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B&B Week 5 Flashcards > Lecture 6: CSF and CNS Infections > Flashcards

Lecture 6: CSF and CNS Infections Flashcards

1
Q

Where is CSF produced and reabsorbed?

A

Produced by Choroid plexus of ventricles
Reabsorbed by arachnoid granulations through the process of transcytosis
CSF formation
500 ml/day of adults (water bottle’s worth)
Total volume
90-150 ml in adults

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2
Q

What is the choroid plexus?

A

Epithelial cells that are specialized ependymal cells

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3
Q

What is the difference between CSF and plasma?

A 
The CSF has
LESS proteins/amino acids
LESS glucose
LESS ion concentration except for Cl- and Mg2+ (around same for Na)
SAME osmolality
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4
Q

What are the 4 physiologic roles of CSF?

A
  1. Physical Support
  2. Protection (protection in sense of maintaining composition of microenvironemt)
  3. Extracellular Homeostasis
  4. Excretory Waste Function
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5
Q

What are the three features of brain capillaries that contribute to formation of blood brain barrier?

A
  1. tight junctions between non-fenestrated capillary endothelial cells
  2. thick basement membrane
  3. astrocyte endfoot
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6
Q

What are the delineating lab findings of bacterial meningitis?

A

High WBC count (over 1000 cells/ul)
Neutrophils
DECREASE in glucose
HUGE increase in protein

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7
Q

What are the delineating lab findings of viral meningitis?

A

Normal opening pressure
NORMAL glucose
NORMAL protein
Lymphocytes for cell differential

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8
Q

What is delineating lab findings of fungal meningitis?

A

Same WBC count as viral meningitis (10-200 cells/ul)
DECREASED glucose
INCREASED protein
Lymphocytes

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9
Q

What are the classic presenting symptoms for meningitis?

A
  1. Photophobia
  2. stiff neck
    Fever, headache, altered mental status
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10
Q

What causes bacterial meningitis is neonates (0-6months)?

A
  1. Listeria monocytogenes
  2. E. coli
  3. Group B streptococcus
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11
Q

What causes bacterial meningitis in children and adults (6mo – 60 years)

A
  1. Streptococcus pneumoniae
  2. Neisseria meningitides
  3. Haemopilus influenza
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12
Q

What causes bacterial meningitis in adult and immunosuppressed patients (over 60 years)?

A
  1. Streptococcus pneumonia

2. Listeria monocytogenes

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13
Q

What are the three classes of viruses that cause viral meningitis?

A
  1. Enterovirus
    -most common cause of viral meningitis in summer/fall and commonly occur in children
  2. Herpes virus
    HSV1 = encephalitis
    HSV2 = meningitis
    Greater moribidity and mortality though less common
  3. Arboviruses
    Spread by mosquitoes and ticks
    e.g. west nile, st. Louis encephalitis virus
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14
Q

What are the 3 fungi that cause HIV associated meningitis?

A
  1. Cryptococcosis neoformans
  2. Coccidioides immitis (Valley Fever aka coccidiodomycosis)
  3. Histoplasma capsulatum (Cave Disease)
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15
Q

What are the 3 bacteria that cause HIV associated meningitis?

A
  1. Listeria monocytogenes
  2. Mycobacterium tuberculosis
  3. Treponema pallidum (Syphillis)
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16
Q

What are the two viruses that cause HIV associated meningitis?

A
  1. CMV

2. VZV

17
Q

What are the HIV associated meningitis?

A
  1. Fungal
    • cryptococcosis neoformans
    • coccidiodes immitis (valley fever)
    • histpolasma capsulatum (cave disease)
  2. Bacteria
    • Listeria monocytogenes
    • Group B strep?
    • Treponema pallidum (syphilis)
  3. Viral
    • CMV
    • VZV
18
Q

What are the mechanisms through which infectious agents enter CNS?

A
  1. bacterial surface proteins attach to endothelial cells and migrate transcellularly
    • lipoteichoic acid in streptococcus pneumonia appears to utilize an endogenous receptor for platelet activating factor to enter CNS
  2. Trojan horse mechanism
    • cross barriers inside a circulating cell (monocyte)
  3. Physically disrupted barriers
19
Q

What are the pathologic processes that can cause fluid to appear?

A
  1. Cloudy
    -increased WBC due to CNS infection
  2. Bloody
  3. Xanthohromia
    ORANGE = carotene ingestion
    BROWN = metastatic melanoma
  4. Viscous
    Metastatic mucinous adenocarcinoma
20
Q

What is the latex agglutination test?

A

Used to look for agglutination or accumulation of bacteria and/or fungi on a latex tube
Rapid test for bacteria

B&B Week 5 Flashcards (13 decks)

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