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NMSP > CNS Infections part 2 > Flashcards

CNS Infections part 2 Flashcards

1
Q

Aseptic Meningitis

A

Viral

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2
Q

With Aseptic (viral) Meningitis, there is usually no organism recognized. What class of viruses is usually to blame?

A

Enteroviruses

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3
Q

What histological findings will be seen with Aseptic (viral) Meningitis?

A

Perivascular lymphocytic cuffs and microglial nodules

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4
Q

Herpes Simplex Virus - 1 affects children and young adults. What will be seen on the brain and where?

A

Necrosis and hemorrhage

= Inferior and medial temporal lobes

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5
Q

Necrosis and hemorrhage on the inferior and medial temporal lobes may indicate what infection?

A

HSV-1

herpes simplex

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6
Q

What intranuclear inclusions will be seen in neurons and glia with HSV-1?

A

Cowdry type A

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7
Q

Who does Herpes Simplex Virus - 2 affect?

A

Children born via vaginal delivery to infected mothers

= Encephalitis

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8
Q

Herpes Zoster’s latent phase is usually in?

A

Trigeminal Ganglia or sensory neurons

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9
Q

Once Herpes Zoster is reactivated, what occurs and what are the symptoms?

A

Shingles

= Painful vesicles following dermatome

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10
Q

What is Postherpetic Neuralgia Syndrome?

A
  • seen with shingles/herpes zoster)

= Painful sensation following NON-painful stimuli

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11
Q

Describe what occurs if a fetus is infected with Cytomegalovirus in utero?

A
  • Periventricular necrosis
  • Brain destruction
  • Microcephaly and calcification
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12
Q

Describe what occurs if a fetus is infected with Cytomegalovirus in utero?

A
  • Periventricular Necrosis
  • Brain destruction
  • Microcephaly and calcification
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13
Q

What does Poliomyelitis affect and thus what are the symptoms?

A

Anterior horn of motor neurons

= Flaccid paralysis, muscle wasting, etc.

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14
Q

What will atrophy in the anterior horn of the motor neurons with Poliomyelitis?

A

Atrophy of the white columns

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15
Q

What is Post-Polio Syndrome?

A

25-35 years after illness resolved there will be weakness and pain that is progressive

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16
Q

What is the incubation period for Rabies?

A

1-3 months

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17
Q

What is diagnostic of Rabies at the wound site?

A

Local paresthesias around the initial wound

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18
Q

What shape is the Rabies virus and what inclusions will be seen?

A

Bullet shaped

Negri bodies

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19
Q

What are the symptoms of Rabies infection?

A
  • CNS hyperexcitability, convulsions
  • Flaccid paralysis
  • Hydrophobia
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20
Q

If HIV is causing Chronic Aseptic Meningitis, what cells will be present?

A

Multinucleated giant cells

21
Q

With HIV, what is there an increased incidence of?

A

Primary CNS lymphoma

22
Q

What virus causes Progressive Multifocal Leukoencephalopathy?

A

JC polyomavirus

23
Q

What does JC polyomavirus cause?

A

Progressive Multifocal Leukoencephalopathy (PML)

24
Q

With PML, what does the JC polyomavirus do?

A

Demyelinates oligodendrocytes

25
Q

What changes (3) in the brain will be seen with JC polyomavirus causing PML?

A

Demyelinates oligodendrocytes
Lipid-laden macrophages
Decreased # of axons

26
Q

What virus causes Subacute Sclerosing Panencephalitis?

A

Paramyxovirus

27
Q

What does Paramyxovirus cause?

A

Subacute Sclerosing Panencephalitis

28
Q

What are the symptoms of infection with Paramyxovirus and what does it follow?

A

Cognitive decline, limb spasticity and seizures following measles infection

29
Q

What are the 3 histologic manifestations of Subacute Sclerosing Panencephalitis (paramyxovirus)?

A
  • Widespread gliosis
  • Myelin degeneration
  • Neurofibrillary tangles
30
Q

Fungal Meningoencephalitis occurs in the immunosuppressed. What are the 2 main pathogens?

A

Mucormycosis

Cryptococcus Neoformans

31
Q

What is infection with Mucormycosis associated with?

A

DIABETES

32
Q

What will be seen microscopically with infection with Cryptococcus Neoformans?

A

Cryptococcal soap bubbles

33
Q

What protozoa causes brain abscesses?

A

Toxoplasmosis Gondii

34
Q

Where are the brain abscesses with Toxoplasmosis Gondii?

A
  • Grey-white matter junction

- Deep grey nuclei

35
Q

What types of lesions will be seen with Toxoplasmosis Gondii?

A

Ring enhancing lesions

36
Q

With Toxoplasmosis Gondii protozoal infection, what occurs centrally in the brain abscess?

A

Central necrosis
Vascular proliferation
Petechial hemorrhages

37
Q

With Toxoplasmosis Gondii protozoal infection, what is seen at the periphery of the central necrosis?

A

Free tachyzoites

Encysted bradyzoites

38
Q

What are the 2 Prion Diseases?

A

Creutzfeldt Jakob Disease

Fatal Familial Insomnia

39
Q

What are the 2 Prion Diseases?

A

Creutzfeldt Jakob Disease

Fatal Familial Insomnia

40
Q

Prion diseases involve a buildup of abnormal proteins. What does this result in and what histo change is usually seen?

A

Result = rapidly progressive disorders

** SPONGIFORM CHANGE - intracellular vacuoles!

41
Q

Spongiform change (intracellular vacuoles) is seen with what diseases?

A

Prion diseases

42
Q

What are the symptoms of Creutzfeldt-Jakob Disease?

A

In 70s, rapid dementia and myoclonus (involuntary jerking)

43
Q

What are the symptoms of Creutzfeldt Jakob Disease and what is there little evidence of?

A

Rapid dementia and myoclonus (involuntary jerking)

– little evidence of brain atrophy

44
Q

How is VCJD in the UK different that regular Creutzfeldt Jakob Disease?

A

Slower progression, exposure to bovine (cow) brains

45
Q

What 3 things are seen with a Kuru plaque?

A

Protein
PAS
Congo red

46
Q

What are the symptoms of Fatal Familial Insomnia?

A

Sleep disturbances –> ataxia, stupor, coma

47
Q

What is the survival rate for Fatal Familial Insomnia?

A

Less than 3 years

48
Q

What amino acid is substituted and where with Fatal Familial Insomnia?

A

Aspartate subbed at codon 129

NMSP (28 decks)

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