Infections Flashcards

1
Q

what will you see with encephalitis lethargica (secondary to influenze in 1917-1928)?

A

fevers, lethargy, HA, disturbance of eye movements

variety of movement disorders including chorea, athetosis, dystonia, and myoclonus

1/4 get severe unremitting PAKINSONISM

also get unique oculogyric crises where eyes deviate to one side or up

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2
Q

Which CN is most likely to be affected in a pt with sarcoid?

A

CN VII

FACIAL PARESIS

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3
Q

Polio attacks what aspect of the nervous system?

A

anterior horn cells

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4
Q

Meningitis in immunocomprimised pt with path stain india ink = ?

A

cryptococcus

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5
Q

CSF in pt with spongiform encephalopathy or CJD will ususally show…?

A

nothing. normal

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6
Q

What comes to mid with rim enhancing brain lesion in AIDS pt?

A

Toxo gondii or primary CNS lymphoma

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7
Q

What is the treatment for Toxoplasma gondii?

A

Sulfadiazine and pyrimethamine

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8
Q

CMV and HIV usually produce what accumulations in the Brain?

A

microglial nodules

with HIV they are around blood vessels

cith CMV they are subpial or subependymal

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9
Q

EEG in person with herpes CNS infection will show what?

A

discharges over the temporal regions

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10
Q

Where do brain abscesses usually originate from (ie where in the body did they migrate from)

A

usually heamtogenous spread from lung, heart, sinuses, and ear.

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11
Q

where in the brain do abscesses usually form?

A

junction of gray and white matter

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12
Q

pt with hx of syphilis may be confused to have a brain tumor if he develops what?

A

intracranial gumma

they grow several centimeters and start as inflammatory but then get fibrosed

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13
Q

Most common cause of fungal meningitis or abscess

A

Aspergillus

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14
Q

Which area of the brian is primarily targeted with late syphilis?

A

rhombencephalon (pons and medulla oblongata)

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15
Q

Most common cause of brain abscess in AIDS pt

A

T. gondii more common than fungal (aspergillus) in AIDS pt

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16
Q

Most common symptom of pt with brain abscess?

A

headache

17
Q

What bug grows in more than half of brain abscesses?

A

strep

staph more common with penetrating head injury

18
Q

Acute meningitis in elderly and babies is most commonly what bug and how do you treat it?

A

Listeria

amp + gent

19
Q

How is CJD usually transmitted?

A

infected nervous system tissue (dura mater grafts, and infected growth hormone preps from cadaver)

Kuru not common in US (New Guniea)

20
Q

What do you see with tabes dorsalis?

A

leptomeningitis, posterior columns and DRG affected.

happens decades later

gait ataxia, + romberg, bowel/bladder disfunction, Argyll Robertson pupils

21
Q

describe argyll robertson pupils

A

ARP-PRA
Accommadation Reflex present (pupils will constric to focus on an object that comes into visual field - like examiners finger)

Pupillary Reflex Absent (pupil will not constrict when light shown in it)