Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro > export_cns infection > Flashcards

export_cns infection Flashcards

1
Q

Tysabri and PML

A

-Prior exposure to JC virus (no exposure is almost no risk while if exposed you have to look at degree of positivity) - Prior immunosupression doubles the risk -Risk increases with number of tysabri infusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Subacute Combined Degeneration

A
  • Lichtheim’s disease -Degenration of the posterior and lateral columns of the spinal cord as a result of B12 def, Cu def, or Vit E def. Usually associated with pernicious anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Toxoplasmosis

A
  • Toxoplasma Gondii, parasite - Infected meat, cat feces, or mother to fetus - Mostly mild flu-like in non-compromised humans - Eccentric target sign of todo on imaging -TX: empiric sulfadiazine/pyrimethamine–if no improvement, then bx the lesion. 90% respond to tx.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Toxoplasmosisv. 1mary CNS lymphoma

A
  • not really easy to differentiate in imaging -Antibody to toxo; mostly helpful if negative. -Lymphoma associated with EBV; do PCR -Lyphoma has no treatment ( 6 mo survival even with rdx)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cryptococcus Neoformans

A

-Meningitis in HIV - HA, mental status changes, meningeal signs -India ink ( 75% +, now cryptococcal antigen via latex agglutination 95% +) -Often opening pressure is elevated; papilledema -Tx: IV amphotercicin, then flucanozole continued for 3 months after CSF is sterilize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

HIV myopathy

A

-HIV or meds ( Zidovudine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

HIV Neuropathy

A
  • distal polyneuropathy -Can also be due to HIV meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HIV Myelopathy

A
  • Can produce myelopathy similar to B12 def
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

HIV meningitis

A

SImilar to any other— but from uncommon hosts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HIV Dementia

A

-Common in late stages of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

HIV eye disease

A

-CMV; Also lumbar radiculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HIV stroke

A

HIV vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Opportunistic diseases HIV -CD4>500

A

-HIV meningitis -Acute Inflammatory demyelinating syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Opportunistic diseases HIV CD4=200-500

A

-HIV associated dementia -Mononeuritis multiplex HIV-associated myopathy/neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Opportunistic diseases HIV CD4

A

CNS toxo PML 1mary CNS lymphoma Cryptococcal meningitis HIV vacuolar myelopathy CMV ventriculitis VZV vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HSV encephalitis

A

-Most common sporadic -non-specific : fever, HA, confusion, personality changes, olfactory/gustatory hallucination. focal seizures/ motor distrubances - Frontal/temporal lobes (swelling-> uncal herniation) - LP grossly bloody CSF, elevated WBC, lymphocytes. PCR to confirm -EEG with PLEDs (temporal lobes) -IV acyclovir ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Human T-lymphotropic virus type I

A

-Tropical spastic paraparesis -Chronic myelopathy common in caribbean and Africa. US IV drug users

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

VZV

A

-zoster/shinglesfrom reactivation of varicella in dorsal root ganglia-painful vesicular rash - usually thoracic dermatome, V1 distribution; zoster ophthalmic us - week of antiviral agents ( acyclovir. valacyclovir) Can occasionally infect cerebral arteries causing strokes. also can infect SC directly leading to severe myelopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CMV

A

-devastating in utero -IC-encephalitis, often fatal in months -Associated with retinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rabies

A

-Bite from infected animal -Can cause encephalitis leading to psychiatric disturbances, death, or fatal paralysis due to SC infection - bx shows Negri bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Polio

A

-Directly infects anterior horn cells of SC -Largely eradicated (vaccine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

West Nile

A

Also infects anterior horn cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bacterial Meningitis

A

-Most common Strep Pneumo -CSF with increased pressure, ^WBC with PMN predominance, elevated protein, and decreased glucose. - Empirically treat –3rd gen ceph/vanc; + ampicillin in neonates, >50 yo - LP but Ct with focal signs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Neonatal Bacterial Meningitis

A

GBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Indication for CT before LP

A
  • Neurological defecits, papilledema, IC, hx of CNS disease, AMS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Causes of bacterial Meningitis

