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Neurology-Week 3 > Pathology of CNS Infections > Flashcards

Pathology of CNS Infections Flashcards

1
Q

How can you grossly tell if brain tissue has a bacterial meningitis?

A

Loses transparency (filled with pus) –> adopts a cloudy/opaque coloration

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2
Q

How can bacteria spread into the meninges? (2 main ways)

A

Bacteremia (hematogenous spread via bloodstream)

Direct extension from mastoid, sinuses, skull, etc.

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3
Q

Signs/Symptoms of Meningitis

A 
Fever and headache
STIFF NECK
Brain edema
Brain ischemia/infarcts
Inc. ICP
Nerve palsies
Communicating hydrocephalus (Meningeal fibrosis)
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4
Q

Difference between Acute vs. Subacute/Chronic Meningitis

A

Acute: onset in HOURS
Subacute: weeks to months

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5
Q

Organisms responsible for SUBACUTE/CHRONIC meningitis

A

TB (mycobacterium)
Fungi (Cryptococcus)
Spirochetes (Syphilis, lyme disease)

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6
Q

Sarcoidosis can cause chronic meningitis (True or False)

A

True

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7
Q

Tuberculous meningitis involves a (granulomatous/nongranulomatous) inflammation mainly affecting what part of the brain?

A

Granulomatous; Base of brain

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8
Q

What cells can histologically be seen in the granulomas of tuberculous meningitis? ____ stain can be used to visualize tuberculous meningitis?

A

multinucleate GIANT cells; acid-fast

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9
Q

Common cause of meningitis in immunocompromised patients

  • Microscopy: single budding yeast with a thick capsule “halo”
  • Gross: brain has outer slimy consistency, yellow-gray exudate in ventricles –> a gelatinous substance with multiple small cysts in brain (“soap bubbles”)
A

Cryptococcosis

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10
Q

How can brain abscess can occur?

A
  1. Direct extension (sinuses, middle ear, etc.)
  2. Implantation (head trauma)
  3. Bacteremia (hematogenous spread via bloodstream)
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11
Q

Frontal lobe abscess can occur when there is a direct extension of infection from the ________.

A

Paranasal sinuses (sinusitis)

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12
Q

Temporal lobe or cerebellar abscess can occur when there is a direct extension of infection from ________

A

Middle ear (or Mastoid air cells) (Otitis or Mastoiditis)

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13
Q

Cause of brain abscesses; usually results in MULTIPLE abscesses and preferentially localizes to gray-white junction

A

Bacteremia

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14
Q

Abscesses of the brain due to BACTEREMIA prefer what area?

A

Gray-white junctions

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15
Q

Consequences of Brain Abscesses

A

Fever
Leukocytosis
Mass effect (headache, nauses, vomiting and herniation due to inc. ICP)
Brain destruction

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16
Q

(Bacteria/Viruses) are most common cause of Encephalitis

A

Virus (Herpesviruses, Arboviruses, Rabies, HIV, etc.)

17
Q

Viruses that can use retrograde spread along axons to infect the CNS (2 total)

A

HSV-1

Rabies

18
Q

_____________ is a virus that commonly causes encephalitis or hemorrhagic necrosis of the Temporal and Frontal lobes

A

HSV-1 (remember is typically orally spread via saliva, so makes sense is centered around the mouth)

19
Q

_____________ is a virus that commonly infects the Anterior Horns cells

A

Poliovirus

20
Q

___________ virus commonly infects oligodendrocytes, causing Progressive Multifocal Leukoencephalopathy

A

JC (John Cunningham) virus

21
Q

_____________ virus commonly infects the Hippocampus and Cerebellum

A

Rabies

22
Q

________________ virus commonly infects the DRG

A

Varicella-Zoster virus

23
Q

______________ virus usually infects the leptomeninges (Arachnoid and Pia mater)

A

Lymphocytic Choriomeningitis virus

24
Q

Examples of Parasitic infections of the CNS

A

Cysticercosis
Toxoplasmosis
Amebiasis

25
Q

MOST common parasitic CNS infection globally; etiologic agent is Taenia solium; due to ingestion of eggs (contaminated water or food); cysts can be either intra/extraparenchymal

A

Cysticercosis

26
Q

Cysticercosis is caused by the ingestion of undercooked pork with Taenia solium (True or False)

A

False: due to ingestion of EGGS in contaminated water or food

  • ingestion of undercooked pork leads to intestinal tapeworm (not CNS infection)
27
Q

CNS pathogen that causes RAPIDLY fatal necrotizing encephalitis; due to swimming in fresh water containing amoebas; treat with Amphotericin B

A

Naegleria fowleri

28
Q

2 main pathways for transmission of an infection to a fetus

A
  1. Ascending infection from vagina/cervix (usually bacterial)
  2. Transplacental infection (hematogenous)
29
Q

What are the STORCH infections that are the common causes of congenital encephalitis via TRANSPLACENTAL spread

A 
Syphilis
Toxoplasmosis
Other congenital infections (HIV)
Rubella
CMV
HSV-2

Neurology-Week 3 (11 decks)

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