Infections Flashcards
(211 cards)
1
Q
Virus associated with Progressive Multifocal Leukoencephalopathy
A
JC Virus
2
Q
The first proven viral polyneuritis in humans
A
HIV
3
Q
In viral infection, _____ is an intermediate step to seeding the brain or CSF.
A
viremia
4
Q
Aside from hematogenous spread, the HSV may spread to the CNS via these structures
A
olfactory neurons > cribriform plate > olfactotry bulbs
trigeminal ganglion > gasserian ganglion
5
Q
the most important route of infection for the majority of viruses
A
hematogenous
6
Q
To be susceptible to a viral infection, the host cell must have
A
on its cytoplasmic membrane specific receptor sites to which the virus attaches.
7
Q
Differentiating cells of the fetal brain have particular vulnerabilities, and viral incorporation may give rise to malformations and to hydrocephalus; an example is
mumps virus which can lead to?
A
ependymal destruction and aqueductal stenosis
8
Q
As a rule, in viral infections of the CNS, the glucose content of the CSF is normal, but infrequently, mild depression of the CSF glucose can be seen but never below
A
25 mg/dL
9
Q
As a rule, in viral infections of the CNS, the glucose content of the CSF is normal, but infrequently, mild depression of the CSF glucose can be seen in which viral meningitides?
A
mumps
HSV-2
LCM
VZV
10
Q
In viral CNSI, Bell’s palsy has been associated to whuch virus/es?
A
HSV-1
11
Q
What is Mollaret meningitis?
A
is characterized by episodes of acute meningitis with severe headache and sometimes low-grade fever, lasting for about 2 weeks, and recurring over a period of several months or years
12
Q
What is the most common cause of viral aseptic meningitis in adults?
A
enterovirus mainly echovirus & Coxsackie virus
Then followed by: HSV2 Varicella HIV Mumps EBV
13
Q
What is the most common cause of viral aseptic meningitis in children?
A
enterovirus-echovirus and Coxsackie virus
Followed by HSV2 LCM HSV1 adenovirus
14
Q
The natural host of LCM virus
A
Lymphocytic choriomeningitis
house mouse Mus musculus
15
Q
The 5th disease is caused by
A
parvovirus
16
Q
strain of parvovirus that can cause meningitis and encephalitis in children
A
B19
17
Q
viruses associated with meningitis + cauda equina neuritis
A
HSV
HIV
18
Q
viruses associated with meningitis + generalized lymphadenopathy, transient rash, mild icterisia
A
EBV
CMV
19
Q
virus associated with aseptic meningitis + intense lymphocytic pleocytosis (1000 cells/mm3)
A
LCM
20
Q
What is Vogt-Koyanagi Harada syndrome?
A
combinations of iridocyclitis, depigmentation of a thick swath of hair (poliosis circumscripta) and of the skin, vitiligo, around the eyes, loss of eyelashes, dysacusis, and deafness (the pathologic basis of the syndrome is not known)
21
Q
Mollaret Syndrome has been associated to which viruses?
A
HSV-1
HSV-2
EBV
Herpes 6 in children
22
Q
What is Elsberg Syndrome?
A
HSV2
lumbosacral radiculitis
urinary retention
23
Q
HaNDL syndrome
A
headache neurologic deficit
lymphocytic pleocytosis
24
Q
Behcet disease
A
a diffuse inflammatory disease of small blood vessels that has several other characteristic features such as oral and genital ulcers
acute inflammatory CNS disease
25
parkinsonism seen as residua of encephalitis from which viruses
Flaviviruses
26
In viral CNSI, you see thalamic signal changes in MRI, the associated viruses are
Japanese B, West Nile, Eastern Equine Encephalitis, rabies
27
The most serious arbovirus in the US because of its high mortality and morbitidy
EEE
| eastern equine encephalitis
28
Among the viral encephalitides, this is the gravestt
HSV
29
Describe the pathology found in HSV encephalitis
intense hemorrhagic necrosis of the inferior & medial temporal lobes & the mediorbital parts of the frontal lobes
30
In the acute stages of HSV encephalitis,
| eosinophilic inclusions are found in
intranuclear regionsn of neurons & glial cells
31
Two routes of entry of HSV to the CNS, which is more favored to be true?