A

>80% adults: N. meningitides ,S. Penumoniae ->50 yo more chance of l. monocytogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Kernig’s Sign

A

Supine; pain with thigh and knee flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Brudzinski’s Sign

A

-Supine, lift head -+ when there is involuntary lifting of the legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Meningitis Drugs by age

A

-Neonate: amp/3rd gen ceph -Child-50: 3rd gen ceph+vanc+rifampin - >50 y.o, IC: Amp, 3rd gen ceph+vanc+rifampin -CSF shunts/neurosurgery:3rd gen ceph+vanc -Skull fracture: 3rd gen ceph+metronidazole ** + steroids to prevent hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

CNS TB

A

-meningitis ( usually basal)-malaise, to stupor, to coma, seizures, and often hemiparesis -IC tuberculomas -Pott’s disease -TX- INH, rifampin, pyrazinamide for 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pott’s Disease

A

-Usually lower thoracic or upper lumbar of the spine. -From hematogenous spread from other sites ( usually pulm) - spreads from 2 adjacent vertebrae into adjoining IVertebral space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Supplement to Izoniazid/rifampin to prevent peripheral neuropathy

A

-pyridoxine/ Vit B -Excess pyridoxine can also lead to peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

CNS Abscess

A

-Brain usually direct invasion–> usually temporal lobe–> focal deficits -Hard to distinguish on imaging - Multiple means heme spread; Single means more direct spread -MOre inflammatory/ edema means early on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Syphilis

A

-primary (chancre) -> 2ndary (rash on palms/soles)-> Tertiary (meningitis, Tabes Dorsalis, General Paresis) -small, irregular pupils that do not react to light, but do to accommodation -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tertiary TB-Meningitis

A

Can cause MCA stroke ( vaculitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Tabes Dorsalis

A

Inflmmatory destruction of lumbosacral dorsal root ganglia with loss of sensation and pain in legs and abdomen, damage to posterior columns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

General paresis

A

Encephalitic infection characterized by dementia, psych symptoms (Syphilis)

38
Q

Syphilis w/u

A

1) Non-troponemal (RPR/ VDRL)-non-specific (CONFIRMATION) 2) Troponemal (TP-PA/TPHA/FTA-ABS/EIA)-specific; remain for life. do not correlate with treatment/titers (SCREEN) LP needed–high CSF WBC and oligoclonal bands

39
Q

Penicillin neurosyphilis

A
  • IV/IM penicillin for 14 days. F/u blood tests 3, 6, 12, 24, 36 months to ensure success. decrease in lymphocyte count and protein, decrease in VDRL titer
40
Q

Lyme Disease

A

-Stage 1- acute-erythema migraines -Stage 2- flu-like, meningitis,cardiac pathology -Stage 3- CNS

41
Q

Stage 3 Lyme

A

Sensory Neuropathy, subtle cognitive changes in some tx: oral doxycycline or if neuro–> IV ceftriaxone

42
Q

Taenia Solium

A

-Pork Tapeworm -Cysticercosis (India/SA–> primary epilepsy) - Infection through fecal.oral or undercooked pork - cysts in muscles, brain, eyes TX:abendezole and steroids to reduce inflammation

43
Q

Naegleria fowleri

A

” brain eating amoeba’ found in warm bodies of fresh water such as ponds, lakes, rivers, and hot springs

44
Q

racemos neurocysticercosis

A
  • cysts in the ventricular system, esp 4th–obstruction of CSF flow and hydrocephalus -May need shunting
45
Q

CJD

A

-double hockey stick sign -Spongiform degeneration of grey matter caused by neuronal loss -Rapid dementia, sporadic 80% of the time ( also genetic/iatorgenic forms) CSF-14-3-3 protein ( non-specific) -Conformational change in prion protein

46
Q

Kuru

A

spongiform encephalopahty formerly seen in new guinea, consumption of human brain tissue

47
Q

-Prior exposure to JC virus (no exposure is almost no risk while if exposed you have to look at degree of positivity) - Prior immunosupression doubles the risk -Risk increases with number of tysabri infusions

