CNS Patho III Flashcards
Infection sites of the brain and the causative agents
Meninges
- Bacterial, Viral, Fungal
Encephalitis
- Viral, Prions,
- most commonly HSV, Rabies
Brain Abscess
- Bacterial, Fungal, Parasite
Meningitis vs Encephalitis clinical presentations
Headache fever,
Neck stiffness, Photophobia VS Altered mental state;
What can cause neck stiffness
SAH and Meningitis;
- meningeal irritation
Diagnosis of brain infections
Localization, CT
CSF
Blood culture
EEG - prions
CSF investigations for bact and virus
Bacteria: Glucose down, protein up, NEUTROPHILS
Virus: Glucose normal, protein up, lymphocytes
TB: glucose down, protein up, lymphocytes
Give some Cx of meningitis [3]
+ 1 children;
Hydrocephelus
- can be both; scarring leading to non-communicating;
- RICP
Brain infraction
- SEPTIC arteritis, endarteritis, thromboembolic event
CRANIAL NERVE DAMAGE
- note CN passes through SAH
Children - mental retardation
List them encephalitis causes
Viral
- HSV, Measles, CMV, HIV; Varicella possible on reactivation
Children - Rubella and CMV
- Rabies
Prions
CNS components and Virus specific targets [5 viruses]
Neurons and Glia
- Temporal Lobe!!! - HSV
- Rabies! (travel by neurons!)
Motor Neuron
- Polio, Enterovirus
Dorsal Root Ganglion (sensory at the back bro)
- Varicella Zoster
Microglia
- HIV
HPV CPE [3]
Perinuclear Halo
Wrinkled nuclear membrane
Enlarged nucleus
What are Cowdry bodies
nuclear inclusions seen in HSV, Varicella, CMV
Rabies
- spread
- symptoms
- pathology feature?
Infected Saliva;
Convulsions
Pharyngeal contractions when swallowing, Hydrophobia
Mania, violent motor responses;
Negri Bodies
- nuclear inclusions in nerve cells;
- found in cerebellum and hippocampus;
– note this is not spongiform encephalopathy lmao
HIV Infection
Histology and CNS damage
KIV spinal tracts
Aseptic Meningitis, Encephalitis
Histology:
MGC, Perivascular lymphocyte cuffing; Microglial Nodules;
Spinal Cord:
- Vacuolar Myelopathy
- Posterior area of spinal cord: posterior column;
- Anterior area of spinal cord: corticospinal tracts;
Presents as: weakness, stiffness legs;
- sensory loss, imbalance - DCML
HIV associated pathologies
Cryptococcus Neoformans, Aspergillus
CMV, Toxoplasmosis, PML Papovavirus
CNS Lymphoma
Kaposi’s Sarcoma
Viral encephalitis histological features [2]
- think of cells involved
Microglial Nodules
– perineuronal aggregation of activated microglia/macrophages indicative of neuronal phagocytosis
Perivascular Lymphocyte Cuffing
– means inflammation around a blood vessel
Where are slipper shaped nuclei cells found
Microglial cell aggregates
- HIV and other viral encephalitis,
- perineuronal aggregation of activated microglia/macrophages indicative of neuronal phagocytosis
Syphilis all stages
and CNS stuff
- give me lab diagnosis
Primary - Chancre - ulcer
Secondary - Rashes, nodules, papules
Tertiary syphillis
- Granulomatous, meningovascular syphilis
- Gummatous syphilis – tumor balls of inflammation
- can have CN defects
- General paresis of the insane, due to cerebral atrophy, neuronal loss - dementia;
- Spinal Cord - Posterior column demyelination, Dorsal root ganglia affected, loss of vibration, proprioception
- joint degeneration, Charcot joints
- — this is just due to neuro loss, sensation loss, uncontrolled blood vessels; diabetes also can
- VDLR: venereal disease RESEARCH LAB; RPR
- EIA - enzyme immunoassay
ALL general fungal infection you think off
- Condition
- which one for meningitis
More or less IC state - diabetes, HIV,
Candida Albican Cryptococcus Neoformans - capsulated yeast -- meningitis Aspergillus - mold --- can have meningitis but v rare
Gimme parasites that we learn and which one associated w HIV
Malaria - Plasmodium (falciparum, vivax, ovale)
Toxoplasmosis - think AIDS
Acanthamoeba; Entamoeba;
Trichomonas
HIV brain REL whats possible [2]
Can be CNS lymphoma or CNS infection, toxoplasmosis
What are Prions?
Whats the pathological damage?
Misfolded proteins
- from alpha helix to beta pleated sheets, resisting digestion and causing spongiform change;
- accumulates as amyloid
Creutzfeldt–Jakob disease (CJD) for humans
w the ability to transmit misfolded shape to other proteins
- leading to transmissible spongiform encephalopathy
How is prion disease transmitted
Genetically
- Familial
Transplanted stuff; Food digestion
- can be Sporadic too
How does CJD present
Dementia Myoclonus Personality change Vision DEaTh
Prion disease histology
Spongiform transformation
Amyloid deposits
CNS Malformations 3 classifications
Neural Tube Defects
Forebrain abnormalities
Posterior fossa abnormalities
