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Neuro 1 > Infections of the Nervous System > Flashcards

Infections of the Nervous System Flashcards

1
Q

Meningitis

A

Infection of the coverings of the brain

Particularly the leptominges (arachnoid and pia)

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2
Q

Acute and subacute/chronic meningitis

A

Acute - bacterial

Subacute/chronic - myco/fungal

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3
Q

Meningococal clinical feature

A

Rash

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4
Q

W-F syndrome

A

N. menin mostly

Speticiemia with rash and necrotic adrenals

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5
Q

Lab findins in bacterial meningitis

A

Increased protein and WBCs (neutrophl) and decreased glucose

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6
Q

Most adults form of meningitis

A

S. pnuemo

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7
Q

Nsocomial mening

A

Gram positive bugs (skin)and gram negative rods

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8
Q

Bacterial meningitis gross

A

Swollen cortex with congested vessels and visible exudae

Can have subdural effusion that can become empyema

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9
Q

Penumo, TB locations

A

Pneumo - convexities

TB - base brain

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10
Q

Bac meningitis microscopic

A

Acute inflammation of leptomeninges extending into the parenchymal vessles sometimes

Venous thrombosis, infarction in neonates

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11
Q

Bacterial menin mortalities and complications

A

Worse in neonates

Cerebral edema and herniation
INfarction
Hydrocephalus
Subdural effusions and empyemas

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12
Q

Mycobacterial meningitis

A

Basilar - hydrocephalus and cranial nerve deficitis

CHronic

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13
Q

Viral mening

A

Enterovirus
Inflammation only lymphocytes
Use PCR and IgM

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14
Q

Cryptococcus

A

Most commin in US
Most often basilar
Slimy film with huge capsule
Varible inflammation

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15
Q

Epidemic/sporadic/ immunosuppressed viral enceph

A

Epi - arbo/entero
Sporadic - HSV, rabies
Immuno - PML

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16
Q

Epidemic vial enceph diagnosis

A

Incubation less than 1 week

Use PCR or IgM

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17
Q

Microscopic and gross viral encepha

A

Gross - not very helpful

Microscopic - chronic inflammation, neuronophagia and microglial nodules

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18
Q

HSV

A 
Most common sporadic
If over 3 mos, frontal and temporal
Neonates - panencephalitis 
Olfactory seizures 
MRI will higlight frontotemporal invovlement

Asymmetric

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19
Q

HSV microscopic

A

Will have neuronophagia and microglial nodules PLUS inclusions

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20
Q

Outcomes of HSV

A

Worse in non-neonatal

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21
Q

Rabies progression

A

Incubation of 10days-1year in skeletal muscle and crawls to reach spinal cord

Prodrome - flu like symtpoms and pain

Acute neurologic dz - furous or dumb

Terminal - death and coma

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22
Q

Rabies gross and microscopic

A

Gross- normal

Micropsopic - negri bodies (purkinje cells) and minimal inflammation

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23
Q

Diagnosis and tx of rabies

A

Mostly clinical history

Passive antibody and rabies vaccine prior to symptoms…after, just symptomatic therpay

24
Q

PML

A

Cause by JC reactivation

Focal neurologic deficits

25
Q

PML diagnosis

A

MRI findings of white matter disruption…CSF PCR

26
Q

PML gross and microscopic

A

Asymmetric gray lesions in white matter

Foci of demyelination…bizarre astrocytes

27
Q

Tx and prognosis of PML

A

Death

Supportive, maybe HAART therapy

28
Q

Absecess

A

Most through local extension, some through hematoenous

29
Q

Bacterial absecess

A

Anaerobes, mixed infections

Immunocomprosimed - nocardia, mycobacteria, listeria

30
Q

Aspergillus abscess

A

Love blood vessels, normally from lung infection, small angles and thin

31
Q

Zygomycetes abscess

A

Usually orbitofrontal
Poorly controlled DM
Looks like balloon animal

Rhizopus, mucor, absidia

32
Q

PAM

A

Primary amebic meningoencephalitis (Naegleria fowelri)

48-72 hours and death

33
Q

Granulomatous amebic encephalitis

A

Acanthamoeba or balamuthia

Heme spread from lung infections

34
Q

Toxoplasma

A

Associated with HIV or neonates…risk of infection most in last trimester but damage greatest in 1st

35
Q

Toxoplasma appearance

A

Cysts and tachyzoites…can immunostain

Mononuclear inflammation

36
Q

Lyme dz

A

Borrelia burgdorferi
Ixodes tick
Northern regions

37
Q

Lyme dz clinical

A

Can cause Bell’s palsy…skin target rash…meningitis like
Stage 1 - flu like smyptoms
2 - systemic
3 - chronic

38
Q

Lyme dz diagnsosi

A

ELISA screening with west blot

39
Q

Herpes zoster symtpoms

A

1st - preherpetic neuralgies (pain, itching in dermatome)

2nd - vesicular rash

40
Q

Ramsay hunt syndrome

A

Facial paralysis associated with zoster…has a motor compoenent

41
Q

Herpes zoster tx

A

Use zostavax as a vaccine

42
Q

Spinal cord and brain HIV

A 
Vacuolar myopathy (just like B12)
HAND - HIV-associated neurocog disorders...dementia
43
Q

HIV-associated ementia pathology

A

Monocytes/macrophages cross BBB

Leukoencephalopathy, with classic multinucleated giant cells

44
Q

Neurosyphilis

A

Men>Women

Insidious attnetion disorders progress

Atrophic brain with thickend meninges

Will see some infllamtion

45
Q

Tabes dorsalis

A

Chronic involvement of DRG

Lighting pain and loss of painproprioception

Shuffling, broad-based gait

Argyll-Robertson pupil - small accomdates, but doesn’t react to light

46
Q

Tabes dorsalis microscopic

A

Lose posterior column fibers

47
Q

Testing for neurosyphilis

A

Early all might be positive…late, may be falsely negative

CANNOT culture

48
Q

Prion dzs

A

PrPsc alters PrPc conformation

Auto dom

49
Q

Most common prions

A

CJD and vCJD (mad cow)

50
Q

Prion dz pathology

A

Neuronal loss with glial proliferation

NO inflammation

Spongiform change

51
Q

CJD clinical

A

Rapid mental eterioration

Myoclonus

Six phenotypes based on codon 129 in the PRNP gene (methionine and valine)

52
Q

CJD lab studies

A

14-3-3 protein in CSF
Tau (CSF)

These are not good

53
Q

CJD imaging

A

Sporadic - basal ganglia

Variant - thalamus

54
Q

CJD diagnositc

A 
2 of 4:
Myoclonus
Visual/cerbeellar distrubs
Pyramid/extrapyramidal dysfunction
Akinetic mutism

Atepyical EEG or pos 14-4-4
Others ruled out

55
Q

vCJD symptoms

A

Psych symptoms
Ataxia
Upward gaze paresis is unique

56
Q

vCJD neuropath

A

Amyloid plaques with spongiform changes

Can use tonsillar biopsy

57
Q

Prion prognosis

A

No tx…vCJD - 14 mos, sCJD - 4-5 months

Neuro 1 (22 decks)

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