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Clinical Neuroscience > Path- 4: Infections > Flashcards

Path- 4: Infections Flashcards

1
Q

What is the most common way infections can enter the brain?

A

Hematogenous spread via arteries or veins

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2
Q

What type of mechanism of injury causes direct implantation of bugs tot he brain?

A

trauma

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3
Q

What does TORCH stand for that are the group of diseases that cause congential conditions?

A

Toxoplasmosis, Other (syphilis, varicella, mumps, parovirus and HIV), Rubella, CMV, Herpes

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4
Q

What is meningitis?

A

inflammatory process of leptomeninges and CSF

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5
Q

What is meningoencephalitis?

A

inflammation of meninges and brain parenchyma

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6
Q

What is the main cause of acute pyogenic meningitis?

A

bacteria

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7
Q

What is the main cause of aseptic meningitis?

A

viral meningitis

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8
Q

What is the main cause of chronic meningitis?

A

TB, spirochetes, cryptococcus

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9
Q

What is normal CSF pressure (in mmHg)?

A

10-18mmHg

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10
Q

When the pts lie on their side for an LP, what is the new pressure in the CSF?

A

20-30mmHg

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11
Q

What condition causes in increased in the IgG content of the CSF?

A

MS

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12
Q

What is the main causitive agent for acute pyogenic meningitis in neonates?

A

Strep. agalactiae

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13
Q

What other bugs cause acute pyogenic meningitis in neonates?

A

E. coli, Strep pneumo, Listeria monocytogenes

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14
Q

What is the main causitive agent for acute pyogenic meningitis in adolescents/young adults?

A

Neisseria meningitidis

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15
Q

What is the main causitive agent for acute pyogenic meningitis in IV drug users?

A

Staph aureus

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16
Q

What is the main causitive agent for acute pyogenic meningitis in children and adults?

A

Strep pneumo

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17
Q

What are the Sx of acute pyogenic meningitis?

A

headache, photophobia, irritability, nuchal rigidity, nausea, vomiting.

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18
Q

What is the CSF content on spinal tap in acute pyogenic meningitis?

A

cloudy CSF, increased pressure, increased neutrophils, increased protein, decreased glucose

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19
Q

What is waterhouse-fridreichsen syndrome?

A

results from meningitis-assocaited septicemia (N. meningiditis), it’s a hemorrhagic infarction of the ADRENAL glands, causes cutaneous petechiae, in kids.

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20
Q

What again is the main causitive agent of acute aseptic meningitis?

A

Viruses

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21
Q

What is the CSF content on spinal tap in acute aseptic meningitis?

A

CSF glucose normal, protein slightly elevated, lymphocytes present

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22
Q

What is the Tx of acute aseptic meningitis?

A

Nothing, it’s self-limiting.

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23
Q

What is the most common viral cause of acute aseptic meningitis?

A

enterovirus (polio, echovirus, coxackievirus)

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24
Q

What are the physiological changes in acute aseptic meningitis?

A

Brain swelling, mild leptomeninges infiltration

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25
Q

What causes drug-induced aseptic meningitis?

A

NSAIDs, antibiotics

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26
Q

What is the CSF content on spinal tap in Drug-induced aseptic meningitis?

A

glucose normal, neutrophils present, increased CSf protein

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27
Q

What causes brain abscesses?

A

variety of routes, often from primary infected site int he heart (endocarditis), lungs, teeth or bones.

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28
Q

What are the msot common abcteria to cause brain abscesses?

A

Strep and staph

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29
Q

True or false: cerebral abscesses are destructive lesions

A

True

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30
Q

What is the pathological findings to abscesses?

A

Central liquefactive necrosis surrounded by a fibrous cap, often in frontal or parietal lobes or the cerebellum, have progressive focal deficits

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31
Q

True or False: Brain abscesses do not cause an increase in ICP

A

False

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32
Q

What is seen on CT’s for a brain abscess that organizes?

A

Collagen deposition around a ring enhancing lesion

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33
Q

What types of Tx’s are there to decrease the lethality of brain abscesses to < 10%?

A

Surgerya nd antiobiotics

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34
Q

How can one get subdural empyema?

