Generalities of Mass lesions

Question 1

what are manifestations of mass lesions

Answer 1

Fever
Severe HA
Seizures

Question 2

what is the most common single pathogen in mass lesions

Answer 2

s. areus

Question 3

mixed anaerobic infections account for 1/2 the cases of what

Answer 3

mass lesions mostly GNR and GPC

Question 4

what fungal agents can cause mass lesions

Answer 4

coccidoides immitis

candida albicans

Question 5

what does ncc stand for

Answer 5

neurocysticercosis

Question 6

what agent is responsible for ncc

Answer 6

taenia solium

Question 7

what is the most common parasitic CNS disease

Answer 7

NCC

Question 8

what is the most common cause of epilepsy in the world

Answer 8

NCC

Question 9

many people carry cysticerci of what

Answer 9

t. solium

Question 10

where is the prevalence of NCC the highest

Answer 10

Cental and South America, India and sub-saharan africa

Question 11

why is the prevalence of NCC in US increasing

Answer 11

influx of immigrants

Question 12

what is the pathogenesis of NCC

Answer 12

pt ingests ova- oncospheres release they disseminate and get lodged in CNS and develop cysicerci

Question 13

what are parenchymal cysts

Answer 13

mature living cysticerci viable up to 10y suppress immune and the host is usually asymptomatic

Question 14

what happens as cycticeri begin to die

Answer 14

they leak Ag an intense inflammatory response begins and host manifest with symptoms

Question 15

what are extraparenchymal cysts

Answer 15

a few oncospheres can lodge in ventricles subarachnoid space or meninges can cause atypical cyst

Question 16

what are the manifestations of NCC

Answer 16

depends on location of cyst

focal or gen tonic-clonic seizures, focal signs. altered mental, symptoms of elevated ICP (cyst in ventricle)

Question 17

how do you diagnose NCC

Answer 17

symptoms usually only occur after cyst calcifies
histological
cyst seen on mri or ct
direct visualization on fundoscopic exam (live are noncontrast)

Question 18

In absence of one or more of these results that confirm a diagnosis of neurocystticercosis, but with imaging results that suggests the diagnosis:

Answer 18

Positive EITB for detection of anticysticercal antibodies
CSF WBC with differential reveals an eosinophilia as high as 15%.
Patient signs and symptoms.

Question 19

what is the treatment for NCC

Answer 19

Niclosamide destroys VIABLE cyst in CNS
Praziquantel destroys VIABLE cyst in CNS
Albendazole destroys VIABLE cyst in CNS
anticonvulsants, steroids, shunt or surgery, good prognosis w/ tx

Question 20

what is the agent in toxoplasmosis

Answer 20

Tissue protozoan t. gondii

Question 21

what type of pathogen is Tissue protozoan

Answer 21

eucaryote obligate intracellular parasite.

Question 22

where can tissue protozoan trophozoite affect

Answer 22

any nucleated cell

Question 23

what is a latent pseudocyst

Answer 23

found primarily in the brain and muscle – T. gondii cannot form a true cyst

Question 24

Clinical implication of latent pseudocyst is with respect to

Answer 24

reactivation due to immunosuppresion

Question 25

what is the 2nd most common cause of cns in aids pts besides hiv

Answer 25

t. gondii

Question 26

what is the definitive host of t. gondii

Answer 26

cat

Question 27

what type of host for t. gondii are humans

Answer 27

intermediate

Question 28

how is ti. gondii transmitted

Answer 28

ingestion of psuedocyst from undercooked food | inhalation of a mature cyst from cat feces

Question 29

what is the main pathogenesis of t. gondii

Answer 29

multifocal mass lesions | following release the protozoan spreads to all organs and tissues where trophozoites infect any nucleated cell

Question 30

what is the sites where t. gondii lesions are found

Answer 30

CNS EYE LUNG MUSCLE

Question 31

reactivation diseases of t. gondii include

Answer 31

diffused encephalitis multifocal mass lesions disease of lung or eye

Question 32

what is the symptoms of t. gondii

Answer 32

alterd mental, weakness, CN abnormalities, neuropsychiatric, focal or tonic clonic

Question 33

what differential dx of mass lesions in aids pts

Answer 33

had, brain tumor (EBV), toxoplasmosis encephalitis, PML,Cryptococcal meningoencephalitis, CMV diseases

Question 34

what would be seen in neuroimaging of t. gondii

Answer 34

CT- ring enhancing lesion | MRI-contrast enhancing lesion after admin of godolinium

Question 35

what would shown in the mri of Toxoplasmosis encephalitis

Answer 35

multiple bilateral cerebral lesions in the juxtacortical and basal ganglia areas. ganglia and are hypodense with ring-enhancement.

Question 36

what would shown in the MRI of cerebral toxoplasmosis

Answer 36

Deep central gray nuclei or lobar gray-white junction.

Question 37

what would be the serology results in t. gondii

Answer 37

IgM will not be present – disease is reactivation. | Absence of anti-Toxoplasma IgG makes a diagnosis of toxoplasmosis unlikely, even in an pt with advanced HIV/AIDS

Question 38

what would be the brain biopsy results in t. gondi

Answer 38

trophs or multiple, ruptured tissue cysts in inflammatory lesions

Question 39

what is the treatment of t. gondii

Answer 39

2→4 months of a combination of sulfonamides (sulfadiazine) or clindamycin plus pyrimethamine. only treats trophozoites not latent infection of pseudocysts

Question 40

what is the prevention of t. gondii

Answer 40

Pregnant women, Advanced HIV patients, SOT patients on immunosuppressive therapy, etc. should be instructed to avoid cats, cat feces and Cook pork well, not pink.