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Neuro II Exam 1 > CNS Infections - Fremont-Smith > Flashcards

CNS Infections - Fremont-Smith Flashcards

1
Q

subdural abscess

A

aka subdural empyema

spread - air sinuses/middle ear

no antibiotics can get here
large - can compress

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2
Q

meningitis

A

infection of arachnoid membrane, subarachnoid space, or CSF

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3
Q

aseptic CSF

A

viral
-monocytes

may see increased pressure and protein

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4
Q

bacterial CSF

A

polys

  • low glucose
  • very high pressure and protein
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5
Q

lymphocytes in CSF

A

viral

aka septic meningitis

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6
Q

fever, lethargy, HA, neck stiffness, altered mental status

A

acute bacterial meningitis

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7
Q

purulent

A

bacterial

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8
Q

most common infection of CNS

A

acute purulent leptomeningitis

  • bacterial
  • aka just meningitis

mortality - due to cerebral edema and herniation

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9
Q

pus

A

bacterial meningitis

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10
Q

herpes

A

shift from leukocytes to lymphocytes

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11
Q

whatever in CSF

A

brought to brain parenchyma

-via virchow robbin space

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12
Q

most common aseptic meningitis

A

enterovirus E71

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13
Q

bacterial meningitis birth to two months

A

E. coli
group B strep
listeria

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14
Q

bacterial meningitis two months to five years

A

strep pneumo

meningococcus

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15
Q

bacterial meningitis in older child/adult

A 
strep pneumo
neisseria meningitidis (epidemics)
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16
Q

bacterial meningitis in elderly

A

strep pneumo
group B strep
e. coli
listeria

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17
Q

bacterial meningitis in epidemics

A

neisseria meningitidis - meningococcus

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18
Q

aseptic meningitis

A

may be due to drug rxn

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19
Q

vessel inflammation and thrombosis

A

occurs with bacterial meningitis

-also see pus

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20
Q

encephalitis

A

inflammation of brain parenchyma

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21
Q

common cause of viral encephalitis

A

CMV - young fetus
herpes
HIV

also rabies, PML, and SSPE

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22
Q

herpes encephalitis

A

remains latent in the trigeminal nerve

w/out tx - fatal**

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23
Q

necrosis of base of frontal and temporal lobes

A

herpes encephalitis

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24
Q

fatal if not treated

A

herpes encephalitis

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25
Q

necrosis of base of frontal and temporal lobes and intranuclear inclusions

A

herpes encephalitis

giant cells - multinucleated

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26
Q

neonatal HSV encephalitis

A

diffuse melt down of brain

-without predilection for frontal and temporal lobes (different than adult)

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27
Q

fetal CMV encephalitis

A

microcephaly, abnormal gyri, hydrocephalus, periventricular calcifications

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28
Q

periventricualr calcifications

A

seen with CMV encephalitis

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29
Q

rabies

A

rhabdovirus

from animal bite - travels axons

variable incubation

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30
Q

clinical rabies

A

HA, fever and malaise, swallowing difficulty
-furious and dumb forms

to stupor, coma, death

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31
Q

negri bodies

A

rhabdovirus

accumulation of protein made by the virus

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32
Q

preference of rabies

A

to hippocampus and cerebellum

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33
Q

PML

A

progressive multifocal leukoencephalopathy
-polyomavirus

brain - JC type
kidney and bladder - BK type

34
Q

path of PML

A

polyomavirus infects and destroys oligodendrocytes

destroys white matter

see intranuclear viral particles

35
Q

PML

A

often asymptomatic in humans

-reactavation - with immunodeficiency

36
Q

focal neuro deficits that progress over months

A

PML

37
Q

prognosis of PML

A

almost invariably fatal

tx of underlying immunosuppression - can cause remission

38
Q

intranuclear viral particles

A

in PML

39
Q

polyomavirus JC

A

infect oligodendrocyte - loss of myelin

40
Q

SSPE

A

subacute sclerosing panencephalitis

-measles virus

41
Q

measles path

A

infect grey and white matter

  • massive necrosis
  • usually to death
42
Q

bird shit

A

cryptococcosis

43
Q

cryptococcosis

A

heme spread from lung

  • in immunosuppressed
  • life-threatening - in AIDS patient

abscess formation

44
Q

india ink stain

A

for cryptococcosis neoformans

  • large polysaccharide capsule - visualized by india ink stain
  • encapsulated yeast

also PAS stain

45
Q

cyst formation

A

cryptococcosis

organism in the virchow robin space

46
Q

PAS stain

A

detect polysaccharide
-schiff - purple-magenta counter stain

id CT, mucus, glycocalyx, basal lamina
-fungal infection

47
Q

CSF with neutrophils, low glucose, and high protein

A

bacterial meningitis

48
Q

meningeal signs, CN palsy, basal meningitis, granular meningeal surface

A

tuberculosis

form tuberculoma

49
Q

potts disease

A

TB of vertebra

50
Q

acid fast stain

A

mycobacterium

51
Q

caseous granuloma with macrophages

A

tuberculosis

52
Q

cerebral abscess

A

walled off - neovascularization

bacterial, fungal, protozoal

trauma, surgery, or hematologic spread

53
Q

anterior cerebral abscess

A

from sinus - polymicrobial

54
Q

temporal cerebral abscess

A

from mastoiditis - ear infection

55
Q

multifocal cerebral abscess

A

hematologic spread

56
Q

ring lesion

A

neovascularization around cerebral abscess

57
Q

toxoplasmosis

A

cat feces

activate when immunosuppressed

58
Q

thin walled cyst

A

toxoplasmosis

59
Q

immunohistochemistry

A

to ID toxoplasmosis

60
Q

aspergillosis

A

spore - lung entry

  • hematogenous dissemination
  • 45 degree branching
61
Q

45 degree branching hyphae with septa

A

aspergillosis

62
Q

neurocysticercosis

A

commonest parasite infection of CNS

leading cause of epilepsy worldwide

63
Q

pork meat

A

neurocysticercosis

64
Q

focal or generalized seizures, papilledema, HA, vomiting and ataxia, vertigo, focal motor and sensory deficits, dementia, hydrocephalus, sudden death

A

neurocysticercosis

65
Q

numerous cysts that calcify in brain

A

neurocysticercosis

66
Q

toxoplasmosis in AIDS

A

CD4 <100

67
Q

cryptococcus in AIDS

A

CD4 <50

68
Q

primary lymphoma in AIDS

A

CD4 <100

69
Q

PML in AIDS

A

CD4 <200

JC polyomavirus

70
Q

HIV dementia

A

CD4 <200

71
Q

prion

A

protein infectious agent

72
Q

creutzfeldt-jacob disease

A

subacute progressive dementia

-tx - none

73
Q

PrP-SC

A

abnormal folded protein (beta-pleated)

induces PrP-C (alpha-pleated) to become abnormal

74
Q

kuru

A

caniballistic prion disese

-new guinea - brain eating

75
Q

14-3-3

A

creutzfeldt jacob disease

76
Q

spongiform degeneration

A

in CJD

vacuoles in parenchyma

axonal and neuronl death

77
Q

brain fixed in formalin

A

does not destroy prion protein

78
Q

definitive diagnosis of CJD

A

western blot

79
Q

ovary/testicle teratoma

A

can lead to autoimmune encephalitis

auto-Ab against neural tissue develops

80
Q

familial CJD

A

conversion happens at higher rate

Neuro II Exam 1 (14 decks)

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