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Host And Defense - Exam 2 > Quiz 4 - Weller - CNS Infections > Flashcards

Quiz 4 - Weller - CNS Infections Flashcards

1
Q

What is meningitis?

A

Inflammation of the meninges

Fever, headache, stiff neck

Bacterial, viral, fungal, protozoan, parasitic

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2
Q

What is encephalitis?

A

Inflammation (swelling) of the brain

Fever, headache, stiff neck

Often viral, but can be bacterial, fungal, protozoan, or parasitic

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3
Q

What are brain abscesses/subdural empyema?

A

Similar symptoms to encephalitis

Mostly BACTERIAL

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4
Q

What is purulent meningitis?

A

Meningitis with inflammatory exudate - usually bacterial

Mostly acute

Fever, stiff neck, irritability

Can be fatal

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5
Q

What is chronic meningitis?

A

Gradual or subtle onset with progressive signs and symptoms over a period of weeks

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6
Q

What is aseptic meningitis?

A

Inflammation from an increase of cells, usually WBCs in CSF and ABSENCE of bacteria/fungi

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7
Q

T/F - Encephalitis is primarily viral etiology.

A

TRUE

Acute or chronic demyelinating diseases w/ or w/o inflammation can happen

Idiopathic encephalitis

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8
Q

What is meningoencephalitis?

A

Pts with both meningeal and encephalitic manifestations

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9
Q

What are the 4 routes leading to a CNS infection?

A

Hematogenous
-Blood
—Viral, bacterial, fungal

Contiguous focus
-Sinus, ear, face, oral cavity
—Bacterial

Direct inoculation/iatrogenic
-Trauma, surgery, lumbar puncture, congenital defects
—Bacterial

Nervous system
-Infection of systemic nn, retrograde movement to brain
—Viral

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10
Q

What is contiguous focus exposure?

A

Any infection close to the CNS that spreads to the CNS - NOT BY BLOOD

  • Otitis media
  • Mastoiditis
  • Sinusitis
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11
Q

What is a great example of a viral CNS direct inoculation?

A

Rabies virus

-Transmitted to peripheral neurons and travels via retrograde transport to CNS

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12
Q

If there is a CSF infection, what do we look for, compared to normal values?

A

Bacterial

  • High WBC (Lots of PMNs)
  • LOW GLUCOSE
  • HIGH PROTEIN
  • High opening pressure

Viral

  • High WBC
  • NORMAL GLUCOSE
  • NORMAL PROTEIN
  • High opening pressure

Fungal

  • Very High WBC
  • LOW GLUCOSE
  • HIGH PROTEIN
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13
Q

What is the most common type of meningitis?

A

VIRAL

Usually less severe than bacterial

Usually resolves on its own w/o treatment

Fever, headaches, stiff neck

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14
Q

What is the most common cause of viral encephalitis?

A

Viruses

Fever, headache, altered cognition, seizure

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15
Q

What are enteroviruses?

A

Most common cause of viral meningitis

*Especially active in the SUMMER and FALL months in children less than 15 years old

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16
Q

Tell me about HSV meningitis.

A

Major cause of viral meningitis, 2nd only to enteroviruses

*In adults, majority of cases of meningitis are due to HSV-2

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17
Q

HSV-1 is responsible for 90% of cases of ____ __________.

A

HSV encephalitis

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18
Q

T/F - Varicella-Zosters Virus (VZV)is suspected in the presence of concurrent chickenpox or shingles, but also linked to meningitis and encephalitis w/o VZV characteristic rash.

A

TRUE

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19
Q

____ _________ may produce aseptic meningitis, w/ or w/o associated infectious MONOnucleosis.

A

EBV infections

S Caleb Freeman

20
Q

What should be suspected in any pt presenting with a viral meningitis w/ known or suspected risk factors for HIV infection?

A

HIV meningitis

This can occur following primary infection with HIV in 5-10% of cases and less commonly at later stages of illness

21
Q

What is considered when clusters of meningitis and encephalitis cases occur in a restricted geographic region during the SUMMER or early FALL?

A

Arboviral meningitis

22
Q

What is the classical presentation of encephalitic rabies?

