Introduction Flashcards

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1
Q

What are the 5 classes of CNS infectious diseases

A
  1. meningitis
  2. Encephalitis
  3. Mass Lesions
  4. Neurotoxemia-Tetnus
  5. Prion
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2
Q

What are the classes of PNS diseases

A
  1. Neurotoxemia-botulism
  2. Leprosy
  3. Guillain-Barre’ Syndrome
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3
Q

What is menigitis

A

meningeal inflammation resulting from an infection of the subarachnoid space

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4
Q

what is encephalitis

A

inflammation of the brain parychema

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5
Q

what is mass lesion/abcess

A

macroscopic in size and of sufficient mass to press against normal brain tissue which increases ICP and causes focal seizures

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6
Q

what does the CT show in mass lesion/abcess cases

A

ring-enhancing (mass) lesion which is used for dx

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7
Q

what is leprosy

A

infection of the sensory nerves

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8
Q

what is Guillain-Barre’ Syndrome

A

demylenation of PNS

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9
Q

what is botulism

A

toxin that inhibits nerves at NM junction

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10
Q

what are the two types of prion disease

A

new variant CJD -prion of bovine spongiform encephalitis

CJD-Human prions

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11
Q

what class of organism causes the most amount of meningitis

A

viruses

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12
Q

what class of organism causes the 2nd most amount of meningitis?

A

bacteria

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13
Q

what disease simulates S&S of meningitis but it is a neurotoxemia

A

tetnus

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14
Q

Focal encephalitis is caused by primarily?

A

HSV-1 which is treatable with antiviral

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15
Q

Diffused encephalitis is caused by primarily?

A

arbovirus

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16
Q

what is encephomyelitis

A

inflammation of brain parenchyma with inflammation of the spinal cord

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17
Q

what is encephomyelitis majorily caused by

A

poliovirus and West Nile virus

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18
Q

What are the slow virus encephalitis diseases

A

HIV-1-associated cognitive/motor complex
Progressive multifocal leukoencephalopathy
subacute, sclerosing panencephalopathy

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19
Q

what are the etiologic agents that cause abcesses

A

s. aureus, anaerobes

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20
Q

what causes neurocysticerosis

A

taenia solium

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21
Q

what causes toxoplasmosis

A

toxoplasma gondii

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22
Q

what are the common causes of purulent/pyogenic meningitis which often results in severe disease? (age-dependent) (7)

A
  1. Neisseria meningitidis
  2. S. pneumoniae
  3. Hib
  4. S. agalactiae
  5. E. Coli K1
  6. Klebsiella pneumoniae
  7. listeria monocytogenes
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23
Q

Common causes of bacterial encephalitis &/or mass leisions (4)

A
  1. mycoplasma pneumoniae
  2. listeria monocytogenes
  3. s. aureas
  4. anaerobic infections
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24
Q

Common causes of Neurotoxic diseases (2)

A

Clostridium Botulism

C. tetani

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25
Q

Common causes Aseptic meningitis (age-dependent) (8)

A
  1. HHV 6/7
  2. non-polio enteroviruses
  3. arbovirus
  4. HSV-2
  5. Lymphocytic choriomeningitis virus (LCM)
  6. HIV (only in sex/ IVDU)
  7. Mumps virus (vaccine)
  8. Polio (vaccine)
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26
Q

what age does aseptic HHV 6/7 meningitis occur in

A

infants and children less that 2

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27
Q

what age does aseptic non-polio enterovirus meningitis occur in

A

more common in children, but severe in adults

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28
Q

what are examples of non-polio enterovirus

A

ECHO
Coxsackie
Enterovirus 68-71

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29
Q

what age does aseptic arbvirus meningitis occur in

A

infect children and other adults

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30
Q

what age does aseptic LCM virus meningitis occur in

A

either children (rodents as pets) or adults (dust eating virus)

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31
Q

Who gets aseptic HIV meningitis

A

sexual activity and IVDU

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32
Q

who gets aseptic mumps meningitis

A

adolescents who do not get immunized

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33
Q

who gets aseptic polio meningitis

A

infants- young adults who do not get immunized

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34
Q

viral encephalitis etiology (9)

A
  1. HSV-1
  2. arbovirus
  3. rabies
  4. polio
  5. non-polio enterovirus
  6. HIV
  7. JC virus
  8. Measles
  9. VZV & CMV
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35
Q

What is the most common cause of epidemic diffuse encephalitis and in what time of year does it occur

A

arbovirus

summer/fall months

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36
Q

what are the different types of arbovirus (7)

A
EEEV
WEEV
SLEV
La Cross virus
WNEV
POWV
Coltiviruses
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37
Q

etiology of focal encephalitis

A
  1. HSV-1 (year round)
  2. arbovirus and the non-polio enterovirus
  3. Rabies Virus
  4. polio and WNEV ( encephalomyelitis)
  5. CMV
  6. VZV
  7. JC (John Cunningham) virus and PML
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38
Q

common fungi agents in CNS diseases?

