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Medical Microbiology > Lecture 5: Infectious Disease Affecting the Nervous System > Flashcards

Lecture 5: Infectious Disease Affecting the Nervous System Flashcards

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Biology 101 flashcards USMLE® Step 1 flashcards
1
Q

BBB

A
  1. allows passage:
    a. water
    b. some gases
    c. lipid-soluble molecules
    all by passive diffusion
  2. selective transpor amino acids
  3. tight junctions create barrier
  4. prevents entry lipohillic potential neurotoxins and pathogen
  5. major consideration when choosing therapy
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2
Q

P glycoprotein

A

gatekeeper of BBB

-can be an issue for abx

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3
Q

Acute bacterial meningitis

A

rapidly developing bacterial infection of meninges

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4
Q

Most dangerous form ABM caused by what pathogen?

A

Neisseria Meningitidis causes meningococcal meningitis

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5
Q

Neissiera meningitis characteristic

A

aerobic, g(-) diplococcus

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6
Q

Neissiera meningitis

transmission
prevalent where
prevention

A

t: person-person transfer of large droplet respiratory secretions
prevalent: where people are in close proximity for long periods time: jails, ,college dorms, military camps, etc

prevention: vaccine fo r kids and adults
- menveo, menacer, minenrix (with tetanus)`

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7
Q

Streptococcus pnuemoniae

  1. characteristics
  2. causes what disease
  3. what %
    - mortality %
  4. prevention
A

causative agent for bacterial meningitis

  1. pairs or short chains
  2. causes pneumococcal meningitis as well as pneumonia
  3. 30% ABM cases
    - high mortality rate 20-30%
  4. VAX- pnemovax >64 yrs, prevanar 13 for < 5 years or > 64 years
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8
Q

Pneumovax 23

A

> 64 years

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9
Q

Prevnar 13

A

pneumococcal vaccine <5 yrs or > 64 yrs

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10
Q

Haemophilus inlufenzae type B

A
  1. once most prevalent species causing bacterial meningitis in american children but now there ic vaccine
  2. less than 40 cases of homophiles meningitis in US
    - VACCINE
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11
Q

Pathogenic steps leading to meningitis

A
  1. organism disseminates, rash appears
    bright red patches -> blue black spots
  2. once in blood, organisms pass BBB
  3. meninges becomes inflamed
  4. pressure on spinal cor and brain casue fever and stiff neck
  5. N/V/
  6. sensitivity to bright light
  7. can die within hours
    * petechaie and purpura
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12
Q

3 organisms causing Meningitis

A
  1. haemophilus influenzae
  2. streoptoccus pnemoniae
  3. neissieria meningitis
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13
Q

ABM IS MEDICAL EMERGENCY (4)

A
  1. early dx and tx are crucial to prevent disabilities and death
  2. seriousness demands tx before results of diagnostic tests are known
  3. IV OF PENICILLIN, CEFOTAXIME, CEFTRIAXONE
  4. vaccines exist but no single vaccine provides immunity to all forms of meningitis
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14
Q

Clinical presentation meningitis

A
  1. HA
  2. Stiff neck
  3. fever
  4. altered mental status
  5. coma
  6. brudzinski’s sign and kernels sign
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15
Q

Brudzinski’s sign

A

if head is pulled upward, legs will pull inward

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16
Q

Listerioris

waht pathogen
transmission

A
  1. causes by listeria monoctyogenes
  2. eating contaminated food
    - contaminated with feces
    - contamintied animal products like cold cuts and soft cheeses
  3. psychotrophic: cold tempereatures do not affect growth
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17
Q

Listeria monocytogenes characteristics

A

gram (+) rod or coccobacilli

psychotrophic

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18
Q

Clinical presentationif listerosis

incubaiton
sx
special pop (3)

A
  1. 2-6 week incubation
  2. most healthy people don’t experience sx
    - menigitis in immunocompromised can cause coma, mental status change
  3. affects pregnant women, immunocompromised, elderly
    - can infect fetus and cause miscarriage or still birth
  4. 45% mortality if it gets into bloodstream
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19
Q

Meningoencephalitis sx (5)

A
  1. stiff neck
  2. HA
  3. fever
  4. delerium
  5. coma
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20
Q