A

bacteria and fungi can spread to subdural space –> subdural empyema

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35
Q

What are the Sx of subdural empyema?

A

Febrile, headaches, neeck stiffness, if untreated –> coma, CSF profile similar to abscesses

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36
Q

What are extradural abscesses commonly assocaited with?

A

Osteomyelitis (of the adjacent bone)

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37
Q

What are the Sx of chronic bacterial meningoencephalitis from TB?

A

headaches, malaise and confusion, vomiting

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38
Q

What is the CSF like on bacterial meningoencephalitis from TB?

A

moderate pleocytosis, proteins are very high, glucose slightly decreased or normal.

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39
Q

Where is the fibrous exudate from the subarachnoid space usually located?

A

at the base of the brain, obliterating the cisterns and encasing the CN’s

40
Q

What are the most serious problem with chronic bacterial meningoencephalitis from TB?

A

arachnoid fibrosis (causing hydrocephalus) and obliterative endarteritis (causing arterial occlusion)

41
Q

What causes neurosyphilis?

A

Tertiary syphilis

42
Q

What are the major forms of meningovascular neurosyphilis?

A

Paretic and tabes dorsalis

43
Q

What is meningovascular neurosyphilis?

A

Chronic meningitis involving th ebase of the brain, spinal leptomininges and cerebral convexitis. May cause oliterative endarteritis (Heubner arteritis)

44
Q

What is paretic neurosyphilis?

A

Invasion of the brain by T. pallidum, progressive loss of mental and physical fxns with mood alterations

45
Q

What causes Tabes dorsalis?

A

damage by the spirochete to the sensory nerves in the dorsal roots, causing locomotor ataxia and sense of position, loss of pain sensation

46
Q

Physical exam of a Tabes dorssalis pt will reveal what anomaly?

A

+ Rhomberg’s sign

47
Q

What causes neuroborreliosis?

A

Borrelia burgorferi (Lyme disease)

48
Q

What are the Sx of neuroborreliosis?

A

aseptic meningitis, facial nerve palsies, mild encephalopathy, polyneuropathies

49
Q

What are the most characteristic features of viral meningoencephalitis?

A

perivascular and parenchumal mononuclear cell infiltration

50
Q

Intrauterine viral infections from Rubella may cause what in the baby?

A

Congenital malformations

51
Q

Many years after the viral infection may cause what?

A

Slowly progressive degenerative diseases

52
Q

What is the virus that is an important cause of epidemic encephalitis, especially in tropical regions, and is spread by arthopods?

A

Arbovirus

53
Q

What are the Sx to arthropod-borne viral meningoencephalitis?

A

Szrs, confusion, delirium, stupor and coma

54
Q

What are the CSF findings to arthropod-borne viral meningoencephalitis?

A

slight increase in pressure, initually a neurtrophilic pleocytosis which rapidly converts to lymphocytes, proteins are increased, glucose is normal

55
Q

What are the ages to HSV1 encephalitis?

A

any age, but most common in kids and young adults

56
Q

What are the Sx to HSV1 encephalitis?

A

mood and memory changes

57
Q

Where are the encephalitis regions for HSV1?

A

Begins in temporal lobes and orbital hyri of frontal lobes

58
Q

What are the neurological complications to HSV2 infections?

A

meningitis

59
Q

What happens in the neonate if mom has a HSV2 infection?

A

~50% develop severe encephalitis

60
Q

What are the clinical progression to shingles?

A

painful vascular skin eruptions that are usually self limiting, but may cause a persistent postheerapetic nerualgia syndrome

61
Q

What are the rare CNS complications to VZV infections?

A

granulomatous arteritis

62
Q

Who gets CMV infections?

A

Fetuses and immunosupressed

63
Q

What happens if a kid is infected inutero with CMV?

A

Periventricular necrosis –> progresses to microcephaly and periventricular calification or severe hemorrhagic necrosis

64
Q

What are the clinical Sx of poliomyelitis?

A

meningeal irritation, CSF similar to aseptic meningitis, anterior horn destruction (hyporeflexia, muscle atrophy)

65
Q

What happens in late “postpolio” syndrome?

