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Flashcards in CNS Viruses Deck (21):
1

What viruses can enter the CNS via neurons of the olfactory bulb?

Herpesviruses

2

How can rabies enter the CNS?

Enter via replication in the muscles and then infection of the neurons and enter the CNS via retrograde spread

3

How does Herpesvirus enter the CNS?

Infection of the olfactory neurons and anterograde movement into the CNS

4

What is unique about Herpesvirus travel on neurons?

Herpes viruses are set apart by their ability to transport bi-directionally in neurons

5

A 24 year old man is brought to the physician by his wife after he had two days of progressive confusion. His temperature is 101F but has no other abnormalities. When he speaks, he enunciates clearly and his phrasing is of average length. However he uses words and word‐ like utterances in a manner that makes litttle sense. He doesn’t follow any commands. What is the likeliest diagnosis?

1. cerebral toxoplasmosis
2. herpes simplex encephalities
3. hiv enencephalopathy
4. meningococcal meningitis
5. subdural empyema

2. herpes simplex encephalities

6

An 18‐year‐old female had an episode of mild intestinal infection. Approximately 6 days later, she developed severe headaches, vomiting and fever. She was alert and oriented but had mild nuchal rigidity. A spinal tap revealed CSF high in cell count and protein level. Bacteriological culture of the CSF resulted in no growth. The physician's report indicated aseptic meningitis. Electron microscopic analysis of CSF particles would MOST likely reveal which of the following?

A. Enveloped viruses with globular projections
B. Naked icosahedral viruses with projections at each vertex
C. Minute naked viruses
D. Bullet shaped viruses with surrounding envelopes
E. Double‐shelled icosahedral viruses

C. Minute naked viruses - likely a Picornavirus

B - Adenovirus
D - Rhabdovirus
E - Rotavirus

7

How do Flavivirus infections lead to CNS infection?

Viremia

8

What is the typical CNS manifestation of Flavivirus infection?

Meningitis

9

What is the typical CNS manifestation of Herpesvirus infection?

Encephalitis

10

What population is most susceptible to West Nile Virus?

Elderly

11

What family does Zikavirus belong to?

Flaviviridae

12

What is Zikavirus associated with in fetuses?

Microcephaly

13

How is Zikavirus transmitted?

Mosquitoes

14

What is subacute sclerosing pan encephalitis?

Develops many years after acute measles; presence of viral inclusion bodies in brain cells; inflammation; general destruction of brain tissue. Progressive dissemination of a defective virus infection in the presence of a normal immune response that is uniformly fatal.

15

Several conventional viruses and unconventional agents cause slow degenerative diseases of the central nervous system. Which virus best matches the following clinical vignette or disease description? A 17‐year‐old girl is diagnosed with subacute sclerosing panencephalitis. Her CSF has a high titer against a paramyxovirus, which can be rescued by fusion with permissive cells. Viral particles are absent from a brain biopsy specimen.

A. Measles
B. Rubella
C. HIV
D. Polyoma
E. Prions

A. Measles

16

What virus is "bullet" shaped?

Rabies Virus

17

How does rabies move to the CNS?

Uni‐directional (retrograde) transport from peripheral sites to CNS

18

What is post-exposure prophylaxis of Rabies?

- Wash wound
- IgG prophylaxis into the wound

19

What CNS manifestation do prions cause?

Infectious encephalopathy - neurodegenereation without inflammation

20

What will be seen on histology of Kuru disease?

Plaques in the cerebellum

21

Fifteen unrelated men, all in their late twenties, developed progressive neurological disorders. Symptoms included presenile dementia and ataxia. Serum and CSF antibody were negative in ELISA tests against a battery of known neurotropic viruses. Each of the men had received, 10‐15 years earlier, a series of growth‐stimulating treatments with pituitary growth hormone. A preliminary diagnosis of Creutzfeldt‐Jakob disease was made. The MOST likely cause of the illness is which of the following agents?

A. Slow virus
B. Unconventional agent
C. Classical virus
D. Latent virus
E. Virus

B. Unconventional agent

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