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MHD- Neuro > Infections of the CNS > Flashcards

Infections of the CNS Flashcards

1
Q

Explain the difference between meningitis and encephalitis

A

Meningitis: inflammation of the leptomeninges

Encephalitis: Infection of the brain parenchyma (neurons and glial cells)

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2
Q

What is the most common type of meningitis?

A

Bacterial

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3
Q

Who gets fungal meningitis?

A

Immunocompromised people

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4
Q

What type of meningitis is caused by amebic and tuberculous infections?

A

Granulomatous

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5
Q

Describe aseptic meningitis

A

Viral meningitis- self-limiting and usually benign

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6
Q

Name two causes of non-infectious meningitis

A

1) chemical (usually post-op)

2) cancer

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7
Q

Which organisms most often cause meningitis in newborns?

A

Group B strep

E.Coli

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8
Q

Which organisms most often cause meningitis in babies (1 month to 1 year)

A 
Strep pneumoniae
Haemophilus influenzae (although less common now due to immunization)
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9
Q

Which organisms most often cause meningitis in young people (1- 16 yrs old)?

A

Neisseria meningitidis
H. influenzae
Strep. Pneumoniae

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10
Q

Which organisms most often cause meningitis in adults (16-50 years old)

A

Strep pneumoniae

Neisseria Meningitidis

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11
Q

Which organisms most often cause meningitis in newborns and the elderly?

A

Listeria monocytogenes

Pseudomonas aeruginosa

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12
Q

How are protein levels of CSF affected by viral meningitis?

A

slightly high

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13
Q

Name 4 major causes of chronic meningitis

A

Tuberculosis
Fungal
Parasitic
Non-infectious - cancer

..Also technically syphilis and Borreliosis

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14
Q

Which infectious agent causes a thick exudate at the base of the brain leading to CN deficits?

A

TB

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15
Q

How are CSF protein levels affected by TB?

A

Moderately high

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16
Q

How are CSF glucose levels affected by TB?

A

Moderately low

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17
Q

Name two ways a fungal infection can lead to secondary vasculitis

A

1) Vascular invasion –> infarct

2) Mycotic aneurysm –> hemorrhage

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18
Q

Name two characteristic findings of a gross dissection of a brain infected with cryptococcus

A

1) Thickened, pale meninges

2) Clear cystic lesions in the basal ganglia –> “swiss cheese” effect

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19
Q

Describe the inflammation of cryptococcus in the brain

A

focal and limited

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20
Q

How do cryptococci appear in virchow-robbins space in the brain?

A

Clear yeasts with a mucoid capsule

21
Q

What is a mycotic aneurysm?

A

Aneurysm arising from fungal or bacteria infection of the arterial wall

22
Q

What is the most common cerebral parasite?

A

Cysticercosis

23
Q

Where is cysticercosis found?

A

Southwestern states and Mexico

24
Q

What type of parasite is toxoplasma gondii?

A

Protozoa

25
Q

Which are the TORCH infections?

A

Toxoplasmosis, Other, Rubella, CMV, Herpes Virus

26
Q

What is the “classic triad” or TORCH infections?

A

chorioretinitis, hydrocephalus, and intracranial calcifications

27
Q

How can toxoplasmosis be identified?

A

Serology, Biopsy

28
Q

How does Toxoplasmosis appear on H and E?

A

Bradyzoites

29
Q

Which virus is the most common cause of viral meningitis?

A

Enterovirus

30
Q

What are some microscopic changes seen in viral hepatitis?

A

Lymphocytic meningeal infiltrates/inflammation
Scanty perivascular lymphocytic extension along the Virchow-Robins space
Microglial clusters
Neuronophagia

31
Q

Does encephalitis tend to be diffuse or regional?

A

Can be either

32
Q

What is the most common cause of encephalitis?

A

Viral infections

33
Q

Which are the primary WBCs seen in a viral encephalitis?

A

T-lymphocytes

Some PMNs can be present in the acute phase

34
Q

What part of the CNS is attacked by the polio virus

A

anterior horn cells –> LMN lesion

35
Q

Where is the polio virus recovered from in a patient?

A

Stool or throat

36
Q

What is the incubation period of rabies?

A

10 days –> year depending on where the bit was located

37
Q

Which are the characteristic histologic findings of rabies?

A

Negri bodies (cytoplasmic inclusions) seen in neurons of the brainstem, hippocampus and cerebellum (Purkinje cells)

38
Q

How is herpes encephalitis transmitted?

A

Saliva

39
Q

Where do latent infections of herpes hang out in the body?

A

Trigeminal ganglion

40
Q

Which lobes does herpes encephalitis localize to?

A

Temporal lobes

Hemorrhagic necrosis of the temporal lobe suggestive of herpes encephalitis. Usually accompanies brain edema

41
Q

What is the characteristic histologic finding of a herpes (HSV-1) inclusion body?

A

owl’s eye

42
Q

What does the chronic form of a herpes HSV-1 infection look like on gross images?

A

“Burnt out” herpes encephalitis –> hemorrhagic necrosis which progresses to cavitation and atrophy. in long term survivors, necrosis will progress to cavitation and atrophy

43
Q

What population is affected by CMV?

A

CMV is one of the TORCH infections (so, neonates)

Also commonly affects AIDS patients

44
Q

WHat are common histologic findings in CMV infections?

A

Large intracytoplasmic and intranuclear inclusion bodies

45
Q

How does the gross appearance of brain appear in someone with a CMV infection?

A

Moderately dilated ventricles with several foci of calcifications in the periventricular area

46
Q

Which infectious agent is responsible for causing Progressive Multifocal Leukoencephalopathy?

A

JC virus- genus polyomavirus

Usually affects immunocompromised, and reversive the immunocompromised state can clear the infection

47
Q

Name 3 histological findings typical of PML.

A

1) Loss of myelin (with axonal sparing)
2) Bizzare astrocytes
3) Oligodendroglial inclusion

48
Q

Describe the HIV induced vaculolar myelopathy

A

Spastic paraparesis with hyperreflexia and ataxia
Vacuolation of spinal cord white matter

Resembles subacute combined degeneration due to B12 deficiency, and viral antigens can not usually be detected

49
Q

List the timing of the 4 stages of a brain abscess

A

1) Early cerebritis (days 1-3)
2) Confluent necrosis (day 2-7)
3) Early encapsulation (days 5-14)
4) Late encapsulation (2 weeks +)

MHD- Neuro (19 decks)

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