latent virus in the trigeminal ganglia with reactivation:
1 infect the olfactory tract - olfactory bulb - CNS
2 spread along nerve fibers innervating anterior & middle fossae leptomeninges
2 more favored
32
EEG changes in HSV encephalitis
lateralized periodic high-voltage sharp waves in the temporal regions and slow-wave complexes at regular 2 to 3Hz
33
Sensitivity of nested PCR in HSV encephalitis for the first 3 weeks of illness
95%
34
Dose of acyclovir for HSV encephalitis
30 mg/kg/d for 10 to 14 days
35
if treatment is begun within ____ of onset of HSV encephalitis in an awake patient, survival is >90%
4 days
36
established cause of a limbic encephalitis in adult patients following allogenic hematopoietic stem cell bone marrow transplantation
HHV-6
37
limbic encephalitis, post bone marrow transplant associated with gray matter damage
adenoviruses
38
Aside from HHV-6, viral agents that can also cause encephalitis in transplant recipient patientts
CMV, EBV, adenovirus, HSV, and varicella zoster virus
39
Incubation period of rabies
20-60 days can be as short as 14 days
40
Describe the evolution of rabies infection
- incubation period of 20-60 days
- tingling numbness reflecting invasion of sensory ganglion
- prodromal symptoms, involvement of tegmental medullary nuclei
- psychosis, seizures
- death within 4-10 days for the paralytic form
41
Characteristic pathologic findings in rabies infection
Negri bodies - cytoplasmic eosinophilic inclusions, most prominent in pyramidal cells of the hippocampus & Purkenje cells
42
What are Babe nodules? where do you find these?
focal collections of microglia in the brainstem of rabies infected patients
43
This compound can inactivate the rabies virus so better wash bite wound with this!
Benzyl ammonium chloride
44
postexposure prophylaxis for rabies
Human rabies immune globulin (HRlG) 20 U/kg
1/2 infiltrated in the wound
1/2 intramuscular
45
active immunization for rabies
human diploid cell vaccine HDCV
1-mL injections on the day of exposure
days 3, 7, 14, and 28 after
46
Acute ataxia of childhood is most associated with this virus
VZV
but can be: enteroviruses (Coxsackie), EBV, CMV
47
vesicles in VZV are called
Lipschutz inclusion bodies
48
pathologic changes in VZV infection (4)
(1) inflammation in several unilateral sensory ganglia of the spinal or cranial nerves, (can cause necrosis /-hemorrhage)
(2) inflammation in the spinal roots & peripheral nerve contiguous with the involved ganglia
(3) poliomyelitis (different from acute anterior poliomyelitis because unilateral, segmental, involves dorsal horn, root, & ganglion)
(4) relatively mild leptomeningitis, limited to the involved spinal or cranial segments & nerve roots
49
True or False. one attack of zoster provides lifelong
| immunity
FALSE
50
VZV DNA is localized primarily in
trigeminal & thoracic ganglion cells corresponding to the dermatomes in which chickenpox lesions are maximal and that are most commonly involved
51
In VZV, the vesicles always appear within
72-96 hours
52
In VZV, pain & dysesthesia last for
1-4 weeks
53
VZV infection can be confirmed by
1 Tzanck smear - inding multinucleated giant cells in scrapings from the base of an early vesicle
2 direct immunofluorescence of a biopsied skin lesion, using antibody to VZV
54
Most common dermatomes affected by VZV
T5-T10
| then cranicervical
55
Acyclovir shortens the duration of acute pain and
| speeds the healing of vesicles in VZV infection, provided that treatment is begun within approximately
48-72 h upon appearance of the rash
56
Treatment for postherpetic neuralgia
amitriptyline 50 mg at bedtime can be increased
| gradually to 125 mg daily
57
True or False. postherpetic neuralgia eventually subsides even in the most severe and persistent cases
True
58
True or False. HIV results in a depressed cell-mediated immunity particularly decreasing the number of CD8+ lymphocytes
False
| CD4+
59
In the later stages of HIV infection, the most common neurologic complication is
AIDS dementia complex
60
AIDS Dementia Complex
subacutely progressive dementia (loss of retentive memory, inattentiveness, language disorder, apathy), abnormalities of motor function
61
Without treatment, survival after the onset of AIDS dementia is
generally 3 to 6 months
62
True or False. In AIDS Dementia complex, treatment with antiretroviral drugs can result in cognitive improvement.
