Parenchymal Infections Flashcards by Austin Gunderson

A bacterial abscess is a _________ CNS infection

Localized

Results from
Sepsis, endocarditis, pulmonary infxn.

Liquefaction necrosis

Increased ICP

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Viral encephalitis is a __________ infection and occurs from ___________.

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

Localized and diffuse

Granulomas

MC= among immunosuppressed

Candida albicans, Aspergillus Fumigatus

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Symptoms of Poliovirus

Gastritis

1% motor neuron damage

Destroy grey matter
Cord and or brainstem
Wasting, flacccidity

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Varicella Zoster Virus

Aka chicken pox- dormant in DRG

Shingles in adults- Postherpetic neuralgia

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What is multiple sclerosis

Autoimmune attack on white matter

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

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What is the MC myelin disorder 1/1000

Multiple Sclerosis

Results in episodes of neurologic impairment

Relapsing-remitting

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Who’s at risk for MS

Young adults. Females 2x more likely

Genetics plays major role 15x more likely risk

HLA-DR2

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Difference between active and inactive MS

Active=ongoing myelin breakdown

Inactive= little myelin and minimal inflammation

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Ms causes

Ataxia, motor/sensory impairments

Bowel/bladder dysfunction sexual dysfunction, siezures, depression

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Man patients report benefits from

CAM, immunosuppresion helps

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What occurs from Thiamine deficiency

Wernicke-Korsakoff syndrome

Beriberi

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What causes lower extremity parethesia/paralysis and nystagmus

Beriberi

Deficiency in Thiamine aka Vitamin B1

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This is a syndrome from chronic alcoholics or chronic gastritis

Wernicke-Korsakoff syndrome

Results in necrosis to the thalamus

Vitamin B1 aka thiamine deficiency

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What does a deficiency in Cobalamin result in

Cord demyelination

Aka Vitamin B12

Results in “subacute combined degeneration of the spinal cord”

Lichtheims disease

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Lichtheims disease is caused from a deficiency in

Cobalamin,

Results in ataxia, parethesia, paraplegia

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What is the most common disorder from inappropriate insulin use

Hypoglycemia

Mimics global hypoxia (edema)

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What is the MC injury from Hypoglycemia

Hippocampus

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What is hyperglycemia

Uncontrolled diabetes

Results in cerebral edema= confusion, stupor, coma

Hyperosmolar state (glycosuria)

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What is a common feature of neurodegenerative diseases

Maintain conscioiusness

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What is the MC cause of dementia elderly

Alzheimer Disease

Insidious onset of dementia, progressive

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What disease is associated with B-amyloid plaques

Accumulate in the brain

Neurotoxic= decreased neurotransmission, and increased atrophy

Breakdown= Tau proteins (tangles)

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What is the MC lethal infection with Alzheimer disease

Pneumonia

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

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Damage to dopaminergic neurons in areas such as Substantia nigra

Parkinsons

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What disease is associated with Lewy Bodies

Parkinson's disease Age 45-65 years Progressive, immobility within 10-15 years

Whats is the treatment for Parkinson's disease

Increase dopamine

What are associated with Parkinson's disease

"Cogwheel" "Pick rolling" Poker face/ mask face

Huntington disease is ___________ dominant

Autosomal dominant Has a Huntington gene

Is Huntington Disease is ___________

Inherited but delayed onset 30-40 years Occurs from trinucleotide repeat CAG

This causes severe atrophy of caudate and putamen nuclei

Huntington disease

What features chorea (dance like jerking)

Huntington disease Severe dementia/insanity Lethal within 15 years

LMN death in the cord and brainstem is a symptom of

ALS

What is another name for ALS

Lou Gehrig's disease

UMN death of Betz cells is also a sign of

ALS

Who's is at risk for ALS

Males ages 40-50 Progressive muscle atrophy Fasciculations (involuntary contractions, visible)

True or False Most of ALS is familial

False only 10% are 90% are sporadic

During ALS

INcreased apoptosis of neurons Difficultly speaking, swallowing, breathing Death: respiratory paralysis/pneumonia

What is more common cranial or spinal tumors

Cranial 15/1000 Spinal 2/1000 Most are primary CNS tumors

Three types of Gliomas

Astrocytoma Oligodendroglioma Ependymoma

What are the two types of Atrocytomas

Diffuse- malignant 80% of adult gliomas Pilocytic- benign

What affects adults more diffuse or pilocytic astrocytoma

Diffuse 30-60 years old Poorly circumscribed ABC A. Well- differentiated B. Anaplastic C. Glioblastoma Poor prognosis

What is well circumscribed lesion diffuse or pilocytic astrocytomas

Pilocytic Diffuse is poorly circumscribed

What is a treatment for glioblastoma

Anticonvulsants, corticosteroids, surgical excision, radiation, chemotherapy Mean survival= 15 months, 25% survive after 2 years

True or false Oligodendroglioma can be benign or malignant

It can be both Lower grades have history of siezures

Who is at risk for gliomas

Adults 30-50 years old

How common are oligodendroglioma

5-15% of all gliomas Prognosis=5-20 years Thx. Surgery, chemo, radiation

Which gliomas is MC in pediatrics

Ependymoma

What is a ependymoma

Cancer of transformed ependymal cells Vary in aggressiveness Located in periventricular regions History of NF2= Increases risk

What makes up 20% of pediatric brain tumors

Medulloblastoma it is malignant

Where are medulloblastomas EXCLUSIVELY found

Cerebellar, midline, infratentorial It is well circumscribed

What is treatment for a medulloblastoma

Excision, radiation therapy, chemotherapy They are HIGHLY radiosensitive 75% 5 year survival rate

Medulloblastoma are similarly to

Primitive Neuroectodermal tumors, but they are located outside the CNS

What is associated with Homer-Wright

Medulloblastoma

Diffuse Large B Cell Lymphoma is located where

inside CNS Aggressive, very poor prognosis, extranodal RARE

who is most at risk for Diffuse Large B Cell Lymphoma

Among immunosuppressed (AIDS) It spreads via ventricles

What is an increased risk for Diffuse Large B Cell Lymphoma

Increased age

What is considered a VERY Invasive brain tumors

Meningioma

Are most meningioma benign or malignant

90% benign

This is a tumor from transformed arachnoid cells

Meningiomas Local compression, ANY CNS surface

Who is MC for meningiomas

Adult females

What disease is associated with syncytial "whorled" cellular clusters

Meningiomas

What is the MC metastasis into the CNS

Lung, breast, melanoma, kidney, G.I. 25-50% of all intracranial tumors

What is tuberous Sclerosis

Autosomal dominant condition, produces benign tumors throughout the body

What is associated with a mutation in TSC1 or TSC2 genes

Tuberous Sclerosis

What disease produces cortical "tubers" in the CNS

Tuberous Sclerosis

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

Von Hippel-Lindau Disease

Where is von Hippel-Lindau Disease located

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

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

Von Hippel-Lindau Disease

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

Von Hippel- Lindau Diseasee