A

Tysabri and PML

48
Q
  • Lichtheim’s disease -Degenration of the posterior and lateral columns of the spinal cord as a result of B12 def, Cu def, or Vit E def. Usually associated with pernicious anemia
A

Subacute Combined Degeneration

49
Q
  • Toxoplasma Gondii, parasite - Infected meat, cat feces, or mother to fetus - Mostly mild flu-like in non-compromised humans - Eccentric target sign of todo on imaging -TX: empiric sulfadiazine/pyrimethamine–if no improvement, then bx the lesion. 90% respond to tx.
A

Toxoplasmosis

50
Q
  • not really easy to differentiate in imaging -Antibody to toxo; mostly helpful if negative. -Lymphoma associated with EBV; do PCR -Lyphoma has no treatment ( 6 mo survival even with rdx)
A

Toxoplasmosisv. 1mary CNS lymphoma

51
Q

-Meningitis in HIV - HA, mental status changes, meningeal signs -India ink ( 75% +, now cryptococcal antigen via latex agglutination 95% +) -Often opening pressure is elevated; papilledema -Tx: IV amphotercicin, then flucanozole continued for 3 months after CSF is sterilize

A

Cryptococcus Neoformans

52
Q

-HIV or meds ( Zidovudine)

A

HIV myopathy

53
Q
  • distal polyneuropathy -Can also be due to HIV meds
A

HIV Neuropathy

54
Q
  • Can produce myelopathy similar to B12 def
A

HIV Myelopathy

55
Q

SImilar to any other— but from uncommon hosts

A

HIV meningitis

56
Q

-Common in late stages of disease

A

HIV Dementia

57
Q

-CMV; Also lumbar radiculitis

A

HIV eye disease

58
Q

HIV vasculitis

A

HIV stroke

59
Q

-HIV meningitis -Acute Inflammatory demyelinating syndrome

A

Opportunistic diseases HIV -CD4>500

60
Q

-HIV associated dementia -Mononeuritis multiplex HIV-associated myopathy/neuropathy

A

Opportunistic diseases HIV CD4=200-500

61
Q

CNS toxo PML 1mary CNS lymphoma Cryptococcal meningitis HIV vacuolar myelopathy CMV ventriculitis VZV vasculitis

A

Opportunistic diseases HIV CD4

62
Q

-Most common sporadic -non-specific : fever, HA, confusion, personality changes, olfactory/gustatory hallucination. focal seizures/ motor distrubances - Frontal/temporal lobes (swelling-> uncal herniation) - LP grossly bloody CSF, elevated WBC, lymphocytes. PCR to confirm -EEG with PLEDs (temporal lobes) -IV acyclovir ASAP

A

HSV encephalitis

63
Q

-Tropical spastic paraparesis -Chronic myelopathy common in caribbean and Africa. US IV drug users

A

Human T-lymphotropic virus type I

64
Q

-zoster/shinglesfrom reactivation of varicella in dorsal root ganglia-painful vesicular rash - usually thoracic dermatome, V1 distribution; zoster ophthalmic us - week of antiviral agents ( acyclovir. valacyclovir) Can occasionally infect cerebral arteries causing strokes. also can infect SC directly leading to severe myelopathy

A

VZV

65
Q

-devastating in utero -IC-encephalitis, often fatal in months -Associated with retinitis

A

CMV

66
Q

-Bite from infected animal -Can cause encephalitis leading to psychiatric disturbances, death, or fatal paralysis due to SC infection - bx shows Negri bodies

A

Rabies

67
Q

-Directly infects anterior horn cells of SC -Largely eradicated (vaccine)

A

Polio

68
Q

Also infects anterior horn cells

A

West Nile

69
Q

-Most common Strep Pneumo -CSF with increased pressure, ^WBC with PMN predominance, elevated protein, and decreased glucose. - Empirically treat –3rd gen ceph/vanc; + ampicillin in neonates, >50 yo - LP but Ct with focal signs.

