infection_inflammation of CNS and movement disorders - Sheet1

Question 1

What is meningitis?

Answer 1

Acute inflammation of meningeal tissues surrounding the brain and spinal cord.

Question 2

How do organisms usually enter the CNS in meningitis?

Answer 2

Through the upper respiratory tract or bloodstream; may also enter through penetrating skull fractures.

Question 3

What are the types of meningitis?

Answer 3

Bacterial (worst form), viral, fungal.

Question 4

Classic signs of meningitis?

Answer 4

Photophobia, phonophobia, severe headache, nuchal rigidity (stiff neck).

Question 5

Other manifestations of meningitis?

Answer 5

Fever, nausea/vomiting, focal deficits, signs of increased ICP, petechial rash with meningococcus.

Question 6

Diagnostic methods for meningitis?

Answer 6

H&P, head CT/MRI, lumbar puncture (LP).

Question 7

What does a lumbar puncture (LP) show in bacterial meningitis?

Answer 7

White/yellow fluid with high pressure due to neutrophils flooding the CSF.

Question 8

What is encephalitis?

Answer 8

Acute inflammation of brain parenchyma caused by a virus.

Question 9

Common etiologies of encephalitis?

Answer 9

Mosquito-borne viruses, herpes simplex virus.

Question 10

Mechanism of viral entry in encephalitis?

Answer 10

Viruses gain access to the CNS through the bloodstream or intraneural routes from peripheral nerves.

Question 11

Manifestations of encephalitis?

Answer 11

Viral prodromes, fever, confusion (progressing to unconsciousness), paresis, paralysis, involuntary movements, abnormal reflexes.

Question 12

Diagnostic methods for encephalitis?

Answer 12

H&P, lumbar puncture, viral blood culture.

Question 13

What is the normal pressure of CSF?

Answer 13

70-150 mm H2O

Question 14

CSF pressure in bacterial meningitis?

Answer 14

Increased

Question 15

CSF pressure in viral meningitis?

Answer 15

Increased

Question 16

CSF pressure in encephalitis?

Answer 16

Normal to slight increase

Question 17

Normal CSF WBC count?

Answer 17

0-5 cells/μL

Question 18

CSF WBC count in bacterial meningitis?

Answer 18

> 1,000/μL, mainly neutrophils

Question 19

CSF WBC count in viral meningitis?

Answer 19

25-500/μL, mainly lymphocytes

Question 20

CSF WBC count in encephalitis?

Answer 20

500/μL; neutrophils early, lymphocytes late

Question 21

Normal CSF protein level?

Answer 21

15-45 mg/dL

Question 22

CSF protein level in bacterial meningitis?

Answer 22

> 500 mg/dL

Question 23

CSF protein level in viral meningitis?

Answer 23

50-500 mg/dL

Question 24

CSF protein level in encephalitis?

Answer 24

Slight increase

Question 25

Normal CSF glucose level?

Answer 25

40-70 mg/dL

Question 26

CSF glucose level in bacterial meningitis?

Answer 26

Decreased (bacteria feed on sugar)

Question 27

CSF glucose level in viral meningitis?

Answer 27

Normal or low

Question 28

CSF glucose level in encephalitis?

Answer 28

Normal

Question 29

CSF appearance in bacterial meningitis?

Answer 29

Cloudy

Question 30

CSF appearance in viral meningitis?

Answer 30

Clear or cloudy

Question 31

CSF appearance in encephalitis?

Answer 31

Clear

Question 32

What is Parkinson disease?

Answer 32

A degenerative disorder of the CNS that affects motor and non-motor systems.

Question 33

What are some etiologies of Parkinson disease?

Answer 33

Autosomal dominant or recessive inheritance, or epigenetic mechanisms related to viruses and environmental toxins.

Question 34

What are early manifestations of Parkinson disease?

Answer 34

Resting tremor, muscle rigidity, bradykinesia (slowness of movement), postural abnormalities (risk for falls), and the Parkinsonian shuffle.

Question 35

What are late manifestations of Parkinson disease?

Answer 35

Cognitive deficits, behavioral changes (depression, agitation), and sleep disturbances.

Question 36

How is Parkinson disease diagnosed?

Answer 36

Based on the presence of 2/4 symptoms: resting tremor, bradykinesia, cogwheel rigidity, and postural instability.

Question 37

What is Huntington disease?

Answer 37

A hereditary, degenerative disorder of the basal ganglia and frontal cerebral cortex.

Question 38

What is the genetic mechanism of Huntington disease?

Answer 38

An autosomal dominant trait caused by a genetic defect on the short arm of chromosome 4.

Question 39

What are the early motor manifestations of Huntington disease?

Answer 39

Abnormal choreiform movements (jerking) starting in the face and arms, eventually involving the whole body.

Question 40

What cognitive and behavioral changes are seen in Huntington disease?

Answer 40

Progressive dysfunction of intellectual processes (e.g., memory loss, difficulty planning), restlessness, disinhibition, and irritability.

Question 41

How is Huntington disease diagnosed?

Answer 41

Based on family history and progression of symptoms.