A

Fever, fluctuating consciousness, autonomic hyperactivity

23
Q

Newborns are at risk for meningitis via what organisms?

A

Group B strep/S. Agalactiae - GPC

E. coli - GNR

L monocytogenes - GPR

Klebsiella

24
Q

Infants and children are at risk of meningitis via what organisms?

A

S. Pneumoniae - GPC

N. Menigitidis - GNDC

H. Influenzae - GNR

25
Q

Adults are at risk for meningitis from what organisms?

A

Strep pneumoniae

N meningitis

26
Q

Difference b/t beta and alpha hemolysis.

A

Beta - Clear zone around bacterial colony. Complete lysis

Alpha - greenish-brown colored halo around colonies. Partial lysis

27
Q

Strep pneumoniae is known to cause what and where is it acquired?

A

Pneumonia, meningitis

Normal oropharyngeal flora, aspiration to lungs/other parts of body

Transmission to CNS may result in meningitis

28
Q

What organism is the leading cause of sepsis and meningitis in the first few days of life for neonates?

A

Group B strep

Found in lower GI and/or vaginal flora of 10-40% of women

Can colonize the newborn if amniotic sac breaks and is open for longer than 18 hours and/or in the vaginal flora

29
Q

What is another organism that commonly causes newborn meningitis?

A

E. coli

From vaginal flora

30
Q

__ _________ is strictly a human pathogen and found in nasopharyngeal flora of 20-80% of healthy people.

A

H influenzae

Meningitis occurs in children in 2 years of age

Immunization has dramatically reduced disease

31
Q

What G- bacterium, that is usually found diplococcus and is exclusively a human parasite?

A

Neisseria meningitidis

Nasopharyngeal colonization common

*Common in pyogenic meningitis in all but most often in children

32
Q

T/F - Listeria monocytogenes is a G+ rod that is beta hemolytic and spread in soil ground water, decayed veggies, and GI tract of animals we eat. It can grow at fridge temps.

A

TRUE

33
Q

T/F - In 2006, the FDA authorized listeria-specific bacteriophage to be added to food products to combat listeria infections.

A

TRUE

34
Q

What does listeria monocytogenes cause, how acquired, and symptoms?

A

Meningitis in newborns and immunocompromised

Dairy, meat, vegetables

Bacteremia, headache, stiff neck, confusion, convulsions

35
Q

Mycobacterium tuberculosis causes what?

A

Tuberculosis

36
Q

Other than tuberculosis, what else does mycobacterium TB cause?

A

Tuberculous meningitis - from the blood spread of primary or post primary TB

Also can be acquired via exposure to individuals with active TB

37
Q

T/F - Fungal pathogenesis is similar to bacteria, and most fungi are opportunists.

A

TRUE

38
Q

Cryptococcus neoformans causes what?

A

Associated CNS involvement/meningitis development in immunocompromised pts

These infections are rare in healthy people

39
Q

T/F - Syphilis is a spirochete.

A

TRUE

40
Q

How is syphilis acquired?

A

STD

Primary infection is genitalia, secondary spreads beyond initial infection site

Can cause neurosyphilis

Headache, nausea, vomiting, neck stiffness, etc.

41
Q

Lyme borreliosis is caused by _______ ___________.

A

Borrelia burgdorferi

42
Q

What does Lyme disease cause?

A

Meningitis and/or chronic encephalopathy

Transmitted by 14 species of tick

Skin lesion, erythema, can spread to CNS

43
Q

What are prions?

A

Protein molecules that have conformational changes of a normal prion protein (same protein, different folding/structure)

**Protein material that can fold in multiple, structurally abstract ways, at least one of which is transmissible to other prion proteins, which leads to disease comparable to a viral infection

Example: Creutzfeldt-Jakob disease

44
Q

What are three examples of immunosuppression?

A

HIV, post organ-transplant, immunosuppression therapies

45
Q

Tell me more about immunosuppression.

A

Reactivation of lantern infections
-EBV, VZV, CMV

Opportunistic susceptibility

Host And Defense - Exam 2 (16 decks)

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