Infections and tumors Flashcards
______ has more protection from infections than most of the body.
brain
Once past BBB, inflammation and infection are hard to control (T/F).
TRUE
____ ____ ____ cannot access brain easily due to the BBB.
white blood cells
CNS has __/__ of antibodies as compared to blood.
1/200
Meningitis is 10X more common in __________ countries.
underdeveloped
Bacterial ________ meningitis common in infants, people with suppressed immune systems, and college students who live in dorms.
meningoccal
___-___% of meningitis case are fatal.
10-15
What are the presentations of meningitis?
- fever and headache
- neck - lumbar - posterior thigh stiffness
- Brudzinski’s sign
- seizures
- vomiting
- focal CNS signs
_______ sign = flex neck –> hips and knees flex involuntarily
Brudzinski’s
Meningitis spreads ___ meningeal layers then cortex, leading to thrombosis, infarction, and scars.
3
In meningitis, ______ can lead to increase intracranial pressure.
edema
What is the pathogenesis of meningitis?
- bacterial
2. viral
When do you see viral meningitis? What causes it?
late teens and infirm; TB meningitis
_______ = infection of the brain or SC of infection of the brain parenchyma
encephalitis
What is the presentation of encephalitis ?
- headache, nausea, vomiting, agitation, meningeal irritation, stiffness
- loss of consciousness
- coma which may last weeks
- can result in focal brain damage
Encephalitis may impact the medial temporal lobes, leading to severe ______.
amnesia
Encephalitis can be caused by _______.
meningitis
_______ encephalitis = acute viral encephalitis caused by a viral infection.
primary
_____-_____ viruses often cause primary encephalitis.
mosquito-borne (such as west nile)
_______ encephalitis = acute disseminated encephalitis and is secondary to another viral infection.
secondary
Herpes simplex encephalitis causes ___% of all cases.
10
Encephalitis can deteriorate very fast, within hours (T/F).
TRUE
________ causes a cascade of cell necrosis, loss of plasma membrane, hemorrhagic necrosis, scarring.
encephalitis
What is included in the medical investigation of meningitis and encephalitis?
- MRI (check cerebral edema)
- Identiy viruses/culture bacteria
- EEG to manage seizure foci
How is meningitis and encephalitis Dx?
lumbar punctue
Do children or adults take longer to recover from meningitis and encephalitis?
children
_____-_____ disease = mis-folded protein, infection of motor system
creutzfeldt jakob disease
What is the presentation of creutzfeldt jakob disease?
often young adults 16-30, movement disorder/dementia, rapidly progressive after symptoms emerge, and FATAL
Pathology of creutzfeldt jakob disease = ________ infection
retrograde
How are you infected in creutzfeldt jakob disease ?
- ingestion
2. inhaled through nose
What is the time course of incubation time?
5-8 years
What are 4 PT concerns for brain infection?
- isolation protocol
- inter-cranial pressure = big concern
- possible behavioural change assessment
- outpatient: monitor changes
____-______ may trigger or accelerate neurodegenerative disease.
cross-seeding
What medical imaging technique would you want to use in order to determine how fast a tumour is growing?
PET scan
Brain tumors are second to _____ in cause of death.
stroke
Brain tumors have a ___% survivial rate.
50
______-______ tumors significant cause of death in children.
infra-tentorial
____-______ tumors often occur in adults.
supra-tentorial
What are the two classifications of neoplasms?
- Intra-cerebral: primary tumours
2. Intra-cerebral: metastatic
What are primary intra-cerebral tumors primarily caused by?
glial cells (glioma)
What are interstitial intra-cerebral tumors primarily caused by?
breast, lung, prostrate
How does the brain compensate for primary tumors?
- decrease volume of brain tissue
- decrease in CSF volume
- decrease in cerebral blood volume
When the brain no longer can compensate for a brain tumor, ______ emerges.
symptoms
What are the presentations of brain tumours?
- headache
- worse with cough, bend and exercise
- nausea and vomiting
- impaired cognition and behaviour changes
- location specific signs
- loss of consciousness
- seizures
________ = swelling of the optic disc, where the optic nerve enters the eyeball, usual associated with an increase in intraocular pressure
papilledema
Papilledema occurs in ___% of people with brain tumors.
75
Stage 0 cancer?
cancer is where is started and hasn’t spread
Stage I cancer?
cancer is small and hasn’t spread anywhere else; can detect symptoms
Stage II cancer?
cancer has grown but not spread
Stage III cancer?
cancer is larger and may have spread to surrounding tissues and/or lymph nodes
Stage IV cancer?
cancer has spread from where it started to at least on other body organ
Stage IV cancer is also known as?
secondary or metastatic cancer
Grade __ glioma: cancer cels look very similar to normal cells and are growing slowly
I
Grade __ glioma: cells don’t look like normal cells and are growing more quickly than normal
2
Grade ___ glioma: cancer cells look very abnormal and are growing quickly
3
What % of tumours are primary gliomas?
50
Are gliomas more common in men or women?
men
There are multiple known risk factors for gliomas (T/F).
FALSE (none known for sure)
What are the two types of primary gliomas?
- Low grade and benign
2. Malignant
______ _____ and ____ tumors = narrow zones of infiltration that are clearly outlined on diagnostic images
low grade and benign
______ = diffuse zones of infiltration that can arise at any location in the CNS, but typical are in the cerebral hemisphere.
malignant
Do malignant gliomas occur primarily in adults or children?
adults
What are the three types of gliomas classified on where they originate from?
- astrocytomas
- oligodendroglioma
- medulloblastomas
Are most oligodendroglioma benign or malignant?
malignant
_______ are the most common infratentorial tumor.
medulloblastomas
____ _____ almost always reoccur.
anapaestic astrocytoma
___ ______ astrocytomas have a 100% survive rate if treated early.
low grade
What are the two common sites of anaplastic astrocytoma?
- frontal lobe
2. temporal lobe
_________ are located in the vermis of the cerebellum, are highly vascular, and spread though the sub arachnoid space.
medulloblastoma
______ are common malignant tumors in children.
medulloblastoma
Intraspinal tumors are __/__ as frequent as brain tumors.
1/6
What are the sings of intraspinal tumors?
Root pain, worse at night when coughing
What is the medical management of of brain tumours?
- neuroimaging to define the extent of the lesion
- surgery and or radiation
- treat side effects
What are 5 things that are important to control in the management of brain tumors?
- intracranial pressure
- tissue damage
- swelling
- hemorrhage
- hydrocephalus