Micro U3 L2.

Question 1

meningitis

Answer 1

inflammation of the lining of the brain (aseptic meningitis not caused by bacteria)

Question 2

encephalitis

Answer 2

inflammation of brain tissues

Question 3

meningoencephalitis

Answer 3

widespread infection of the meninges and brain

Question 4

aseptic meningitis causes

Answer 4

viruses, fungi, TB, infections near CNS

Question 5

MC virus for aseptic meningitis

Answer 5

enteroviruses

Question 6

symptoms of aseptic meningitis

Answer 6

mental status remains normal, headache, fever, chills, stiff neck, also malaise, sore throat, nausea, vomiting, ab pain, rash, muscle pain, photophobia

Question 7

how is aseptic meningitis distinguished from encephalitis?

Answer 7

mental status normal in meningitis

Question 8

diagnosis of aseptic meningitis

Answer 8

elevated WBC in spinal fluid - NO BACTERIA

Question 9

treatment for aseptic meningitis

Answer 9

supportive care (usually benign), drugs for herpesvirus, fungal, and mycobacterial infections

Question 10

brudzinski sign

Answer 10

symptom of meningitis - neck so stiff that knees flex when neck is flexed

Question 11

encephalitis incidence

Answer 11

infants and elderly

Question 12

encephalitis causes

Answer 12

influx of immune cells to brain

Question 13

distinguishing feature for encephalitis

Answer 13

intracerebral hemorrhage

Question 14

encephalitis symptoms

Answer 14

mental status altered (due to increase pressure/injury), confusion, sleepiness, irritability, stumbling, also fever, headache, vomiting, photophobia, still neck

Question 15

diagnosis of encephalitis

Answer 15

spinal tap = inflammation (PCR gold standard for definitive diagnosis), EEG suggestive of seizures, brain MRI/CT show inflammation/hemorrhage

Question 16

treatment for encephalitis

Answer 16

supportive care and symptom relief, antivirals for herpes, anti seizure medications, anti-inflammatories, sedatives

Question 17

prognosis for encephalitis

Answer 17

benign with full recovery but can also be severe and fatal

Question 18

pathogenesis of viral CNS disease

Answer 18

death of neurons (cytolytic viruses), infants and elderly more susceptible, immunosuppressive, genetics, exercise increase dissemination of viruses to CNS

Question 19

acute disseminated encephalomyelitis (ADEM)

Answer 19

postinfectious encephalitis follows viral infection 1-2 weeks - associated with measles, mumps, VZV, influenze, parainfluenza viruses, autoimmune disorder

Question 20

Which herpes viruses can often cause meningitis (from most likely to only in immunocompromised)

Answer 20

HSV-2, HSV-1, VZV, CMV, EBV

Question 21

What should herpes viruses be treated with?

Answer 21

acyclovir

Question 22

MCC of sporadic viral encephalitis

Answer 22

HSV-1 encephalitis

Question 23

Route of infection HSV-1 encephalitis

Answer 23

primary HSV-1 in oropharynx -> trigem nerve -> CNS

Question 24

What is the hallmark for HSV-1 encephalitis diagnosis?

Answer 24

brain imaging: MRI shows unilateral temporal lobe abnormalities

Question 25

How is rabies neurovirulent and how does it do it?

Answer 25

-infects peripheral nerves and travels to brain -> transmitted from salivary glands

Question 26

Symptoms of rabies (what are they due to)

Answer 26

hydrophobia, seizures, hallucinations, paralysis, coma, death due to replication in brain

Question 27

When does enterovirus cause disease? How? In who?

Answer 27

MC in summer; fecal-oral; newborns and neonates

Question 28

picornaviruses

Answer 28

polio, coxsackie, echoviruses, enterovirus

Question 29

Where does replication of picornaviruses take place? Where does it disseminate?

Answer 29

replicates in oropharynx and intestine (mucosal surfaces) disseminates via lymph nodes to blood and endes in skin, muscle, brain, and meninges

Question 30

Togaviruses

Answer 30

VEE, EEE, WEE, rubella

Question 31

How are toga viruses transmitted? Which cause encephalitis?

Answer 31

via mosquito bite usually (also birds) to skin, blood, brain - VEE, EEE, WEE

Question 32

What are the flaviviruses that cause encephalitis?

Answer 32

Japanese encephalitis, west nile, st louis encepalitis, russian spring-summer, powassan virus

Question 33

transmission of flaviviruses

Answer 33

mosquito or tick; more common in summer

Question 34

Which flavivirus has a vaccine?

Answer 34

japanese encephalitis

Question 35

What is the dissemination of flaviviruses?

Answer 35

mucosal surface -> lymph -> primary viremia (blood, liver, spleen, macrophages) -> secondary viremia (encephalitis, yellow fever, hemorrhagic fever)

Question 36

west nile virus meningoencephalitis symptoms

Answer 36

less than 1% WNV infections; headache, high fever, stiff neck, disorientation, coma, tremors, seizures, paralysis

Question 37

WNV high risk populations

Answer 37

cancer, diabetes, hypertension, kidney disease