A

progressive weakness, decreased muscle mass and pain

66
Q

What does rabies cause?

A

Severe encephalitis, transmitted by rabid animals

67
Q

What is the pathogenesis to rabies?

A

Virus enters CNS in ascending fashion –> goes along PNS around wound site –> incubation 1-3 mo –> advances to extreme hypersensitivity to pain + szrs + foaming of mouth –> death by resp failure

68
Q

What happens in HIV meningoencephalitis?

A

dementia, mental slowing, memory loss, mood disturbances, ataxia, bladder/bowel incontincence, szrs.

69
Q

What special cells are present in HIV meningoencephalitis?

A

microglial nodules with multinucleated giant cells

70
Q

What is vacuolar myelopathy?

A

spinal cord disorder in 20-30% of AIDS pts in the US. Sx similar to subacute combined degeneration (B12 dieficiency)

71
Q

What are the Sx to the HIV pts with inflammatory myopathy?

A

proximal weakness, pain, icnreased serum CK

72
Q

What are the CNS problems with AIDS in kids?

A

microcephaly with mental retardation, motor development delay, CALCIFICATION of small and large vessels and parenchyma within the basal ganglia

73
Q

Are you

A

still awake?

74
Q

I

A

am not.

75
Q

Progressive Multifocal Leukoencephalopathy (PML) is caused by what viral agent?

A

JC polyomavirus

76
Q

Which cells are infected with JC polyomavirus?

A

oligodendrocytes (they get glassy inclusiuons)

77
Q

What are the Sx to PML?

A

abnormal speech and vision, ataxia and dementia, demyelination

78
Q

How can you test for JC papovavirus in PML?

A

immunoperoxidase stain for a Dx of PML

79
Q

What are the Sx of Subacute Sclerosing Panencephalitis?

A

cognitive decline, spasticity of limbs and szrs

80
Q

What causes Subacute Sclerosing Panencephalitis?

A

happens months or years after initial infection with MEASLES

81
Q

What are the clinical findings in Subacute Sclerosing Panencephalitis?

A

myelin degeneration, viral inclusions of oligodendrocytes and neurons, inflammation of white and grey matter with neurofibrillary tangles. VERY RARE B/C OF VACCINATION.

82
Q

Who typically gets fungal meingoencephalitis?

A

immunosupressed pts

83
Q

Who are the major players to fungal meingoencephalitis?

A

candida albicans, mucor, aspergillus, cryptococcus neoformans (obstructive chronic meningitis)

84
Q

What causes vasculitis in fungal meingoencephalitis?

A

mucor, aspergillus and hemorrhagic infarct (w/subsequent sepsis with infectious agents)

85
Q

What causes the parenchymal invasions with fungal meingoencephalitis?

A

granulomas or abscesses, occur with most organisms but Candida and cryptococcus are most common

86
Q

What causes cerebral toxoplasmosis?

A

T. Gongii

87
Q

What pt’s get cerebral toxoplasmosis?

A

AIDS

88
Q

What is the timespan for cerebral toxoplasmosis?

A

evolves over 1-2 weeks, focal or diffuse

89
Q

What are the clinical findings for cerebral toxoplasmosis?

A

ring enhancing lesions, multiple abscessses with areas of necrosis, may occur in fetus

90
Q

What does naegleria sp. cause?

A

rapidly fatal necrotizing encephalitis

91
Q

What does acanthamoeba cause?

A

Chronic granulomatous meningoencephalitis

92
Q

Prion diseases are from the abnormal form of which protein?

A

Prion protein (PrP)

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93
Q

What are the main changes that occur in prion diseases?

A

Spongiform changes (in the vacuoles in neurons and glia), injured neurons shrivel and become hyperchromatic

94
Q

What are the Sx of prion diseases?

A

Main1 is progressive dementia (esp with Creutzfeld-Jacob disease)

95
Q

What is fatal familial insomnia?

A

fatal familial insomnia.

96
Q

Who are those CRAZY ASS people eating shit that they shouldnt be eating because theyre so super crazy and adjdawdnwunawdunhhwef?

A

Kuru

Clinical Neuroscience (12 decks)

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