitis

A

usually viral in origin
•Viruses gain access to CNS via blood or neurons
•Primary encephalitis
–First exposure to virus results in virus directly affecting brain / spinal cord
•Secondary encephalitis
–Virus first infects another part of body, then affects CNS when reactivated

20
Q

what are brain abscesses

A
  • Begin as diffuse inflammation of brain matter progressing to focal lesion
  • Arise from pia mater suppuration
  • Visualised by MRI or CT scans
  • Diagnosed by culture from aspirated pus
21
Q

what are the possible causes of brain abscesses

A

•Predisposing factors
–Otitismedia
–Mastoiditis
–Sinusitis
•Oral-nasopharyngeal flora
–Aerobic (S. aureus, Strep. milleri)
–Anaerobic (Bacteroidessp., Fusobacteriumsp.)
•Immunocompromised(eg. HIV, transplantation)
–Protozoa (Toxoplasmagondii)
–Fungi (Candida sp., Nocardiasp., Aspergillussp.)

22
Q

what are Transmissible Spongiform Encephalopathies(TSEs)

A 
•Prion diseases
•Affects humans...
–Creutzfeldt-Jakob disease (CJD)
–New variant Creutzfeldt-Jakob disease (nvCJD)
•...and animals
–Bovine Spongiform Encephalopathy (BSE)
–Kuru
–Scrapie

MD4001 Pathology (23 decks)

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