A

Cryptococcus- a meningoencephalitis
Candida- meningitis
Coccidioides immitis- a meningoencephalitis

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39
Q

Agents that can affect a person with humoral diffeciency

A
  1. s. pneumoniae
  2. s. agalactiae
  3. Hib
  4. N. meningitidis
  5. E. Coli K1
  6. K. pneumoniae
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40
Q

Agents that can affect a person with Cell-mediated deficiency

A
  1. listeria monocytogenes
  2. Toxoplasma gondii
  3. cryptococcus neoformans
  4. CMV
  5. JC virus and PML
  6. HIV
  7. LCMV
  8. E. Coli K1?
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41
Q

Why is diagnosing Infectious diseases in elderly patients difficult?

A
  1. hypothermic so don’t present with fever
  2. neck arthritis so already manifest with nuchal ridgidity
  3. dementia can masks
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42
Q

How should you approach a newborn with fever

A

lumbar puncture

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43
Q

Nosocomial related infectious diseases

A

IVC

cochlear implants

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44
Q

bacteria carraige in nasopharynx and humans are only host

A

s. peumoniae
Hib
N. menegitidis
s. agalactiae (also vagina, GIT, skin)

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45
Q

bacteria carriage in nares

A

s. aureus

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46
Q

bacteria carriage in humans mostly on mucosal surfaces

A

endogenous anaerobic flora

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47
Q

bacterial carriage in humans mostly in colon

A

s. agalactiae
E. coli
K. pneumoniae
Listeria monocytogenes

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48
Q

bacterial carriage in humans mostly in colon with migration to vagina

A

s. agalactiae
e. coli
k. pneumoniae

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49
Q

Animals and humans are reservoir for which bacteria:

A
E. coli K1
K. pneumoniae
L. monocytogenes
M. leprae
S. agalactiae
S. aureus (humans mostly source of infection)
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50
Q

Reservoir for c. tetani

A

soil

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51
Q

reservoir for c. botulinum

A

soil, water, animal

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52
Q

reservoir for L. moncytogenes

A

everywhere

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53
Q

Viral Zoonosis

A

Arbovirus- animals and arthropods
Rabies- mammals
LCMV- mammals esp. rodents

54
Q

humans are sole reservoir for which viruses

A
enterovirus
measles
herpes virus
HIV
JC and BK viruses
mumps
55
Q

what is the reservoir for cryptococcus neoformans

A

soil and bird

56
Q

what is the reservoir for toxoplasma gondii

A

aminal

57
Q

what is the reservoir for taenia solium

A

pig an human

58
Q

what is the reservoir for naegleria fowleri

A

warm water

59
Q

what is arbovirus Mode of Transmission (MOT)

A

animals and arthropods

60
Q

what is rabies MOT

A

bat , racoon, skunk, and Dog

61
Q

what is LCMV MOT

A

rodent

62
Q

what agents have MOT of through tainted food

A

BOvine spongiform encephalopathy prion
Taenia solium ( not directly to CNS)
toxoplasma gondii

63
Q

Fecal-Oral MOT

A
taenia solium
Tocoplasma gondii
enterovirus
listeria
LCMV
64
Q

in-utero transmission

A
s. agalactiae
listeria (more common)
non-polio enterovirus
LCMV
Toxoplasma
rubella
CMV (more common)
HSV (more common)
65
Q

Parturition transmission

A
s. agalactiae (more common)
listeria monocytogenes
E. Coli
K. pneumoniae
HSV/CMV
66
Q

