CNS Micro

Question 1

are levels of complement low or high in CNS?

Answer 1

low

Question 2

what cell of the CNS regulates the immune response?

Answer 2

astrocytes

Question 3

what cell of the CNS is a macrophage?

Answer 3

microglia

Question 4

what cytokine do astrocytes make?

Answer 4

TGF-b

Question 5

can T cells enter the BBB if they are unactivated?

Answer 5

no must be activated to enter

Question 6

what is the rule for B cell to enter BBB?

Answer 6

BBB must be inflamed

Question 7

what antibody is mainly in the CNS?

Answer 7

IgG

Question 8

what are three child causes of bacterial meningitis?

Answer 8

E coli
Group B strep
listeria monocytogene

Question 9

what are two adult causes of bacterial meningitis?

Answer 9

strep pneumo and neisserie meningitidis

Question 10

what is the structure of E coli?

Answer 10

encapsulated rods

Question 11

is E coli gram pos or neg?

Answer 11

negative

Question 12

if H flu gram neg or pos?

Answer 12

negative

Question 13

what is the structure of H flu?

Answer 13

encapsulated coccobacilli

Question 14

what is structure of streptococcus agalactiae?

Answer 14

encapsulated cocci in chains

Question 15

is strep agalactiae gram neg or pos?

Answer 15

pos

Question 16

what type of hemolysis in strep agalactiae?

Answer 16

beta hemolytic

Question 17

what is structure of strep pneumo?

Answer 17

encapsulated diplococci

Question 18

is strep pneumo gram neg or pos?

Answer 18

pos

Question 19

what type of hemolysis in strep pneumo?

Answer 19

aplpha

Question 20

what is structure of staph A?

Answer 20

encapsulated cocci in clusters

Question 21

is staph A gram neg or pos?

Answer 21

pos

Question 22

what type of hemolysis in staph A?

Answer 22

beta hemolysis

Question 23

what is the structure of mycobacterium TB?

Answer 23

acid fast bacilli

Question 24

what is structure of listeria monocytogenes?

Answer 24

facultative intracellular rods…no capsule

Question 25

is listeria monocytogenes gram neg or pos?

Answer 25

pos

Question 26

what is structure of neisseria meningitidis?

Answer 26

encapsulated diplococci

Question 27

is neisseria menigitidis gram neg or pos?

Answer 27

neg

Question 28

where is neiserrie menigitidis commonly found?

Answer 28

respiratory tract

Question 29

what is the yeast that can cause menigitis?

Answer 29

cryptococcus neoformans

Question 30

what is the structure of cryptococcus neoformans?

Answer 30

encapsulated round yeast

Question 31

where do we pick up cryptococcus neoformans?

Answer 31

inhaled pigeon shit

Question 32

what is the one type of infection that leas to a cloudy colored CSF?

Answer 32

bacterial

Question 33

what three infection types lead to elevated opening pressure of subarachnoid space?

Answer 33

bacterial fungal TB

Question 34

what infection type does not lead to elevated opening pressure

Answer 34

viral

Question 35

what cell type is elevated in bacterial menigitis?

Answer 35

PMNs

Question 36

what cell type is elevated in viral meningitis?

Answer 36

lymphocytes

Question 37

what happens to protein in bacterial meningitis?

Answer 37

protein is up

Question 38

what happens to glucose in bacterial, Tb and fungal meningitis?

Answer 38

is down because immune cells using it up to fight

Question 39

what was the issue with the neisseria mengitidis vaccine originally?

Answer 39

it did not cover the B group capsule so you could still get infected with that strand

Question 40

what does the new N. meningitidis vaccine cover?

Answer 40

the B group capsule

Question 41

what type of vaccine is the N. meningitidis B?

Answer 41

protein based

Question 42

meningococcal meningitis leads to what in CSF?

Answer 42

super high levels of the bug, cloudy CSF, elevated opening pressure, high PMNs, elevated protein and decreased glucose

Question 43

what happens to skin with meningococcal meningitis?

