CNS Infections, HIV/AIDS, CNS Tumors, Psychiatric Sxs of Tumors & Infections, Surfboard Repair, etc.-Rothrock Flashcards
What are the major Primary CNS tumors?
- astrocytomas
- oligodendrogliomas
- ependymomas
- meningiomas (sort of)
- others (pituitary adenomas, chordomas, craniopharyngiomas, pinealomas)
What is the most common way to get metastatic brain tumors?
Lung (50%)
Breast (15%)
Melanoma (10%)
GI, gynecologic, urologic (10%)
Are mets to the brain typically unifocal or multifocial?
multifocal (75%)
Lung, melanoma, and tumors of unidentified origin are typically (blank) metastases
multiple
What lobes of the brain are most commonly involved with metastases?
frontal and parietal
What are the cranial nerve tumors?
- acoustic “neuroma” (schwannoma)
- optic nerve glioma
What are the spinal nerve tumors?
- extradural (metastatic)
- intradural/extramedullary (meningioma)
- intramedullary (astrocytoma, ependymoma)
What is the hallmark of extradural mets?
PAIN!!
What are the 2 types of intramedullary tumors?
astrocytoma and ependymoma
What is the intradural/extramedullary tumor?
meningioma
What is the meningeal tumor?
carcinomatous meningitis
What are the five types of CNS infections?
- meningitis
- encephalitis
- meningoencephalitis
- abscess> brain versus spinal canal
- HIV
What are the subtypes of infectious meningitis?
What microorganism causes each of these?
acute> bacterial, viral
subacute> tuberculous
chronic> fungal (cryptococcus, coccidiomycosis)
If you check a meningitis patient's CSF and this is what you find: glucose low (even zero), protein high (up to a gram or more), WBCs (polys) 100s to 1,000s/cubic mm
What caused their meningitis?
bacteria
If you check a meningitis patient’s CSF and this is what you find:
glucose normal (nl >50 mg/dl), protein ~75-250, WBCs (lymphs) ~50-500
What caused their meningitis?
Viral
If you check a meningitis patient’s CSF and this is what you find:
glucose low(~10-40), protein high (~ 100-300), WBCs (polys/lymphs) ~100-500
What caused their meningitis?
tuberculous
If you check a meningitis patient’s CSF and this is what you find:
glucose low (~20-40), protein high (~50-150), WBCs (lymphs) ~25-100
fungal
Encephalitis it typically caused by (blank)
viruses
If you have a sporadic episode of encephalitis what caused it?
HSV1
If you see an epidemic of encephalitis, what caused it?
AN INSECT!!!!! (ARBOVIRUS)
What does the patients CSF look like in encephalitis?
glucose: low normal or normal
Protein: modestly elevated
WBCs (lymphs) 10-100S
What causes brain abscesses?
What about in AIDS patients?
mixed bacterial flora
-Protozoan toxoplasma gondii
How do you treat brain abscesses?
antibiotics or surgery
What causes spinal abscesses?
staph aureus
If you are giving an epidural and it is SUPER painful, what is the cause?
spinal abscess
A spinal abscess is a (blank) emergency
neurosurgical
What is the pathogenesis of toxoplasmosis?
- oocyts become tachyzoites after ingestion
- tachyzoites go to neural tisse and muscle tissue and become bradyzoites
- can infect fetuses
What does HIV/AIDs do to your brain?
HIV-associated dementia/encephalopathy
HIV myelopathy
What are the opportunistic infections associated with HIV/AIDs that can mess with your nervous system?
- syphilitic meningitis
- cryptococcal meningitis
- toxo abscess
- CMV myelitis
- progressive multifocal encephalopathy (PML)> JC virus
A 34 year old guy comes in, he had hallucinations, and smells stuff, and has seizures.. .whats up?
his temporal lobe is screwy cuz of a glioblastoma
A 82 year old female begins to act impulsively, she is loquacious and animated historian. Her neuro exam is unremarkable, memory normal. What does she have?
bifrontal dumbell meningioma
A 38 year old female psychologist complains of nagging headache. He develops low grade fever. He is experiencing seizures. He is stuporous, arousing to noxious stimuli only. Abnormal right temporal lobe. What does he have?
How do you treat it?
HSV
acyclovir
