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Systems Path Exam 2 > Parenchymal Infections > Flashcards

Parenchymal Infections Flashcards

1
Q

A bacterial abscess is a _________ CNS infection

A

Localized

Results from
Sepsis, endocarditis, pulmonary infxn.

Liquefaction necrosis

Increased ICP

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2
Q

Viral encephalitis is a __________ infection and occurs from ___________.

A

Diffuse, meningitis

Is a parenchymal infxn.
Lymphocytes/macrophages= neuronophagia

Ex. Rabies, polio. Rubella, west Nile, HSV-1 or 2, VZV, CMV, HIV

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3
Q

Fungal encephalitis is _______ and _________ pattern of infection and causes possible ____________.

A

Localized and diffuse

Granulomas

MC= among immunosuppressed

Candida albicans, Aspergillus Fumigatus

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4
Q

Symptoms of Poliovirus

A

Gastritis

1% motor neuron damage

Destroy grey matter
Cord and or brainstem
Wasting, flacccidity

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5
Q

Varicella Zoster Virus

A

Aka chicken pox- dormant in DRG

Shingles in adults- Postherpetic neuralgia

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6
Q

What is multiple sclerosis

A

Autoimmune attack on white matter

Type IV hypersensitivity=white matter “plaques” at areas of demyelination

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7
Q

What is the MC myelin disorder 1/1000

A

Multiple Sclerosis

Results in episodes of neurologic impairment

Relapsing-remitting

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8
Q

Who’s at risk for MS

A

Young adults. Females 2x more likely

Genetics plays major role 15x more likely risk

HLA-DR2

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9
Q

Difference between active and inactive MS

A

Active=ongoing myelin breakdown

Inactive= little myelin and minimal inflammation

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10
Q

Ms causes

A

Ataxia, motor/sensory impairments

Bowel/bladder dysfunction sexual dysfunction, siezures, depression

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11
Q

Man patients report benefits from

A

CAM, immunosuppresion helps

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12
Q

What occurs from Thiamine deficiency

A

Wernicke-Korsakoff syndrome

Beriberi

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13
Q

What causes lower extremity parethesia/paralysis and nystagmus

A

Beriberi

Deficiency in Thiamine aka Vitamin B1

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14
Q

This is a syndrome from chronic alcoholics or chronic gastritis

A

Wernicke-Korsakoff syndrome

Results in necrosis to the thalamus

Vitamin B1 aka thiamine deficiency

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15
Q

What does a deficiency in Cobalamin result in

A

Cord demyelination

Aka Vitamin B12

Results in “subacute combined degeneration of the spinal cord”

Lichtheims disease

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16
Q

Lichtheims disease is caused from a deficiency in

A

Cobalamin,

Results in ataxia, parethesia, paraplegia

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17
Q

What is the most common disorder from inappropriate insulin use

A

Hypoglycemia

Mimics global hypoxia (edema)

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18
Q

What is the MC injury from Hypoglycemia

A

Hippocampus

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19
Q

What is hyperglycemia

A

Uncontrolled diabetes

Results in cerebral edema= confusion, stupor, coma

Hyperosmolar state (glycosuria)

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20
Q

What is a common feature of neurodegenerative diseases

A

Maintain conscioiusness

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21
Q

What is the MC cause of dementia elderly

A

Alzheimer Disease

Insidious onset of dementia, progressive

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22
Q

What disease is associated with B-amyloid plaques

A

Accumulate in the brain

Neurotoxic= decreased neurotransmission, and increased atrophy

Breakdown= Tau proteins (tangles)

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23
Q

What is the MC lethal infection with Alzheimer disease

A

Pneumonia

It has a 10% genetic component, Down syndrome allows for early onset

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24
Q

Damage to dopaminergic neurons in areas such as Substantia nigra

A

Parkinsons

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25
Q

What disease is associated with Lewy Bodies

A

Parkinson’s disease

Age 45-65 years

Progressive, immobility within 10-15 years

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26
Q

Whats is the treatment for Parkinson’s disease

A

Increase dopamine

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27
Q

What are associated with Parkinson’s disease

A

“Cogwheel”
“Pick rolling”
Poker face/ mask face

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28
Q

Huntington disease is ___________ dominant

A

Autosomal dominant

Has a Huntington gene

29
Q

Is Huntington Disease is ___________

A

Inherited but delayed onset 30-40 years

Occurs from trinucleotide repeat CAG

30
Q

This causes severe atrophy of caudate and putamen nuclei

A

Huntington disease

31
Q

What features chorea (dance like jerking)

