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Neuro II > Viral Encephalitis, Meningitis, and Poliomyelitis > Flashcards

Viral Encephalitis, Meningitis, and Poliomyelitis Flashcards

1
Q

Aseptic Meningitis

A

Aseptic Meningitis is a non-bacterial inflammation of the tissues lining the brain

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2
Q

Encephalitis:

A

Encephalitis: viruses that infect neurons within the CNS and induce intense inflammation of the parenchyma

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3
Q

Myelitis:

A

Myelitis is inflammation of the spinal cord

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4
Q

What are the two main routes of entry for a virus into the CNS?

A

The two main routes of a virus into the CNS are:

  1. Blood Supply
    1. Respiratory/fecal-oral which then colonizes the mucosal epithelial (oropharyngeal or bowel lymphoid tissue) and then into the blood stream.
    2. Once it infects the vascular endothelial cells it has direct access across the BBB or the infection can lead to a breakdown of the BBB
  2. Peripheral nerves
    1. Mucosal epithelial cells can then infect the peripheral nerves (HSV) and then move into the CNS
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5
Q

What is the General Presentation of All CNS Viruses?

A

Headache

High fever (>105)

Neck Stiffness

AMS

Seizures

Focal neurologic signs

Behavorial changes

Language disturbances

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6
Q

Arbovirus

collectively they are the largest cause of ______ worldwide?

4 Families

what is the most common mosquito in WV?

A

collectively they are the largest cause of encephalitis worldwide?

the 4 families of the Arbovirus are:

  1. Flavivirus
  2. Togavirus
  3. Reovirus
  4. Bunyavirus

The most common mosquito in WV is the Aedes species

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7
Q

Flavivirus

diseases:

Virus characteristics:

transmission cycle:

ID confirmed by:

Geographic distribution:

A

Flavivirus

diseases: West Nile

virus characteristics: +RNA, icosahedral, enveloped

transmission cycle: Bird-Mosquito-Human (human is a dead end host)

ID confirmed by: serum/CFS or PCR

Geographic distribution: mostly southern, more tropical and warmer states

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8
Q

Togavirus

diseases:

Virus characteristics:

transmission cycle

Geographic distribution:

“Waldo:”

what types of infection can this cause:

A

Togavirus (Arbovirus)

diseases: chikungunya

Virus characteristics: +RNA, icosahedral, enveloped

transmission cycle: nonhuman primate-mosquito-human

Geographic distribution: Caribbean and Mexico

“Waldo:” joint pain/joint swelling

chikungunya virus can cause meningioencephalitis and myelitis

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9
Q

Reovirus

diseases:

genus:

Virus characteristics:

transmission cycle:

Geographic distribution:

A

Reovirus (arbovirus)

diseases: Colorado Tick Fever
genus: coltivirus

Virus characteristics: dsRNA, icosahedral, nonenveloped, segmented genome (12)

transmission cycle: rodent-tick-human/elk

Geographic distribution: Western states

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10
Q

Bunyavirus

species:

Virus characteristics:

transmission cycle:

infection:

Geographic distribution:

A

Bunyavirus (arbovirus)

species: La Crosse

Virus characteristics: (-)RNA, segmented, helical, enveloped

transmission cycle: mosquito-human

infection: encephalitis or meningoencephalitis

Geographic distribution: high mountains of the east (prominent in WV and OH)

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11
Q

Rabies Virus

genus:

Virus characteristics:

transmission cycle:

infection:

“Waldo:”

treatment:

A

Rabies Virus

genus: Lyssavirus

Virus characteristics: -ssRNA, helical capsid, enveloped, “bullet shaped” simple 5 gene genome

transmission cycle: bite from an infected animal- most often dogs. *the severity of the disease depends on the amount of virus shed- the bite gives you the innoculating dose

infection: encephalitis

Waldo: hydrophobia, delirium with rapid progression to coma, myelitis with ascending flaccid weakness

High mortality

treatment: post-exposure prophylaxix with rabies immune globulin and vaccine

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12
Q

Herpesvirus

1) HSV-1 is the most common cause of HSV based cases of _____ in the US
2) HSV-2 is the most common in HSV based ______cases
3) Both HSV-1 and HSV-2 can can be seen in cases of ____ and _____
4) . VZV, CMV, EBV, HBV, HSV-7,8,9 can be seen in cases of _____ and _____.

A

Herpesvirus

1) HSV-1 is the most common cause of HSV based cases of encephalitis in the US
2) HSV-2 is the most common in HSV based meningitis cases
3) Both HSV-1 and HSV-2 can can be seen in cases of meningitis and myelitis
4) . VZV, CMV, EBV, HBV, HSV-7,8,9 can be seen in cases of encephalitis and meningitis.

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13
Q

Encephalitis cause by herpes often presents with?

What is the Waldo in the history for dx herpesvirus?

A

Encephalitis cause by herpes often presents with?

acute focal neurological findings (<1 week)

altered consciousness, ataxia, focal seizures, speech problems, hemiparesis, amnesia, fever

Herpes is the only sexually transmitted virus that can move into the CNS for this exam

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14
Q

Aseptic meningitis caused by Herpes often presents as:

A

Aseptic meningitis caused by Herpes often presents as:

sudden onset, headache, fever, nausea, vomiting, malaise, photophobia

also possible are: rash, diarrhea, upper respiratory symptoms

(genetal lesions- anything from the repro course can help dx herpes)

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15
Q

Poliovirus

Genus:

Family:

Virus Characteristics:

symptoms are due to:

transmission:

types of cells are infected:

disease characteristics:

A

Poliovirus

Genus: Picornavirus

Family: Enterovirus

Virus Characteristics: (+)ssRNA, icosahedral, nonenveloped

symptoms are due to: total lysis of the neuron cell- poliomyelitis

transmission: fecal-oral highly infectious

types of cells are infected: motor neurons

disease characteristics: slow growing. 2 weeks to establish infection in primary site (oropharynx/GI) and then another week to move into neurons.

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16
Q

what type of vaccine is still used for Poliovirus and in what countries?

A

A live attenuated vaccine is still used for polio in endemic areas (Nigeria, Afganastan, Pakistan)

17
Q
A
18
Q

MMR infections

Measles and Mumps: family, viral characteristics

Rubella: family, viral characteristics

A

MMR infections can lead to enchephalitis

Measles and Mumps: paramyxoviruses, -ssRNA, enveloped

Rubella: toga, +RNA, enveloped

*A vaccine is available for MMR. U.S. outbreaks are usually from travel by unvaccinated individuals**

19
Q
A
20
Q

JC Polyomavirus

viral characteristics:

closely associated with _______ positive patients

transmission:

primary infection site:

primary infection results in latent infections of the ____, _____, and ______.

reactivation in immunocompromised patients results in infections of ________.

Develops into ________.

A

JC Polyomavirus- “small DNA tumor viruses”

viral characteristics: dsDNA, circular genome, non-enveloped

closely associated with HIV positive patients

transmission: fecal-oral

primary infection site: tonsils or GI tract

primary infection results in latent infections of the kidney, bone marrow, and tonsils.

reactivation in immunocompromised patients results in infections of Ogliodendrocytes.

Develops into Progressive Multifocal Leukoencaphalopahthy (PML).

Neuro II (12 decks)

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