Thursday 2 - Diebel intro to encephalitis

Question 1

Seizures - more common in encephalitis or meningitis?

Answer 1

Encephalitis

Question 2

Classic example of a meningoencephalitis?

Answer 2

Mycobacterium tuberculosis

Question 3

What symptom of encephalitis is an indicator of a very poor prognosis?

Answer 3

Seizure

Question 4

Main host to host encephalitis virus (vector transmission)

Answer 4

Arbovirus (i.e. wes nile)

“arthropod borne”

Question 5

Two major causes of encephalitis, most common listed first.

Answer 5

idiopathic

herpes simplex

Question 6

What do you do first thing you see signs of encephalitis?

Answer 6

start acyclovir.

Question 7

Best imaging method for encephalitis?

Answer 7

MRI

Question 8

Antibody that you would find in the acute phase of an encephalitis infection?

Answer 8

IgM

Question 9

What is almost always in the CSF in encephalitis?

Exceptions?

Answer 9

WBCs - mainly lymphocytes

exceptions -
autoimmune will have very low WBC.

WNV will show neutrophils early

Acute disseminated encephalomyelitis will sometimes have neutrophils in CSF

Question 10

Lobe of the brain often infected first in encephalitis (especially HSV encephalitis)?

Answer 10

temporal lobe on one side (usually)

Question 11

Site of latency for alpha herpes virus?

Answer 11

in the neuron!!! (i think he wants us to know this)

Question 12

three types of alpha herpes viruses

Answer 12

HSV 1 and 2, varicella zoster

Question 13

Most common type of encephalitis in immunocompromized patients

Answer 13

VZV

Question 14

Acyclovir

mech
spectrum

Answer 14

Viral thymidine kinase can add a phosphate to acyclovir, from that point, cellular kinases can take over and add on two more phosphates.

Viral DNA polymerase will use this in place of a GTP, but this acyclovir doesnt have a ribose sugar and the chain terminates

Alpha herpes virus (not effective during latency)

Question 15

Drug used for beta herpes viruses

Answer 15

Gancyclovir

Question 16

Most common form of postinfectious encephalitis

Answer 16

Acute disseminated encephalomyelitis (ADEM)

Question 17

measles virus - group

primary measules encephalitis

Measles induced acute postinfection disseminated encephalomyelitis (ADEM)

Subacute sclerosing panencephalitis (SSPE)

Answer 17

ssRNA (-), group V

primary - encephalitis that occurs during the first phase of measles infection - rare - fever, headache

ADEM - results in demyelination via the immune system overreacting. virus is cleared from the body when this happens. 3-20 years after primary infection

SSPE - slow progression that causes degreneration in mental capacity

Question 18

Two types of arboviruses that can cause encephalitis

Answer 18

West nile virus (WNV)

La crosse encephalitis virus