Infections Flashcards
what will you see with encephalitis lethargica (secondary to influenze in 1917-1928)?
fevers, lethargy, HA, disturbance of eye movements
variety of movement disorders including chorea, athetosis, dystonia, and myoclonus
1/4 get severe unremitting PAKINSONISM
also get unique oculogyric crises where eyes deviate to one side or up
Which CN is most likely to be affected in a pt with sarcoid?
CN VII
FACIAL PARESIS
Polio attacks what aspect of the nervous system?
anterior horn cells
Meningitis in immunocomprimised pt with path stain india ink = ?
cryptococcus
CSF in pt with spongiform encephalopathy or CJD will ususally show…?
nothing. normal
What comes to mid with rim enhancing brain lesion in AIDS pt?
Toxo gondii or primary CNS lymphoma
What is the treatment for Toxoplasma gondii?
Sulfadiazine and pyrimethamine
CMV and HIV usually produce what accumulations in the Brain?
microglial nodules
with HIV they are around blood vessels
cith CMV they are subpial or subependymal
EEG in person with herpes CNS infection will show what?
discharges over the temporal regions
Where do brain abscesses usually originate from (ie where in the body did they migrate from)
usually heamtogenous spread from lung, heart, sinuses, and ear.
where in the brain do abscesses usually form?
junction of gray and white matter
pt with hx of syphilis may be confused to have a brain tumor if he develops what?
intracranial gumma
they grow several centimeters and start as inflammatory but then get fibrosed
Most common cause of fungal meningitis or abscess
Aspergillus
Which area of the brian is primarily targeted with late syphilis?
rhombencephalon (pons and medulla oblongata)
Most common cause of brain abscess in AIDS pt
T. gondii more common than fungal (aspergillus) in AIDS pt
Most common symptom of pt with brain abscess?
headache
What bug grows in more than half of brain abscesses?
strep
staph more common with penetrating head injury
Acute meningitis in elderly and babies is most commonly what bug and how do you treat it?
Listeria
amp + gent
How is CJD usually transmitted?
infected nervous system tissue (dura mater grafts, and infected growth hormone preps from cadaver)
Kuru not common in US (New Guniea)
What do you see with tabes dorsalis?
leptomeningitis, posterior columns and DRG affected.
happens decades later
gait ataxia, + romberg, bowel/bladder disfunction, Argyll Robertson pupils
describe argyll robertson pupils
ARP-PRA
Accommadation Reflex present (pupils will constric to focus on an object that comes into visual field - like examiners finger)
Pupillary Reflex Absent (pupil will not constrict when light shown in it)