A

Huntington disease

Severe dementia/insanity

Lethal within 15 years

32
Q

LMN death in the cord and brainstem is a symptom of

A

ALS

33
Q

What is another name for ALS

A

Lou Gehrig’s disease

34
Q

UMN death of Betz cells is also a sign of

A

ALS

35
Q

Who’s is at risk for ALS

A

Males ages 40-50

Progressive muscle atrophy

Fasciculations (involuntary contractions, visible)

36
Q

True or False

Most of ALS is familial

A

False only 10% are 90% are sporadic

37
Q

During ALS

A

INcreased apoptosis of neurons

Difficultly speaking, swallowing, breathing

Death: respiratory paralysis/pneumonia

38
Q

What is more common cranial or spinal tumors

A

Cranial 15/1000

Spinal 2/1000

Most are primary CNS tumors

39
Q

Three types of Gliomas

A

Astrocytoma

Oligodendroglioma

Ependymoma

40
Q

What are the two types of Atrocytomas

A

Diffuse- malignant 80% of adult gliomas

Pilocytic- benign

41
Q

What affects adults more diffuse or pilocytic astrocytoma

A

Diffuse 30-60 years old

Poorly circumscribed

ABC

A. Well- differentiated

B. Anaplastic

C. Glioblastoma

Poor prognosis

42
Q

What is well circumscribed lesion diffuse or pilocytic astrocytomas

A

Pilocytic

Diffuse is poorly circumscribed

43
Q

What is a treatment for glioblastoma

A

Anticonvulsants, corticosteroids, surgical excision, radiation, chemotherapy

Mean survival= 15 months,

25% survive after 2 years

44
Q

True or false

Oligodendroglioma can be benign or malignant

A

It can be both

Lower grades have history of siezures

45
Q

Who is at risk for gliomas

A

Adults 30-50 years old

46
Q

How common are oligodendroglioma

A

5-15% of all gliomas

Prognosis=5-20 years

Thx. Surgery, chemo, radiation

47
Q

Which gliomas is MC in pediatrics

A

Ependymoma

48
Q

What is a ependymoma

A

Cancer of transformed ependymal cells

Vary in aggressiveness

Located in periventricular regions

History of NF2= Increases risk

49
Q

What makes up 20% of pediatric brain tumors

A

Medulloblastoma it is malignant

50
Q

Where are medulloblastomas EXCLUSIVELY found

A

Cerebellar, midline, infratentorial

It is well circumscribed

51
Q

What is treatment for a medulloblastoma

A

Excision, radiation therapy, chemotherapy

They are HIGHLY radiosensitive

75% 5 year survival rate

52
Q

Medulloblastoma are similarly to

A

Primitive Neuroectodermal tumors, but they are located outside the CNS

53
Q

What is associated with Homer-Wright

A

Medulloblastoma

54
Q

Diffuse Large B Cell Lymphoma is located where

A

inside CNS

Aggressive, very poor prognosis, extranodal

RARE

55
Q

who is most at risk for Diffuse Large B Cell Lymphoma

A

Among immunosuppressed (AIDS)

It spreads via ventricles

56
Q

What is an increased risk for Diffuse Large B Cell Lymphoma

A

Increased age

57
Q

What is considered a VERY Invasive brain tumors

A

Meningioma

58
Q

Are most meningioma benign or malignant

A

90% benign

59
Q

This is a tumor from transformed arachnoid cells

A

Meningiomas

Local compression, ANY CNS surface

60
Q

Who is MC for meningiomas

A

Adult females

61
Q

What disease is associated with syncytial “whorled” cellular clusters

A

Meningiomas

62
Q

What is the MC metastasis into the CNS

A

Lung, breast, melanoma, kidney, G.I.

25-50% of all intracranial tumors

63
Q

What is tuberous Sclerosis

A

Autosomal dominant condition, produces benign tumors throughout the body

64
Q

What is associated with a mutation in TSC1 or TSC2 genes

A

Tuberous Sclerosis

65
Q

What disease produces cortical “tubers” in the CNS

A

Tuberous Sclerosis

66
Q

What produces autosomal dominant condition, produces vascular (capillary) hemangioblastomas

A

Von Hippel-Lindau Disease

67
Q

Where is von Hippel-Lindau Disease located

A

Primarily in the cerebellum

Also can occur in the brainstem, spinal cord, nerve roots, retina

68
Q

A VHL mutation (TSG) is a highly vascular tumor is caused by a

A

Von Hippel-Lindau Disease

69
Q

THis puts you at a high risk for renal cell carcinoma and pancreatic cysts

A

Von Hippel- Lindau Diseasee

Systems Path Exam 2 (6 decks)

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