Tx listeriosis

A
  1. 2 week antibiotic tx
    - ampicillin or penicillin PLUS gentamicin
  2. delay in tx assoc. with poor outcomes
  3. longer course tx for immunocompromised
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21
Q

prevention listeriosis

A
  1. throtoughly cook raw food

2. wash hands, knives, cutting boards

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22
Q

Listeria -> brain/meninges (4)

A
  1. ingested
  2. invades epithelium cells in GI
  3. moves in and between cells useing hot cell actin tail formaiton
  4. invades macrophages to get into blodstread wheret can cross BBB
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23
Q

Tetanus

pathogen
complications

A
  1. clostridium tetani
  2. causes hyperactive muscles contractions
  3. toxin tetanospasmin inhibits compounds needed to inhibit muscle contraction
    - uncontrolled muscle contraction
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24
Q

clostridium tetani characteristic

A

causes tetanus

aerobic
gram (+) endospore-forming
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25
Q

Sc tetanus intoxicaiton

A
  1. develop rapidly
  2. trismus (lockjaw): spasms jaw muscles, clenching of teeth
  3. Opisthotonus invokes muscles spasms that cause an arching of back
  4. spasmodis inhalation and seizures in diaphragm and rib cage- reduce ventilation
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26
Q

Trismus

A

lockjaw

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27
Q

Opisthotonnus

A

muscle spasms causing arching of back

28
Q

Tx tetanus (3)

A
  1. sedative
  2. muscle relaxant
  3. penicillin
29
Q

Tetanus prevention

A

toxoid used in tx and vaccination

  1. DTap for kids
  2. Tdap 11-12 ys
  3. Tdap or Td at 10 year intervals fo adults
30
Q

Clostridium botulism pathogen charcteristics(4)

A
  1. spore forming
  2. anaerobe
  3. G (+) rod
  4. causes botulism
31
Q

C. boutlism complications

A

produces dealdly exotoxin

  • attack nervous system
  • flaccid paralysis
32
Q

Botulism tx

A

large doses antitoxins can neutralize toxin if treated early
-most outbreaks due to home-canned foods or foods eaten cold

*boiling deserts toxin

33
Q

Botulism toxin affects in body (4)

A
  1. inhibits release acetylcholine
  2. nerve impulses can’t pass snypase
  3. no muscle contraciton
  4. flaccid paralysis
34
Q

Botulism variants (3)

A
  1. wound botulism, when wound infected with c. botulism
  2. infant botulism AKA floppy baby, when infant fed honey
  3. minute doses botulism toxin can treat movement disorders, wrinkles, hyperhidrosis, migraine
35
Q

Leprosy

pathogen
transmission
incubation

A

Hansen disese

  1. mycobacterium leprae
  2. spread through nasal secretions
  3. 3-6 year incubation
36
Q

Mycobacterium Leprae characteristsis

A
  1. obligate
  2. intracellular parasite
  3. acid fast abacilli
37
Q

Complications leprosy

A
  1. multibacjilliary or lepramatous leprosy, tumor-like lepromas form
    on skin and respiratory tract
  • numbless and muscle weakness
  • thickening peripheral nerves
  • can lead to disability
38
Q

Damage to peripheral nerves from leprosy

A
  1. leads to deformities

- twisting of limbs, curlings of fingers, loss facial features, glaucoma/blindness

39
Q

efforts to eradicate leprosy

A

WHO

dapsone
rifampicin
clofazimine

40
Q

Viral (aseptic meningitis)

A
  1. viruses cause asceptic meningitis
  2. most caused by enteroviruses
  3. viral menignitis MILDER than bacterial
41
Q

Tx viral meningitis

A

best rest, fluids, more mild than bacterial

42
Q

Viral encephalitis

A
  1. consequence primary or secondary infeciton
  2. encephalitis imflammaiont of brain
  3. many viral causes
  4. some cases due to herpes virus
    - can occur in newborns of passed through brith
43
Q

transmission enteroviruses

A

most likely respiraroty secretions

44
Q

Secondary encephalitis

A

results from viral infection that first occurs elsewhere in the body

can be a late virus that reactivates and travels to brain

ex) VZV, measles, mumps, german measles

45
Q

Arboviral encephalitis

A
  1. primary viral infection
  2. tx arthropods
    - zoonosis-transmitted between animal host to humans by arthropods
  3. most NOT transmitted person-person
  4. many forms transmitted by mosquitoes and ticks
46
Q

