Parenchymal Infections Flashcards
A bacterial abscess is a _________ CNS infection
Localized
Results from
Sepsis, endocarditis, pulmonary infxn.
Liquefaction necrosis
Increased ICP
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
Fungal encephalitis is _______ and _________ pattern of infection and causes possible ____________.
Localized and diffuse
Granulomas
MC= among immunosuppressed
Candida albicans, Aspergillus Fumigatus
Symptoms of Poliovirus
Gastritis
1% motor neuron damage
Destroy grey matter
Cord and or brainstem
Wasting, flacccidity
Varicella Zoster Virus
Aka chicken pox- dormant in DRG
Shingles in adults- Postherpetic neuralgia
What is multiple sclerosis
Autoimmune attack on white matter
Type IV hypersensitivity=white matter “plaques” at areas of demyelination
What is the MC myelin disorder 1/1000
Multiple Sclerosis
Results in episodes of neurologic impairment
Relapsing-remitting
Who’s at risk for MS
Young adults. Females 2x more likely
Genetics plays major role 15x more likely risk
HLA-DR2
Difference between active and inactive MS
Active=ongoing myelin breakdown
Inactive= little myelin and minimal inflammation
Ms causes
Ataxia, motor/sensory impairments
Bowel/bladder dysfunction sexual dysfunction, siezures, depression
Man patients report benefits from
CAM, immunosuppresion helps
What occurs from Thiamine deficiency
Wernicke-Korsakoff syndrome
Beriberi
What causes lower extremity parethesia/paralysis and nystagmus
Beriberi
Deficiency in Thiamine aka Vitamin B1
This is a syndrome from chronic alcoholics or chronic gastritis
Wernicke-Korsakoff syndrome
Results in necrosis to the thalamus
Vitamin B1 aka thiamine deficiency
What does a deficiency in Cobalamin result in
Cord demyelination
Aka Vitamin B12
Results in “subacute combined degeneration of the spinal cord”
Lichtheims disease
Lichtheims disease is caused from a deficiency in
Cobalamin,
Results in ataxia, parethesia, paraplegia
What is the most common disorder from inappropriate insulin use
Hypoglycemia
Mimics global hypoxia (edema)
What is the MC injury from Hypoglycemia
Hippocampus
What is hyperglycemia
Uncontrolled diabetes
Results in cerebral edema= confusion, stupor, coma
Hyperosmolar state (glycosuria)
What is a common feature of neurodegenerative diseases
Maintain conscioiusness
What is the MC cause of dementia elderly
Alzheimer Disease
Insidious onset of dementia, progressive
What disease is associated with B-amyloid plaques
Accumulate in the brain
Neurotoxic= decreased neurotransmission, and increased atrophy
Breakdown= Tau proteins (tangles)
What is the MC lethal infection with Alzheimer disease
Pneumonia
It has a 10% genetic component, Down syndrome allows for early onset
Damage to dopaminergic neurons in areas such as Substantia nigra
Parkinsons
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