Answer 43

get non blanching petechial rash

Question 44

how does listeria get into CNS?

Answer 44

retrograde transmission along the cranial nerves, especially those in oral cavity

Question 45

what is abnormal about CSF in listeria meningitis?

Answer 45

not usual findings...no cloudiness and no PMN elevations

Question 46

what is listeria meningitis associated with?

Answer 46

atypical sub acute course...leading to abnormal movements, seizures and loss of consciousness

Question 47

what is the structure of enteroviruses?

Answer 47

SS +RNA

Question 48

are enteroviruses enveloped?

Answer 48

non enveloped

Question 49

what enteroviruses can lead to CNS infection?

Answer 49

polio and coxsackie viruses

Question 50

what is transmission of polio virus?

Answer 50

fecal to oral

Question 51

how does polio spread to CNS?

Answer 51

via motor neurons in the GI tract

Question 52

what are the two vaccines for polio? which is used now?

Answer 52

SAlk and Sabin...salk used now

Question 53

what virus associated with animals is common to cause CNS issues?

Answer 53

rabies virus

Question 54

what is structure of rabies virus?

Answer 54

ss negative sense RNA

Question 55

is rabies virus enveloped?

Answer 55

enveloped

Question 56

how does rabies virus reach the CNS?

Answer 56

retrograde movement from bite site along a peripheral nerve

Question 57

what is the histologic finding in rabies?

Answer 57

Negri bodies

Question 58

what do negri bodies look like?

Answer 58

cytoplasmic inclusions in neurons...little bumps

Question 59

what are symptoms of rabies?

Answer 59

acute progressive encephalitis....fever headache dysphagia

Question 60

what are the viruses associated with the togaviridae class that can affect CNS?

Answer 60

eastern/western equine enceph | venzuelan equine enceph

Question 61

what are the viruses associated with flaviviridae that can affect CNS ?

Answer 61

west nile and zika

Question 62

what is structure of viruses in flaviviridae and togaviridae families?

Answer 62

pos sense ssRNA with envelope

Question 63

what is gene type of herpes viruses?

Answer 63

ds DNA

Question 64

are herpes viruses enveloped??

Answer 64

yes they are

Question 65

what are the two herpes simplex viruses that can lead to CNS issues?

Answer 65

HSV1 and HSV2

Question 66

who is at risk for severe disease from HSV1/2?

Answer 66

neonates with mother who has primary infection late in pregnancy

Question 67

where does HSV1 and 2 remain latent?

Answer 67

in neuronal cell bodies

Question 68

how do HSV1 and 2 get into neuronal cell bodies?

Answer 68

break through keratin in skin and do retrograde transport along neurons

Question 69

what can HSV1/2 cause in CNS?

Answer 69

only encephalitis...no meningitis

Question 70

how does HSV1/2 spread?

Answer 70

anterograde transport from neuron cell bodies leads to viral replication in epithelial cells

Question 71

what can happen to eye in HSV infection?

Answer 71

corneal scarring

Question 72

what can induce HSV1 reactivatiom?

Answer 72

stress...nerve damage...sunlight..illness

Question 73

what does HSV1 reactivation look like on skin?

Answer 73

vesicles on erythematous base

Question 74

HSV meningitis has what special thing in CSF?

Answer 74

RBCs!! with elevated lymphocytes too

Question 75

where does latency of VZV occur?

Answer 75

in ganglia of cervical, lumbar and thoracic ganglia

Question 76

reactivated VZV looks like what? is called?

Answer 76

shingles...dermatomal rash

Question 77

what is drug used to treat HSV?

Answer 77

acyclovir

Question 78

what must happen to acyclovir when you give it?

Answer 78

needs to be activated

Question 79

what activates acyclovir?

Answer 79

HSV thymidine kinase...adds to its specificity

Question 80

what is the more active form of acyclovir that you can give?

Answer 80

valacyclovir

Question 81

what is the drug used to treat CMV?

Answer 81

ganciclovir

Question 82

how does ganciclovir work?

Answer 82

activated by CMV kinase and chain termination of DNA synthesis