ID, Tox, nutritional Flashcards
Whipple’s disease sx, tx
Oculomasticatory myorhythmia
ocular dysfxn (esp vertical gaze palsy)
GI sx, systemic non-spec, + arthritis
Dementia, gait ataxia,
Tx w/ ceftriaxone
JC virus path
Glassy intranuclear inclusions in oligodendrocytes
CMV path
Lg inflammatory cells (“Galac”
Lg intranuclear inclusions
Rabies path
Intracytoplasmic “negri bodies”
Round, bright pink
Commonly in purkinje cells
Cryptococcal meningitis path, tx
encapsulated yeast
+ india ink, round + cup shaped, variable size
Tx - acute amphoterocin and flucytosine, long term fluconazole
Toxoplasmosis path, teratogenicity
Path - bradyzooites (lg mottled blue/pink circle)
Hydrocephalus, intracranial calcifications, chorioretinitis
Aspergillosis path
90 dgree branching hyphae
Rituximab neuro tox
PML
Bevacizumab neuro tox
Intracerebral hemorrhage
5-fluorouracil neuro tox
Pancerebellar syndrome (less than cytarabine)
Cytarabine neuro tox
Subacute pancerebellar syndrome (10-20%)
Poss aseptic meningitis
Methotrexate neuro tox
Leukoencephalopathy
Aseptic meningitis
Pyridoxine deficiency sx
Angular chelitis, glossitis, stomatitis, poor appetite
Generalized axonal sensorimotor neuropathy
BL distal numb –> distal parasthesias, sensory ataxia, weakness
Lead toxicity - acute severe sx
Encephalopathy with brain edema –> dead
Lead toxicity adults sx, tx
Subacute motor > sensory peripheral neuropathy
Classic - wrist and finger extension weakness
Tx w/ EDTA
Carbon monoxide tox MRI findings
T2 bright or necrosis globus pallidus. Diffuse leukoencephalopathy (not as bright)
Organophosphate toxicity sx
Salivation, lacrimation, sweat
Miosis
n/v, diarrhea, abd cramps
Flaccid paralysis with fasciculations
Thallium toxicity source
Previously rat and insect killers. Now - herbal products
Thallium toxicity sx
Rapid onset painful sensory neuropathy
Alopecia
Thallium toxicity tx
prussian blue
Manganese tox source
TPN, chronic liver disease
Manganese tox sx
Parkinsonian sx, dystonia, HA
hallucinations, psychosis, aggressive
Manganese tox MRI
Increased T1 signal globus pallidus
Mercury tox source, sx
Miner, dentist. After weeks-months exposure
Ataxia, intention tremor, dysarthria, parasthesias
Cognitive and behavioral changes
Constricted visual fields, deafness
Oral - inflamed tender gums, increased salivation, swollen salivary glands
Cyanide tox source, sx
Industrial
Ha, anxiety, encephalopathy, vertigo, sz
Bright red skin, abnl (almond) taste
Cardiac - Tachycardia + HTN –> bradycardia and hypotension, AV block, arrhythmia
Arsenic tox acute, subacute, chronic
Acute: GI/cardiac sx, encephalopathy, garlic breath
Subacute: GBS like
Chronic: ascending sensorimotor peripheral neuropathy, skin hyperpigmentation/macular rash, scaling palms/soles
Vitamin E deficiency
Ataxia, areflexia, dysarthria
Lg fiber sensory loss
Copper deficiency
B12 like Myelopathy with spastic paraparesis
Peripheral neuropathy with axonal loss
loss proprioception & vibration
Pancytopenia
primarily seen in cervical region
Lithium teratogenicity
Ebstein’s anomaly (malformed tricuspid valve)
VPA teratogenicity
Neural tube defects
Craniofacial (cleft), cardiac
Carbamazepine teratogenicity
Dysmorphic face - Craniofacial (incl cleft), doll-like facies, long philtrum, short palpebral fissures
Neural Tube Defects, developmental delay
Fingernail hypoplasia
Hip dislocation, inguinal hernia
Wernicke vs. Korsakoff
Wernicke - reversible, acute, has motor sx + cognitive
Encephalopathy + confusion, nystagmus + ataxis
Korsakoff - chronic, irreversible, just cognitive Confabulation amnesia (anterograde > retrograde) Personality change Hallucinations
Trichinosis sx, path, tx
Acute-subacute onset
Puffy eyelids, dysphagia, myalgia. Prox > distal weak
Little circles in biopsy
Tx with thiobendazole and steroids
Nitrous oxide toxicity mechanism, sx
NO –> irreversible oxidation of B12, most acute with underlying B12 deficiency
