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D&T2 Exam 1 > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

Acute bacterial meningitis- Neonatal

A

Group B strep
Listeria monocytogenes
E. coli

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2
Q

Acute bacterial meningitis- children

A

Neisseria meningitidis

H. Influenza B

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3
Q

Acute bacterial meningitis-adolescents

A

Neisseria meningitidis

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4
Q

Acute bacterial meningitis- immunosuppressed

A

Listeria monocytogenes

Gram negative bacilli

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5
Q

Acute bacterial meningitis-all ages

A

Strep pneumonia

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6
Q

Acute viral meningitis

A

Enteroviruses- echovirus, coxsackievirus, nonparalytic pilio

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7
Q

Waterhouse-Friderichsen Syndrome

A

Meningitis-associated septicemia

Hemorrhagic infarction of adrenal glands
Hypotension and shock
Petechiae or purpura from DIC
Adrenocortical insufficiency

Most common with meningococcal and pneumococcal meningitis

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8
Q

Bacterial meningitis CSF

A

Neutrophils (PMNs)
Increase protein
Decrease glucose

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9
Q

Viral meningitis CSF

A

Lymphocytes
Normal to elevated protein
Normal glucose

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10
Q

Cerebral abscess

A

Most common sites- frontal and parietal lobes, cerebellum

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11
Q

Subdural empyrean

A

Collection of pus in subdural space

Due to bacterial or fungal infection of skull bones or air sinuses

Thrombophlebitis of bridging veins- occlusion- infarction

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12
Q

Chronic bacterial meningoencephalitis (TB)

A

Fibrinous exudate in subarachnoid space at base of brain, entrap cranial nerves and arteries, cause hydrocephalus by blocking outlet of 4th ventricle

Obliterative endarteritis of arteries crossing subarachnoid space

Acid fast mycobacterial culture

HA, malaise, confusion, vomiting, low grade fever

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13
Q

Lyme disease

A

Chronic meningoencephalitis neuroborreliosis

Facial nerve palsies, encephalopathy

Microglial nodules, scattered organisms

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14
Q

Viral meningoencephalitis CSF

A

First pmns then lymphocytes
Elevated protein
Normal glucose

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15
Q

Viral meningoencephalitis histology

A

Perivascular lymphocytic cuffing, necrosis with neuronophagia, microglial nodules

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16
Q

Viral meningoencephalitis Herpes simplex

A

Temporal and inferior frontal lobe, orbital gyri

Necrotizing, hemorrhagic encephalitis

Intranuclear cowdry A inclusions

PCR is used to identify virus

17
Q

Viral meningoencephalitis CMV

A

Fetus infected in last trimester

Periventricular necrosis and calcification leads to microcephaly, chorioretinitis

Virus localized in paraventricular subependymal regions of the brain

18
Q

Viral meningoencephalitis poliomyelitis

A

Fecal-oral

Causes a mild gastroenteritis invading CNS in fraction of patients

Selectively infects meninges and anterior horn motor neurons of spinal cord

Acute paralysis: muscle wasting, hyporeflexia

19
Q

Viral meningoencephalitis rabies

A

Virus ascends peripheral nerve to CNS

Incubation: 1-3 months

Severe necrotizing encephalitis: midbrain, medulla, basal ganglia

Negri bodies in pyramidal neurons of hippocampus or purkinje cells without inflammation

20
Q

HIV encephalopathy

A

Virus enters CNS in infected macrophages
Microglial nodules, giant cells

Mental slowing, memory loss, apathy, depression

21
Q

Viral meningoencephalitis PML

A

Reactivation of JC virus in setting of immunosuppression

Infects oligodendrocytes
Widespread focal demyelination of cerebral white matter
Giant atypical astrocytes
Enlarged oligodendrocytes with intranuclear inclusions

High mortality

22
Q

Viral meningoencephalitis SSPE

A

Uncommon since MMR vaccine

Seen in children and adults months to years after measles

Widespread gliosis
Myelin degeneration
Intranuclear inclusions
Variable inflammation
Neurofibrillary tangles

Spasticity if limbs
Seizures
Relentless, death in 1 to 2 years

23
Q

Fungal meningoencephalitis

A

Cryptococcus neoformans
Candida albicans
Mucor sp.

24
Q

Fungal meningoencephalitis patterns of infection

A

Vasculitis
Chronic meningitis
Parenchymal invasion

25
Q

Protozoan CNS infections- toxoplasmosis

A

Toxoplasmosis Gondii intracellular Protozoa
Common cause of neurologic disease in HIV/AIDS puts

Brain abscess- cerebral cortex
Central foci of necrosis with petechiae
Tachyzoites and bradyzoites

26
Q

Toxoplasmosis clinical features

A

Fever
Symptoms of acute cerebral dysfunction
Ring-enhancing mass lesion

27
Q

Congenital toxoplasmosis

A

Risk of transplacental transmission increases with gestational age at maternal infection

Infection causes calcification and ventricular dilation

28
Q

Prion encephalopathies

A

Associated with abnormal form of normal cellular protein PrP

Altered PrP facilitates conversion of normal PrP

Intracellular vacuoles in neurons and glia

29
Q

Creutzfeldt-Jacob disease

A

Most common human prion disease
Peak incidence in seventh decade

Progressive mental deterioration
Myoclonus

30
Q

CJD morphology

A

Neuronal loss
Reactive gliosis
Spongiform change in neurons and glia of cerebral white matter
No inflammatory cells

31
Q

Variant CJD

A

Younger age of onset

Evidence links to bovine spongiform encephalopathy
More psychiatric symptoms than CJD

Amyloid plaques surrounded by spongiform changes

Slower progression

D&T2 Exam 1 (11 decks)

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