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Neuro 1 > Intro to NS Inf Diseases > Flashcards

Intro to NS Inf Diseases Flashcards

1
Q

3 major functions of nervous system

A

sensory, integrative, motor

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2
Q

immunologically privileged

A

mount a partial or different immune responses when exposed to immunologic challenges

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3
Q

Microglial cells

A

derived from monocyte cells
tissue-resident macrophages of CNS
inflammatory macrophages (but less?), also activate T lymphocytes as APC.
TLR2 and TLR9

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4
Q

Microglial cells express high levels of ____ and _____

A

TLR2 and TLR9

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5
Q

TLR2

A

recognizes peptidoglycans, lipoproteins…

gram + bacteria, trypanosomes (bruceii – ASS)

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6
Q

TLR9

A

recognizes CpG unmethylated dinucleotides, dinucleotides, herpes virus components, hemozoin

bacterial DNA, some herpesviruses, malaria parasite heme byproduct

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7
Q

Normal biota of CNS

A

none?

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8
Q

Defense of CNS

A

body structures (bone), blood-brain barrier, microglial cells, macrophages

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9
Q

Inflammation of meninges =

A

meningitis

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10
Q

____ (#) organisms cause meningitis

A

many

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11
Q

more serious meningitis caused by _______ (organism type)

A

bacteria

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12
Q

Initial infection facilitated by _______ –> meningitis

A

Upper respiratory infection

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13
Q

When meningitis is suspected, _______ (test)

A

lumbar puncture

CSF gram-stained and potentially cultured

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14
Q

Sxs meningitis

A

photophobia, headache, painful and/or stiff neck, fever, usually increased WBC in CSF

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15
Q

Empiric treatment for meningitis

A

Covers N. meningitidis d/t high fatality rate

Ceftriaxone

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16
Q

Major causes of meningits

A 
N. meningitidis
Strep pneumoniae
H. influenzae
Listeria monocytogenes
Cryptococcus neoformans
Coccidioides immitis
variety of virus
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17
Q

gram-negative diplococci (remember N. gonnohhreae). Associated with epidemic forms of meningitis. Most serious form of acute meningitis. Portal of entry for this pathogen is through the upper respiratory tract.

A

N. meningitidis

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18
Q

N. meningitidis type of bacteria

A

gram-negative diplococci

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19
Q

N. meningitidis associated with ___ forms of acute meningitis

A

epidemic, most serious form

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20
Q

portal of entry for N. meningitidis

A

upper respiratory tract

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21
Q

Gram-positive coccus - most common cause of bacterial pneumonia. Most frequent cause of community-acquired meningitis. Often associated with alcoholics, sickle-cell individuals, or those with absent of deficient spleen function.

A

S. pneumoniae

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22
Q

S. pneumoniae type of bacteria

A

Gram + coccus

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23
Q

gram-negative coccobacillus. Human only pathogen. Also starts as an upper respiratory infection.

A

Haemophilus influenzae

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24
Q

H. influenzae type of bacteria

A

gram-neg coccobacillus

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25
Q

route of entry H influenza

A

upper respiratory infection

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26
Q

gram-positive bacterium. Listeriosis in elderly, immunocompromised patients, fetuses, neonates affects the brain and meninges. Death rate 20%

A

Listeria monocytogenes

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27
Q

L. monocytogenes type of bacteria

A

gram + bacterium

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28
Q

chronis menigitis. (unless immunocompromised). Fungus. Most common reservoir is in the bird population. Prevalent in urban areas (pigeons). Proliferates in bird poop. Dried yeast cells spread via the wind, etc. Portal of entry is the lung.

A

Cryptococcus neoformans

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29
Q

Cryptococcus neoformans is a ______

A

fungus

30
Q

C. neoformans portal of entry

A

lung

31
Q

fungal infection. Begins as a fungal infection of the lungs but can quickly turn into a systemic infection. Can also cause osteomyelitis and skin granulomas. Most common in the Southwest of the US.

A

Coccidioides immitis

32
Q

Coccidioides immitis is a ______

A

fungus

33
Q

Most common causes of neonatal/infant meningitis

A 
strep agalaciae (group B strep) and e. coli
Cronobacter sakazakii
34
Q

Gram-negative bacillus. Most commonly found in the environment. Outbreaks are associated with contaminated powered infant formula. Mortality rates can be as high as 40%.

A

Cronobacter sakazakii

35
Q

C. sakazakii type of bacteria

A

gram neg bacillus

36
Q

Encephalitis also involving the meninges. Two structures are closely connected. Infections of these structures can involve each other.

A

meningoencephalitis

37
Q

2 major causes of meningioencephalitis (specifically)

A

Naegleria fowleri

Acanthamoeba

38
Q

associated with swimming in warm, natural bodies of fresh water. Infection starts in nasal passages. Uses the olfactory nerve to travel to the brain. In the brain it uses the CSF to further infect other tissues.

A

Naegleria fowleri

39
Q

– invades broken skin, conjunctiva, lugs and urogenital epitheilia. Enviornmental exposures.

