new material for Final

Question 1

Progressive loss of mental and physical functions caused by invasion of Treponema pallidum into the CNS:

Answer 1

neurosyphilis

Question 2

Neurosyphilis - 4 chief manifestations:

Answer 2

• asx neurosyphilis
• meningovascular syphilis
• paretic syphilis
• tabes dorsalis

Question 3

Meningovascular syphilis:

Answer 3

characterized by perivascular inflammation in the brain

Question 4

Paretic syphilis:

Answer 4

result of widespread parenchymal invasion by spirochetes and resultant inflammatory changes that cause individual brain cell death and brain atrophy

Question 5

Tabes dorsalis:

Answer 5

• slowly progressive degenerative form of syphilis involving the posterior columns and posterior roots,
• results in damage to sensory nerves in dorsal roots
• produces ataxia, loss of pain sensation/proprioception

Question 6

MC presentation of meningovascular syphilis:

Answer 6

Stroke syndrome in a relatively young adult, involving the middle cerebral artery or branches of the basilar artery; freq involves base of brain and may result in cranial nerve palsies

Question 7

Paretic syphilis usu occurs how long after exposure?

Answer 7

20-30 yrs as a result of progressive meningoencephalitis, resultant ongoing loss of cortical function

Question 8

Paretic syphilis is characterized by:

Answer 8

• tissue invasion with spirochetes
• chronic perivascular and meningeal inflammatory changes
• meningeal fibrosis

Question 9

MC sx of paretic syphilis:

Answer 9

• personality change (33%)
• ataxia (28%)
• stroke (23%)
• ophthalmic sx (17%)

Question 10

Neurosyphilis often results in the formation of meningeal granulomas, called:

Answer 10

gummas - well-circumscribed, non-cancerous mass of granulation tissue resulting from a cell-mediated immune response to Treponema, tertiary stages.

Question 11

Gummas are MC found in:

Answer 11

LIVER

also found in brain/dura, heart, skin, bone, testes

Question 12

Several hours after tx of early stage syphilis, pts may undergo febrile reaction called:

Answer 12

Jarisch-Herxheimer reaction

Question 13

Progressive multifocal leukoencephalopathy (PML) is caused by:

Answer 13

JC virus (polyomavirus family)

rare, progressive, demyelinating dz -> loss of oligodendrocytes

Question 14

Subacute sclerosing panencephalitis (SSPE) is a rare complication of _______ that can develop from ____ years after the initial infx.

Answer 14

measles (rubeola)

1 to 20+

Question 15

The only change in the CSF profile of SSPE is a marked elevation in a specially ordered CSF immunoglobulin:

Answer 15

Rubeola IgG Antibody

Question 16

Poliovirus is an RNA virus that is transmitted:

Answer 16

• through the oral-fecal route

* ingestion of contaminated water

Question 17

After a period of viremia, poliovirus becomes ________ and produces destruction of the motor neurons in the anterior horn and brainstem, leading to ____________.

Answer 17

neurotropic

flaccid paralysis

Question 18

Zoonotic dz that is transmitted via saliva of animals:

Answer 18

Rabies virus

• severe HA
• irritability
• muscle spasm
• inc saliva production
• hydrophobia

Question 19

Diagnostic finding for rabies:

Answer 19

Negri bodies - round/oval inclusion bodies

100% diagnostic, found in 20% of cases

Question 20

Complicated syndrome of different nervous system and mental status symptoms, frequency inc with advancing effects of HIV disease, particularly as CD4+ cell counts decrease:

Answer 20

AIDS dementia complex (ADC)

Question 21

Unusual, often fatal, two-phase encephalopathy characterized by fever, vomiting, fatty infiltration of the liver and swelling of the kidneys and brain:

Answer 21

Reye’s syndrome

• post-viral (VZV)
• NOT contagious
• assoc w/aspirin use

Question 22

An infx of the brain d/t infx by a prion:

Answer 22

Spongiform encephalopathy

• Kuru
• CJD

Question 23

Related spongiform encephalopathies that are invariably fatal brain diseases with unusually long incubation periods measured in years:

Answer 23

mad cow dz (BSE)

variant Creutzfeld-Jakob dz (vCJD)

Question 24

Most prevalent neurologic disorder in terms of morbidity and mortality:

Answer 24

cerebrovascular dz - 3rd leading cause of death in US (particularly stroke)

Question 25

3 major categories of cerebrovascular dz:

Answer 25

• thrombotic
• embolic
• hemorrhagic

Question 26

From a pathophys standpoint, consider cerebrovascular disease as representing two processes:

Answer 26

• hypoxia, ischemia, infarction from impaired blood supply and oxygenation of CNS tissue
• hemorrhage from rupture of vessels in the CNS

Question 27

Cerebral infarction (aka stroke) is characterized by:

Answer 27

sudden loss of circulation to an area of the brain which results in loss of neurologic function corresponding to the part of brain involved.
Leading cause of major disability in US

Question 28

If you think I’m gonna get to the end of CNS…

Answer 28

you’ve got another thing coming! sorry kids.