A

Bacterial Meningitis

70
Q

GBS

A

Neonatal Bacterial Meningitis

71
Q
  • Neurological defecits, papilledema, IC, hx of CNS disease, AMS
A

Indication for CT before LP

72
Q

>80% adults: N. meningitides ,S. Penumoniae ->50 yo more chance of l. monocytogenes

A

Causes of bacterial Meningitis

73
Q

Supine; pain with thigh and knee flexion

A

Kernig’s Sign

74
Q

-Supine, lift head -+ when there is involuntary lifting of the legs

A

Brudzinski’s Sign

75
Q

-Neonate: amp/3rd gen ceph -Child-50: 3rd gen ceph+vanc+rifampin - >50 y.o, IC: Amp, 3rd gen ceph+vanc+rifampin -CSF shunts/neurosurgery:3rd gen ceph+vanc -Skull fracture: 3rd gen ceph+metronidazole ** + steroids to prevent hearing loss

A

Meningitis Drugs by age

76
Q

-meningitis ( usually basal)-malaise, to stupor, to coma, seizures, and often hemiparesis -IC tuberculomas -Pott’s disease -TX- INH, rifampin, pyrazinamide for 12 months

A

CNS TB

77
Q

-Usually lower thoracic or upper lumbar of the spine. -From hematogenous spread from other sites ( usually pulm) - spreads from 2 adjacent vertebrae into adjoining IVertebral space

A

Pott’s Disease

78
Q

-pyridoxine/ Vit B -Excess pyridoxine can also lead to peripheral neuropathy

A

Supplement to Izoniazid/rifampin to prevent peripheral neuropathy

79
Q

-Brain usually direct invasion–> usually temporal lobe–> focal deficits -Hard to distinguish on imaging - Multiple means heme spread; Single means more direct spread -MOre inflammatory/ edema means early on

A

CNS Abscess

80
Q

-primary (chancre) -> 2ndary (rash on palms/soles)-> Tertiary (meningitis, Tabes Dorsalis, General Paresis) -small, irregular pupils that do not react to light, but do to accommodation -

A

Syphilis

81
Q

Can cause MCA stroke ( vaculitis)

A

Tertiary TB-Meningitis

82
Q

Inflmmatory destruction of lumbosacral dorsal root ganglia with loss of sensation and pain in legs and abdomen, damage to posterior columns

A

Tabes Dorsalis

83
Q

Encephalitic infection characterized by dementia, psych symptoms (Syphilis)

A

General paresis

84
Q

1) Non-troponemal (RPR/ VDRL)-non-specific (CONFIRMATION) 2) Troponemal (TP-PA/TPHA/FTA-ABS/EIA)-specific; remain for life. do not correlate with treatment/titers (SCREEN) LP needed–high CSF WBC and oligoclonal bands

A

Syphilis w/u

85
Q
  • IV/IM penicillin for 14 days. F/u blood tests 3, 6, 12, 24, 36 months to ensure success. decrease in lymphocyte count and protein, decrease in VDRL titer
A

Penicillin neurosyphilis

86
Q

-Stage 1- acute-erythema migraines -Stage 2- flu-like, meningitis,cardiac pathology -Stage 3- CNS

A

Lyme Disease

87
Q

Sensory Neuropathy, subtle cognitive changes in some tx: oral doxycycline or if neuro–> IV ceftriaxone

A

Stage 3 Lyme

88
Q

-Pork Tapeworm -Cysticercosis (India/SA–> primary epilepsy) - Infection through fecal.oral or undercooked pork - cysts in muscles, brain, eyes TX:abendezole and steroids to reduce inflammation

A

Taenia Solium

89
Q

” brain eating amoeba’ found in warm bodies of fresh water such as ponds, lakes, rivers, and hot springs

A

Naegleria fowleri

90
Q
  • cysts in the ventricular system, esp 4th–obstruction of CSF flow and hydrocephalus -May need shunting
A

racemos neurocysticercosis

91
Q

-double hockey stick sign -Spongiform degeneration of grey matter caused by neuronal loss -Rapid dementia, sporadic 80% of the time ( also genetic/iatorgenic forms) CSF-14-3-3 protein ( non-specific) -Conformational change in prion protein

A

CJD

92
Q

spongiform encephalopahty formerly seen in new guinea, consumption of human brain tissue

A

Kuru

Neuro (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions