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Flashcards in Generalities of Mass lesions Deck (40):
1

what are manifestations of mass lesions

Fever
Severe HA
Seizures

2

what is the most common single pathogen in mass lesions

s. areus

3

mixed anaerobic infections account for 1/2 the cases of what

mass lesions mostly GNR and GPC

4

what fungal agents can cause mass lesions

coccidoides immitis
candida albicans

5

what does ncc stand for

neurocysticercosis

6

what agent is responsible for ncc

taenia solium

7

what is the most common parasitic CNS disease

NCC

8

what is the most common cause of epilepsy in the world

NCC

9

many people carry cysticerci of what

t. solium

10

where is the prevalence of NCC the highest

Cental and South America, India and sub-saharan africa

11

why is the prevalence of NCC in US increasing

influx of immigrants

12

what is the pathogenesis of NCC

pt ingests ova- oncospheres release they disseminate and get lodged in CNS and develop cysicerci

13

what are parenchymal cysts

mature living cysticerci viable up to 10y suppress immune and the host is usually asymptomatic

14

what happens as cycticeri begin to die

they leak Ag an intense inflammatory response begins and host manifest with symptoms

15

what are extraparenchymal cysts

a few oncospheres can lodge in ventricles subarachnoid space or meninges can cause atypical cyst

16

what are the manifestations of NCC

depends on location of cyst
focal or gen tonic-clonic seizures, focal signs. altered mental, symptoms of elevated ICP (cyst in ventricle)

17

how do you diagnose NCC

symptoms usually only occur after cyst calcifies
histological
cyst seen on mri or ct
direct visualization on fundoscopic exam (live are noncontrast)

18

In absence of one or more of these results that confirm a diagnosis of neurocystticercosis, but with imaging results that suggests the diagnosis:

Positive EITB for detection of anticysticercal antibodies
CSF WBC with differential reveals an eosinophilia as high as 15%.
Patient signs and symptoms.

19

what is the treatment for NCC

Niclosamide destroys VIABLE cyst in CNS
Praziquantel destroys VIABLE cyst in CNS
Albendazole destroys VIABLE cyst in CNS
anticonvulsants, steroids, shunt or surgery, good prognosis w/ tx

20

what is the agent in toxoplasmosis

Tissue protozoan t. gondii

21

what type of pathogen is Tissue protozoan

eucaryote obligate intracellular parasite.

22

where can tissue protozoan trophozoite affect

any nucleated cell

23

what is a latent pseudocyst

found primarily in the brain and muscle – T. gondii cannot form a true cyst

24

Clinical implication of latent pseudocyst is with respect to

reactivation due to immunosuppresion

25

what is the 2nd most common cause of cns in aids pts besides hiv

t. gondii

26

what is the definitive host of t. gondii

cat

27

what type of host for t. gondii are humans

intermediate

28

how is ti. gondii transmitted

ingestion of psuedocyst from undercooked food
inhalation of a mature cyst from cat feces

29

what is the main pathogenesis of t. gondii

multifocal mass lesions
following release the protozoan spreads to all organs and tissues where trophozoites infect any nucleated cell

30

what is the sites where t. gondii lesions are found

CNS
EYE
LUNG
MUSCLE

31

reactivation diseases of t. gondii include

diffused encephalitis
multifocal mass lesions
disease of lung or eye

32

what is the symptoms of t. gondii

alterd mental, weakness, CN abnormalities, neuropsychiatric, focal or tonic clonic

33

what differential dx of mass lesions in aids pts

had, brain tumor (EBV), toxoplasmosis encephalitis, PML,Cryptococcal meningoencephalitis, CMV diseases

34

what would be seen in neuroimaging of t. gondii

CT- ring enhancing lesion
MRI-contrast enhancing lesion after admin of godolinium

35

what would shown in the mri of Toxoplasmosis encephalitis

multiple bilateral cerebral lesions in the juxtacortical and basal ganglia areas.
ganglia and are hypodense with ring-enhancement.

36

what would shown in the MRI of cerebral toxoplasmosis

Deep central gray nuclei or lobar gray-white junction.

37

what would be the serology results in t. gondii

IgM will not be present – disease is reactivation.
Absence of anti-Toxoplasma IgG makes a diagnosis of toxoplasmosis unlikely, even in an pt with advanced HIV/AIDS

38

what would be the brain biopsy results in t. gondi

trophs or multiple, ruptured tissue cysts in inflammatory lesions

39

what is the treatment of t. gondii

2→4 months of a combination of sulfonamides (sulfadiazine) or clindamycin plus pyrimethamine.
only treats trophozoites not latent infection of pseudocysts

40

what is the prevention of t. gondii

Pregnant women, Advanced HIV patients, SOT patients on immunosuppressive therapy, etc. should be instructed to avoid cats, cat feces and Cook pork well, not pink.