micro bio related neuro

Question 1

35 yo man dvps hemiparesis, homonymous hemianopia and cognitive deterioration. MRI shows widespread abnormal T2 in white matter, EEG show diffuse slowing over both cerebral hemispheres. Tissue biopsy: demyelination w/abnormal giant oligodendrocytes, some of which contain eosinophilic inclusions. What is pt’s condition? It occurs most commonly in assoc w/which disease?

Answer 1

Condition is Progressive Multifocal Leukoencephalopathy (PML) - a rapidly progressive demyelinating disorder in which the JC virus (polyomavirus) infects oligodendrogial cells in the brain.

Disease: AIDS- PML occurs in about 1% of AIDS pt

Question 2

symptoms of PML (Progressive multifocal leukoencephalopathy)-

Answer 2

aphaseia, cortical blindness, hemiparesis, ataxia, conjugate gaze abnormalities. The condition can progress to quadriparesis and coma-

Question 3

txt for PML (progressive multifocal leukoencephalopathy)

Answer 3

there is no txt

Question 4

encephalitis that affects the gray and white matter and subacute sclerosing panencephalitis (SSPE) (usually seen before the age of 18) can result from prior ifxn with…

Answer 4

measles

Question 5

measles infection can later lead to…

Answer 5

encephalitis that affects the gray and white matter and subacute sclerosing panencephalitis (SSPE) (usually seen before the age of 18)

Question 6

immunologic basis of MS pathology…

Answer 6

TH1 lymph. reactive agst myelin stimulate macrophages to destroy myelin.

Question 7

MS is an example of what type of hypersensitivity response?

Answer 7

Type IV

Question 8

MS has relapsing and remitting symp that may involve…

Answer 8

visual impairment, cranial nerve signs, ataxia, nystagmus, internuclear ophthalmoplegia. Spinal cord lesions give rise to motor and sensory difficulties of trunk and limbs and spasticity and loss of control of bladder func.

Question 9

treatment of MS with natalizumab is associated with an increased risk of…

Answer 9

PML (progressive multifocal leukoencephalopathy)

Question 10

the eosinophilic inclusions (Negri bodies) produced in rabies are bound where?

Answer 10

gray matter of the brain

Question 11

signs of rabies include…

Answer 11

excessive salivation, hallucinations and hydrophobia

Question 12

syphilis can cause. what damage to the CNS?

Answer 12

meningitis, encephalitis and spinal cord damage- affecting white and gray matter

Question 13

tuburculosis can cause what in the CNS?

Answer 13

granulomatous meningitis, typically affeting the base of the brain

Question 14

What is PML? what is it caused by?

Answer 14

progressive multifocal leukoencephalitis is a viral encephalitis caused by JC polyomavirus

Question 15

PML infects what in the brain, causing what?

Answer 15

oligodendrocytes causing demyelination

Question 16

PML is characterized by what?

Answer 16

multifocal lesions in the hemispheric or cerebellar white matter.

Question 17

drooping eyelids, diminished pupillary light reflex, and difficulty opening mouth are signs of what disease you can get from foods

Answer 17

clostridium botulinum

Question 18

why does clostridium germinate spores and produce toxins in canned goods and preserved fish/vacuum sealed things?

Answer 18

bc it’s anaerobic

Question 19

how do you treat botulism?

Answer 19

supportive txt (watch for resp arrest!) there’s an antidote, but usually can’t get it quick enough

Question 20

a 1 wk old newborn has irritability, fever and is developing a stupor. A lumbar puncture is perfomed and CSF shows high neutrophils. The neutrophils indicates that the meningitis ifxns is bacterial, viral, fungal or other?

Answer 20

bacterial!

Question 21

if a 1 wk old presents with bacterial meningitis, the most likely pathogen has what gram stain and shape?

Answer 21

Gram-positive coccus (Group B strep (streptococcus Agalactiae))

Question 22

if a 1 wk old presents with bacterial meningitis, what is the most likely pathogen?

Answer 22

Group B strep– a Gram-positive coccus

Question 23

an acid fast bacillus describes what type of bacterium? do thees cause neonatal meningitis?

Answer 23

a mycobacterium, which do not cause neonatal meningitis

Question 24

double stranded DNA virus with nuclear membrane envelope describes a virus in what family?

Answer 24

herpes family

Question 25

do herpes family viruses cause neonatal meningitis?

Answer 25

no- they may cause encephalitis, but wouldn’t likely cause meningitis

Question 26

what is the second leading cause of neonatal meningitis, and what is the gram stain/shape of that bacteria?

Answer 26

Escherichia coli- a gram-neg bacillus

Question 27

a gram negative diplococcus describes what three genera?

Answer 27

neisseria, moraxella and Veillonella

Question 28

which gram neg diplococcus causes meningitis and in what age group does it cause it?

Answer 28

neisseria meningitidis causes meningitis in adolescents and young adults

Question 29

what is the third most common cause of neonatal meningitis and what is the gram stain/shape?

Answer 29

gram pos bacillus

Question 30

listeria monocytogenes causes what in new borns?

Answer 30

3rd most common cause of meningitis

Question 31

gram stain/shape of listeria monocytogenes?

Answer 31

gram-positive baccilis