CNS Infections, HIV/AIDS, CNS Tumors, Psychiatric Sxs of Tumors & Infections, Surfboard Repair, etc.-Rothrock

Question 1

What are the major Primary CNS tumors?

Answer 1

• astrocytomas
• oligodendrogliomas
• ependymomas
• meningiomas (sort of)
• others (pituitary adenomas, chordomas, craniopharyngiomas, pinealomas)

Question 2

What is the most common way to get metastatic brain tumors?

Answer 2

Lung (50%)
Breast (15%)
Melanoma (10%)
GI, gynecologic, urologic (10%)

Question 3

Are mets to the brain typically unifocal or multifocial?

Answer 3

multifocal (75%)

Question 4

Lung, melanoma, and tumors of unidentified origin are typically (blank) metastases

Answer 4

multiple

Question 5

What lobes of the brain are most commonly involved with metastases?

Answer 5

frontal and parietal

Question 6

What are the cranial nerve tumors?

Answer 6

• acoustic “neuroma” (schwannoma)

- optic nerve glioma

Question 7

What are the spinal nerve tumors?

Answer 7

• extradural (metastatic)
• intradural/extramedullary (meningioma)
• intramedullary (astrocytoma, ependymoma)

Question 8

What is the hallmark of extradural mets?

Answer 8

PAIN!!

Question 9

What are the 2 types of intramedullary tumors?

Answer 9

astrocytoma and ependymoma

Question 10

What is the intradural/extramedullary tumor?

Answer 10

meningioma

Question 11

What is the meningeal tumor?

Answer 11

carcinomatous meningitis

Question 12

What are the five types of CNS infections?

Answer 12

• meningitis
• encephalitis
• meningoencephalitis
• abscess> brain versus spinal canal
• HIV

Question 13

What are the subtypes of infectious meningitis?

What microorganism causes each of these?

Answer 13

acute> bacterial, viral
subacute> tuberculous
chronic> fungal (cryptococcus, coccidiomycosis)

Question 14

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?

Answer 14

bacteria

Question 15

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?

Answer 15

Viral

Question 16

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?

Answer 16

tuberculous

Question 17

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

Answer 17

fungal

Question 18

Encephalitis it typically caused by (blank)

Answer 18

viruses

Question 19

If you have a sporadic episode of encephalitis what caused it?

Answer 19

HSV1

Question 20

If you see an epidemic of encephalitis, what caused it?

Answer 20

AN INSECT!!!!! (ARBOVIRUS)

Question 21

What does the patients CSF look like in encephalitis?

Answer 21

glucose: low normal or normal
Protein: modestly elevated
WBCs (lymphs) 10-100S

Question 22

What causes brain abscesses?

What about in AIDS patients?

Answer 22

mixed bacterial flora

-Protozoan toxoplasma gondii

Question 23

How do you treat brain abscesses?

Answer 23

antibiotics or surgery

Question 24

What causes spinal abscesses?

Answer 24

staph aureus

Question 25

If you are giving an epidural and it is SUPER painful, what is the cause?

Answer 25

spinal abscess

Question 26

A spinal abscess is a (blank) emergency

Answer 26

neurosurgical

Question 27

What is the pathogenesis of toxoplasmosis?

Answer 27

- oocyts become tachyzoites after ingestion - tachyzoites go to neural tisse and muscle tissue and become bradyzoites - can infect fetuses

Question 28

What does HIV/AIDs do to your brain?

Answer 28

HIV-associated dementia/encephalopathy | HIV myelopathy

Question 29

What are the opportunistic infections associated with HIV/AIDs that can mess with your nervous system?

Answer 29

- syphilitic meningitis - cryptococcal meningitis - toxo abscess - CMV myelitis - progressive multifocal encephalopathy (PML)> JC virus

Question 30

A 34 year old guy comes in, he had hallucinations, and smells stuff, and has seizures.. .whats up?

Answer 30

his temporal lobe is screwy cuz of a glioblastoma

Question 31

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?

Answer 31

bifrontal dumbell meningioma

Question 32

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?

Answer 32

HSV | acyclovir