Arboviral encephalitis sx

A
  1. pain head and neck
  2. convulsion
  3. coma
47
Q

Arboviral complication

A
  1. paralysis

2. mental disorders

48
Q

West nile fever

A
  1. many infected people remain asymptomatic or are ill for a few days
  2. rarely can lead to encephalitis or meningitis
  3. can results in permanent neurological effects or death
  4. no vaccin or treatment
49
Q

Zika Virus

A
  1. transmitted by mosquitoes
  2. transmitted mother-child
  3. transmitted sexually
  4. 80% asymptomatic
    5, 20% develop rash, joing paint, conjunctivitis
50
Q

Rabies in animal

A
  1. furrious rabies
    - wide eyes
    - drooling
    - unprovokes attacked
  2. dumb rabies
    - docile, lethargic
  3. wild animals are vaccinated with inoculated dog food and fish meal
51
Q

Rabies transmission

A

enters through human skin wound, contaminated with bodily fluid from an infected animal

  1. incubation 6days-1year
    - depends on location of entry and amount of virus entering body
52
Q

Rabies Sx (7)

A
  1. tinglins, burning, coldness at bite side
  2. fever, HA, increased muscle tension
  3. alert, aggressive
  4. paralysis
  5. brain degeneration
  6. hydrophobia
  7. death from respiratory paralysis
53
Q

Rabies tx

A

Post exposure immunizaiton can be doe immediate after exposure

54
Q

Polio virus

A

may be next eradicated

55
Q

Abortive poliomyelitis sx

A

HA, nausea, sore throat

1% passe thorugh bloodstream to meninges

56
Q

nonparalytic poliomyelitis sx (3)

A

fever, HA, stiff neck

57
Q

Paralytic poliomyelitis

A

paralysis arms, legs, body trunk, facial muscles, tongue, diapragh

58
Q

Postpolio syndrome PPS

A

Patient’s who have recovered form polio can sometimes experience symptoms again

  • reactivation viruts
  • autoimmune reactiom
59
Q

Trivalent vaccines

A

contain all 3 strains poliovirus

60
Q

Cryptococcosis

complication
pathogen (2)
sx (3)
dx (2)
tx (2)
A
  1. fungal lung disease
  2. can cause mepningo-ecephalitis in immuno compromoised
  3. Crypto. Neiforomans and C. gattii
  4. sx: HA, fever, change in mental status
  5. dx: spinal tap, MRI
  6. Tx: amphocetriun B and fluconozole
61
Q

Coccidiomycosis

pathogen (2)
sx (2)
dx(2)
tx

A

fungal disease affecting CNS
1. valley fever

  1. c immitis, c posadasii
  2. Sx: flu-like, can cause menigitis
  3. dx: spinal tap
  4. Tx: ampoceterin B
62
Q

Primary amoebic meningoencephalitis

pathogen
pathogenesis
tx

A
  1. caused by Naegleria Fowleri
  2. rare: 95% die within 4-5 days
  3. inhaled from swimming in warm water
  4. amoeba enters nose and swims ups to the brain along olfactory tracts
  5. tx with limited success
63
Q

Tyrpanosomiasis

A
  1. disease caused by 2 species of trypanosoma
64
Q

African sleeping sickness

Pathogen
pathogenesis

A
  1. trypanosoma Brucei
  2. t: tstes fly
    - chancre forms at bite site
    - paraside invade blood stream and enter CNS
65
Q

T. brucei variants and their disease (2)

A
  1. T. brucei gambiense
    - chronic
    - fever, HA, change in sleep patterns and behavior, wasting, coma when parasites enter brain
  2. T. brucei rhodesience
    - more acute, high fever, rapid coma, death
66
Q

Toxoplasmosis

pathogen
complication
transmission
special population 
tx
A
  1. toxoplasma gondii
  2. cause encephalitis in immunocompromised patients
  3. t: to him and via contaminated pork, before, lamb
    - domestic cats acquire it from birds or rhodens
  4. can cross through placenta
    - lead to hearing loss, mental disability, lesions in the retina causing blindness
  5. tx: trimethoprim/sulamethox

Medical Microbiology (11 decks)

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