A

Acanthamoeba

40
Q

Acute encephalitis is almost always a ______ infection (examples)

A

viral
Arboviruses and herpesviruses most common
Also JC virus, measles, other childhood rash-associated diseases

41
Q

Symptoms acute encephalitis

A

Vary, include behavior changes and confusion, decreased consciousness, and seizures. Symptoms related to meningitis are also common.

42
Q

Tx acute encephalitis

A

Swift therapy with acyclovir can save patients with herpersvirus encephalitis. Empiric therapy with acyclovir is common with suspected encephalitis.

43
Q

Example of arbovirus –> encephalitis

A

west nile

44
Q

Herpes Simplex Viruses and Acute EE

A

HSV positive mothers can cause neonatal encephalitis in newborns. Past the age of 5 HSV 1 predominates. Usually a reactivation of dormant HSV from the trigeminal ganglion. Rarely VZV can also be involved.

45
Q

JC virus and Acute EE

A

polyomavirus w/ seropos rates near 80% in US
immune dysfunction –> progressive multifocal leukoencephalopathy (PML)
uncommon, generally fatal

46
Q

When encephalitis symptoms take longer to show up and when the symptoms are less striking, the condition is known as _______

A

subacute encephalitis

47
Q

Most common cause of subacute EE + other causes

A

Toxoplasma gondii

persistant measles virus (subacute sclerosing panencephalitis), prions (spongiform encephalopathy)

48
Q

slow, progressive zoonotic disease that causes fatal encephalitis

A

rabies, caused by rabies virus

49
Q

average incubation of rabies

A

1-2 months
depends on wound site and inoculation dose
if near scalp/neck, shorter than if distally

50
Q

Symptoms rabies

A

with fever, headache, vomiting, fatigue, and other nonspecific symptoms –> agitation, disorientation, seizures, and twitching. This is followed by hydrophobia and progressively worsening neurological symptoms leading to coma and death.

51
Q

rabies virus causative agent

A

ssRNA (-) virus

52
Q

rabies virus encounter, reservoir

A

zoonotic (animals) –> humans

mostly wild animals (raccoons, skunks, coyotes, foxes, bats, also domestic animals)

53
Q

rabies mode of transmission

A

The virus, present in the saliva of rabid animals, enters the body through a wound from a bite or through contamination of mucous membranes by the infected saliva. The virus multiplies at the site of inoculation and then travels to the CNS.

54
Q

dx rabies

A

Observation of tissue samples (brain or corneal tissue) using immunological tests that detect rabies, observation of characteristic inclusion bodies (Negri bodies) in the cytoplasm of nerve cells obtained in tissue samples are taken as confirmation of rabies.

55
Q

Tx rabies

A

rabies immune globulin (Ab, RIG, buys time for vaccine) at site, intramuscular

inactivated rabies virus prep (antigen)

56
Q

rabies prevention

A

vaccine w/ inactivated rabies for humans and animals

57
Q

Acute enteroviral infection of the spinal cord that can cause neuromuscular paralysis.

A

poliomyelitis

58
Q

Tetanus caused by

A

clostridium tetani

59
Q

c. tetani found in

A

soil, GI tracts of animals

60
Q

C. tetani kind of bacteria

A

gram + endospore-forming rod

obligate anaerobe

61
Q

C. tetani endospores

A

Endospores it
produces often swell the vegetative cell but are only produced under anaerobic conditions (need deep seeded wounds, poor blood supply)

62
Q

C. tetani releases _______

A

neurotoxin = tetanospasmin

63
Q

tetanospasmin action

A

binds to target sites on peripheral motor neurons, on the spinal cord and brain, and in the sympathetic nervous system.
The toxin acts by blocking the inhibition of muscle contraction. Without inhibition of contraction, the muscles contract uncontrollably, resulting in spastic paralysis.

64
Q

sxs tetanus

A

clenching of jaw
succession by extreme arching of back, flexion of arms, extension of legs
risus sardonicus (eery smile)
death by respiratory arrest

65
Q

tetanus tx

A

is aimed at deterring the degree of toxemia and infection and maintaining patient homeostasis.
immediately receive antitoxin therapy with human tetanus immune globulin (TIG). Penicillin G is also administered.
cleanse/remove affected tissue to get rid of bound toxins
support tx (respirator, trach)

66
Q

Botulism caused be

A

Clostridium botulinum

67
Q

common cause of death in livestock that havegrazed on contaminated food and in aquatic birds that have eaten decayed vegetation.

A

botulism (associated with eating poorly preserved foods)

68
Q

Botulinum mechanism of action

A

prevent the release of the acetylcholine, the neurotransmitter that initiates the signal for muscle contraction

69
Q

onset botulism

A

12-72 hrs depending on dose amt

70
Q

botulism sxs

A

Neuromuscular symptoms first affect the muscles of the head and include double vision, difficulty in swallowing, and dizziness, but there is no sensory or mental lapse. Although nausea and vomiting can occur at an early stage, they are not common. Later symptoms are descending muscular paralysis and respiratory compromise.

Neuro 1 (13 decks)

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