CNS Infections III

Question 1

associated with alphavirus

Answer 1

Venezuelan Equine Encephalitis Virus
Eastern Equine Encephalitis Virus
Western Equine Encephalitis Virus

Question 2

associated with flavivirus

Answer 2

St. Louis Encephalitis Virus
West Nile Virus
Japanese Encephalitis Virus

Question 3

associated with bunyaviridae

Answer 3

California Encephalitis Virus

Question 4

associated with reoviridae

Answer 4

Colorado Tick Fever Virus

Question 5

what is abnormal on MRI of West Nile and Eastern Equine Virus

Answer 5

thalamus, basal ganglia, brain stem

Question 6

what is abnormal on MRI of St. Louis Encephalitis Virus

Answer 6

substantia nigra (or could be normal)

Question 7

vector, reservoir, and dead end host of west nile virus

Answer 7

vector - mosquito
reservoir - bird
dead end host - horses and humans

Question 8

vector, reservoir, and dead end host of eastern equine encephalitis virus

Answer 8

vector - mosquito
reservoir - bird
dead end host - human

Question 9

what has a bridge vector and what is the bridge vector

Answer 9

eastern equine encephalitis virus

mosquito is the bridge vector

Question 10

west nile virus is most common where

Answer 10

US

Question 11

what is atypical in CSF in comparison to other viruses in eastern equine encephalitis virus

Answer 11

in CSF of EEEV, the inflammatory cells are 2/3 neutrophils as opposed to lymphocytes in other viruses

it does have normal glucose, increased proteins, and RBCs though

Question 12

complications and symptoms of Colorado Tick Fever virus

Answer 12

complication - encephalitis or meningitis

symptoms present like meningitis - photophobia, nuchal rigidity, mild altered mental state

Question 13

which one of the encephalitis uses ELISA with the IgM antibodies as their

Answer 13

west nile virus, eastern equine, california encephalitis, japanese encephalitis, and colorado tick fever

CC JEW

Question 14

which one of the virus presents with poliomyelitis like (acute flaccid paralysis)

Answer 14

west nile virus

Question 15

which one of the viruses presents with acute anterior poliomyelitis

Answer 15

non polio enterovirus

Question 16

viruses seen in non polio enterovirus

Answer 16

enterovirus 71, enterovirus D68, enterovirus 18, coxsackieviruses

Question 17

what population does one see non polio enterovirus more commonly

Answer 17

neonates and it is sepsis like with 10% mortality rate

Question 18

common in western US and Canada (mountains)

Answer 18

colorado tick fever virus

Question 19

common in Lacrosse, Jamestown Canyon, and Tahyna virus

Answer 19

california encephalitis

Question 20

presents with febrile prodome –> encephalitis

Answer 20

western equine encephalitis

Question 21

0-2 weeks incubation but could start presenting at 3 days

Answer 21

colorado tick fever virus

Question 22

has neurologic symptoms hemiparesis, aphasia, chorea, dysarthria

Answer 22

california and japanese encephalitis

Question 23

virus associated with rabies

Answer 23

rhabdovirus

Question 24

how does one get rabies

Answer 24

from an animal bite - dog, bat, skunks, raccoons (common in US), foxes

Question 25

how do you diagnose rabies

Answer 25

-- skin biopsy - Immunohistochemical staining - Rabies Ag – Negri bodies: Intracytoplamsic inclusions in neurons – Corneal smears – Rabies Ag – Rabies virus neutralizing Ab – CSF or serum (unimmunized) Direct Ab Test

Question 26

how do you treat rabies for non immunized people

Answer 26

- wash the wound with soap and water + providone iodine - give 1 dose of HRIG at site of wound - then 4 doses of vaccine in different location maybe on opposite limb (Day 0, 3, 7, 14)

Question 27

how do you treat rabies for immunized people

Answer 27

- wash the wound with soap and water + providone iodine | - give two boosters of vaccine on Day 0 and 3

Question 28

What does one get from infection with measles

Answer 28

SSPE: sub acute sclerosing panencephalitis - it mutates and stays dormant then presents a month to years later - so it is a slow progression of symptoms

Question 29

how long can it takes to see symptoms of measles

Answer 29

could take 5-15 years post initial infection | but the post initial infection can range from 1 month - 27 years

Question 30

what is transmission and spread of polio virus

Answer 30

fecal oral route | pharyngeal spread

Question 31

what decreases the incidence of measles

Answer 31

immunization

Question 32

what part of the brain does polio affect

Answer 32

anterior horn cells (grey matter)

Question 33

how many strains and vaccines of polio are available

Answer 33

strain (3) - 1, 2, 3 | and 4 vaccines available

Question 34

what are the vaccines for polio

Answer 34

live oral polio vaccine (OPV) sabin - Monovalent (mOPV1 & mOPV3), Bivalent (bOPV) inactivated polio vaccine (IPV) - salk

Question 35

where has polio not been eradicated

Answer 35

Afghanistan, Pakistan, & Nigeria | Somalia, Ethiopia, Kenya, South Sudan & Cameroon

Question 36

risk factors for shunt infections

Answer 36

``` – Premature birth – Previous shunt infection – Cause of hydrocephalus – Length of the shunt procedure – Shunt revision ```

Question 37

bacterial etiology of CSF shunt infections

Answer 37

– Staphylococci (epidermidis & aureus) – Gram negative bacteria (E. coli, Klebsiella, Proteus & Pseudomonas) – Streptococci – Diphtheroids (Propionibacterium acnes) – Anaerobes – Mixed culture

Question 38

where does measles start and how does it spread

Answer 38

it starts at the head/neck and spreads downwards

Question 39

symptoms of measles

Answer 39

coryza, conjuctivis, cough