inhalation of dust transmission

A

cryptococcus neoformans

LCMV

67
Q

CNS infectious diseases agents that cause close contact outbreaks

A

hib
meningococcus
Non-polio enterovirus
T. solum

68
Q

Predisposing factor of anaerobes

A

endogenous flora

69
Q

Predisposing factor of arbovirus

A

exposure to mosquitoes; ticks

70
Q

Predisposing factor of cryptococcus neoformans

A

bird droppings

71
Q

Predisposing factor of HSV-1

A

reactivation of latent infection

72
Q

Predisposing factor of HSV-2

A

sexual contact

73
Q

Predisposing factor of HIV

A

blood/ sex

74
Q

Predisposing factor of LCMV

A

rodents, droppings secretions and fluids

75
Q

Predisposing factor of listeria monocytogenes

A

animals, food

76
Q

Predisposing factor of Measles-SSPE

A

humans exposure before 1yo

77
Q

Predisposing factor of mycobacterium leprae

A

animals and humans

78
Q

Predisposing factor of mycobacterium tuberculosis

A

human exposure

79
Q

Predisposing factor of N. meningitis

A

human exposure, terminal complement deficiency

80
Q

Predisposing factor of non-polio enterovirus

A

human feces

81
Q

Predisposing factor of naegleria fowleri

A

fresh water with algae

82
Q

Predisposing factor of polio entervirus

A

human feces

83
Q

Predisposing factor of rabies

A

amimal exposure

84
Q

Predisposing factor of s. aureus

A

another person

85
Q

Predisposing factor of s. agalactiae

A

LBW, membrane rupture membrane >1 day before delivery vaginal colonization

86
Q

Predisposing factor of s. pneumoniae

A

congenital csf leak

87
Q

Predisposing factor of t. solium ova

A

human feces

88
Q

Predisposing factor of t. solium cysticerci

A

undercooked pork

89
Q

Predisposing factor of toxoplasma oca

A

cat feces

90
Q

Predisposing factor of toxoplasma pseudocyst

A

uncooked meat

91
Q

bacteria with year round seasonality

A

s. agalactiae
e. coli k1
k. pneumoniae

92
Q

bacteria with summer seasonality

A

listeria

93
Q

bacteria with late winter-early spring seasonality

A

Hib

n. meningitidis
s. pneumoniae

94
Q

virus with year round seasonality

A

Herpes (including CMV)
HIV
Rabies

95
Q

virus with late summer early fall seasonality

A

ECHO and Coxsackie virus
Polio virus
arbovirus

96
Q

virus with winter seasonality

A

LCMV

97
Q

most common causes of congenital infections

A
TORCH
Toxplasma
Rubella
CMV
HSV 1, 2
98
Q

what is the leading cause of infection and morbidity in the neonate

A

CMV

99
Q

bacterial agent by age: neonate

A
  1. s. agalactiae
  2. E. Coli K1
  3. L. monocytogenes
  4. K pneumoniae
100
Q

bacterial agent by age: infant to adult

A
  1. n. menegitides

2. s. pneumoniae

101
Q

bacterial agent by age: elderly

A
  1. n. menigitides
  2. s. pneumoniae
  3. listeria monocytogenes
102
Q

agents that have intra-axonal transport inside nerves

A

rabies
herpes
polio
tetnus toxin

103
Q

signs and symptoms of any neonatal meningitis

A
fever
lethergy
poor feeding
gi disturbances
resp. abnormalities
cardiac abnormalities
bulging fontanelle
104
Q

signs and symptoms of any meningitis > 2yo

A
irritability
lethargy
fever
rash
progressive of symptoms which can show progression to meningoencephalitis
105
Q

5 different signs of meningeal inflammation

A
Nuchal ridity
Kernig sign
Brudzinski sign
Opisthotonos
Hoyne Sign (Amoss, Tripod position)
106
Q

agents that cause a maculopapular rash

A
non-polio enterovirus
arbovirus 
HSV
s. pneumoniae
N. meningitides 
Hib
107
Q

agents that cause a vesicular rash

A

HSV
fungi
non-polio enterovirus

108
Q

agents that cause a petechial/purpuric rash

A

s. pneumoniae
n. meningitides
Hib

109
Q

what is encephalopathy

A

altered consciousness lasting >24hrs

110
Q

Encephalitis is encephalopathy plus 2 or more of the following symptons

A
fever
seizures
altered mental status
severe headache
focal neurologic indins
CSF pleocytosis
abnormal neuroimaging
111
Q

signs and symptoms specifically for neonate sepsis or encephalitis include

A
same as meningitis:
fever
lethargy
poor feeding
gi disturbances
cardiac abnormalities
Resp. abnormalities
Bulging fontanelle
112
Q

signs and symptoms of a mass lesion

A
fever 
headaches 
seizures- focal or tonic-clonic
focal signs
altered mental status
113
Q

what three syndromes are considered floppy (hypotonic) paralysis

A

Gullain-Barre’ Syndrome
Botulism
Polio virus- kills neurons

114
Q

what syndrome is considered spastic (hypertonic) paralysis

A

tetanus

115
Q

treatment for c. tetenaii

A

metronidazole

116
Q

treatment for e. coli

A

metronidazole

117
Q

treatment for hib

A

cetriaxone, cefotaxime, or TMP-SMX

118
Q

Treatment for listeria

A

ampicillin plus gentamycin or TMP-SMX

119
Q

treatment for k. pneumoniae

A

ampicillin plus gentamycin or TMP-SMX

120
Q

tx for m. leprae

A

dapsone plus rifampin or clofazimine

121
Q

tx for n. meningitidis

A

ceftriaxone or ceftaxomine

122
Q

tx for s. pneumoniae

A

vancomycin plus extend spectrum cephalosporin

123
Q

tx for s. agalactiae

A

Penicillin G

124
Q

tx forToxoplasma gondii

A

sulfonamides or clindamycin plus pyrimethamine

125
Q

tx forcryptococcus neoformans

A

amphotericine B with 5-fluorocytosine

126
Q

tx for HSV

A

acyclovir

127
Q

tx for non polio enterovirus

A

pleconaril

128
Q

tx for Naegleria fowleri

A

miltefosine

129
Q

tx for Neurocysticercosis

A

niclosamide, praziquantel, albendazole

130
Q

which CNS agents do vaccines exist for:

A
s. pneumoniae
Hib
n. meningitides
polio
rabies
botulism
tetanus
measles
mumps