infections

Question 1

what organism causes Lyme disease? how is the diagnosis made?

Answer 1

borrelia burgdorferi (spirochete) Antibodies in the serum and CSF.

Question 2

how is neuro lyme disease treated?

Answer 2

2-4 weeks of IV ceftriaxone or penicillin G.

Question 3

what organsisms cause mucormycosis?

Answer 3

mucor, rhizopus, rhizomucor (fungi)

Question 4

what are risk factors for developing mucor?

Answer 4

immunocompromised states and iron chelation therapy with desferoximine.

Question 5

In what disease does the pathology show white matter pallor, activated macrophages, multinucleated giant cells and vacuolar changes in the brain?

Answer 5

HIV associated Dementia

Question 6

immunocompromised patients, exposure to bird droppings and positive india ink stain.

Answer 6

cryptococcus neoformans

Question 7

what is the most sensitive test for cryptococcus?

Answer 7

CSF antigen testing

Question 8

what is the treatment of cyrptococcus?

Answer 8

amphotericin plus flucytosine for 2-3 weeks, then switch to fluconozone.

Question 9

most common opportunistic infection in patients with HIV, multiple ring enhancing lesions

Answer 9

Toxoplasmosis

Question 10

what is the treatment for Toxoplasmosis?

Answer 10

sulfadiazine plus pyrimethamine plus folinic acid. Or can use Clindamycin

Question 11

what medication is used for toxoplasmosis prophylaxis?

Answer 11

trimethoprine-sulfamethoxazole

Question 12

multiple non-enhancing white matter lesions, myelin loss, giant astrocytes, oligodendrocytes with viral inclusions, “spagetti and meatball” appearance on electron microscopy.

Answer 12

PML

Question 13

length dependent symmetric polyneuropathy in HIV

Answer 13

HIV neuropathy

Question 14

ascending neuropathy occurring around the time of HIV seroconversion.

Answer 14

AIDP

Question 15

multifocal neuropathy occurring late in HIV

Answer 15

mononeuritis multiplex

Question 16

myositis occurring any time in HIV, MHC I expression on muscle cells.

Answer 16

auto immune myositis

Question 17

muscle wasting in late stage HIV

Answer 17

AIDS cachexia

Question 18

causes of meningitis in neurosurgical patients

Answer 18

pseudomonas, s. aureus, S. epidermidis, p. acnes.

Question 19

empiric meningitis tx in older or immunocompromised patients .

Answer 19

Vanc, ceftriaxone, ampicillin (for listeria)

Question 20

thickened nerves, multiple neuorpathies and weakly positive acid fast bacili

Answer 20

m. leprae (aka leprosy)

Question 21

granulomatous inflammation, multinucleated giant cells, caseating necrosis

Answer 21

Tuberculous meningitis

Question 22

in what stages of syphilis does syphilitic meningitis occur?

Answer 22

secondary syphilis

Question 23

endarteritis obliterans and vasculitis

Answer 23

meningovascular syphilis

Question 24

areflexia, lightening pains, sensory ataxia, loss of pain and temp sensation.

Answer 24

tabes dorsalis, tertiary syphilis.

Question 25

abdominal symptoms, neurolgoci symptoms, adrenal insufficiency, cutaneous hypopigmentation.

Answer 25

Whippel’s diasease (t. whippelii)

Question 26

schiff positive macrophage inclusions

Answer 26

whipples disease

Question 27

what is the treatment for Whipple’s disease?

Answer 27

TMP-SMX

Question 28

main difference between primary CNS lymphoma in immunocompromised and immunocompetent people.

Answer 28

EBV is usually causative in immuno compromised ppl.

Question 29

EEG pattern in CJD

Answer 29

repetitive periodic pattern