True
63
Most sensitive test in the early stages of AIDS Dementia complex
psychomotor speed testing
| e.g., trail making, pegboard, and symbol-digit testing
64
MRI findings in AIDS Dementia Complex
patchy but confluent or diffuse white matter changes with ill-defined margins
65
Pathologic findings in AIDS Dementia Complex
diffuse & multifocal rarefaction of the cerebral white matter with scanty perivascular infiltrates of lymphocytes & clusters of a few foamy macrophages, microglial nodules & multinucleated giant cells
diffuse myelin breakdown, white matter pallor
diffuse poliodystrophy
66
True or False. AIDS dementia complex is due to secondary brain destruction due HIV infection elsewhere
False
| It is a result of a direct virus invasion
67
Pathologic picture of HIV myelopathy
vacuolar degeneration
68
Most common form of peripheral neuropathy in HIV infection
distal, symmetrical, axonal polyneuropathy, predominantly sensory & dysesthetic in type
69
the first proven viral polyneuritis in humans
HIV
70
HIV myopathy
inflammatory myositis
71
Most frequent focal infectious complications in AIDS
toxoplasmosis
72
True or False. Asymptomatic Toxoplasma-seropositive AIDS patients should be treated with oral pyrimethamine & sulfonamide
True
| Because Toxoplasmosis in AIDS usually represents a reactivation of a previous infection
73
Treatment of Toxoplasmosis?
| if this is not tolearted, what can you give?
oral pyrimethamine (100 mg then 25 mg daily) + sulfonamide (4 to 6 g daily in four divided doses)
clindamycin
74
Most frequent nonfocal infectious complications in AIDS
CMV
| crytococcosis
75
CMV encephalitis in AIDS is usually accompanied by
retinitis
76
MRI findings in AIDS with CMV encephalitis
T2 signal hyperintensity in the ventricular borders
77
Diagnostic test for CMV infection
PCR
78
Treatment for CMV infection
ganciclovir
| foscarnet
79
Quaternary Syphilis
consists of an aggressive and rapidly progressive
| necrotizing process that causes strokes and dementia as a result of involvement of brain parenchyma and vessels
80
Shingles involving several contiguous dermatomes is known to occur in AIDS with CD4 counts below
500
81
Forms of VZV infection AIDS patients
- multifocal lesions of the cerebral white matter like PML
- cerebral vasculitis with hemiplegia
- myelitis
82
A special result of HlV antiretroviral treatment may induce an intense inflammatory response to a coexistent infection
immune reconstitution inflammatory syndrome, or IRIS
83
Tropical Spastic Paraplegia
HTLV-1
84
Virus causing lower motor neuron paralysis + hemorrhagic conjunctivitis
enterovirus 70
85
Viruses that can cause acute anterior poliomyelitis
poliomyelitis
Coxsackie groups A and B
Japanese encephalitis
West Nile Virus
86
The polio virus multiplies in the
pharynx & intestinal tract
87
2 Types of Poliomyelitis
NonParalytic
| Paralytic
88
Paralytic Poliomyelitis symptomatology
- weakness at the height of fever then improvement then rapid muscle weakness peak within 48 hours
- no progression of weakness after the temperature has been normal for 48 hours
- muscle atrophy 3 weeks, maximal 12-15 weeks
89
Pathologic reactions in poliomyelitis
- lesions are found i n the precentral gyrus, brainstem, spinal cord
- hypothalamus, thalamus, brainstem (motor nuclei of reticular formation), vestibular nuclei and roof nuclei of the cerebellum, spinal cord anterior & intermediate gray matter
90
Polio Vaccine
Sabin Vaccine
| 2 doses 8 weeks apart at 1 year of age then before schooling
91
"Inclusion body encephalitis"
SSPE
| subacute sclerosing panencephalitis
92
Describe the symptomatic evolution of SSPE
- usually there is a primary measles infection before 2 years old then an asymptomatic period of 6-8 years
- progressive intellectual deterioration, seizures, mycolonus
- decorticate
93
progressive ataxic-myoclonic chronic dementia in a child
SSPE
| subacute sclerosing panencephalitis
94
characteristic EEG in SSPE
periodic (every 5 to 8 s) bursts of 2 to 3/s highvoltage waves, followed by a relatively flat pattern
95
Histopathologic hallmark of SSPE
Eosinophilic inclusions in the cytoplasm & nuclei of neurons and glia cells
96
Oligoclonal bands found in the CSF of SSPE represent
measles-virus-specific antibody
97
Histopathologic picture of PML
- gigantic reactive astrocytes containing bizarre-shaped nuclei and mitotic figures (resemble high grade glioma)
- nuclei of oligodendrocytes are greatly enlarged & contain abnormal inclusions
98
CSF picture of PML
normal
99
MRI of PML
variable size & location of nonenhancing demyelinating lesions
100
Pathogenesis of PML
JC virus thought to be dormant in the kidney or bone marrow until an immunosuppressed state permits its active replication
101
True or False. approximately 70% of the normal adult population has antibodies vs JC virus
True
102
True or False. PML caused by JC virus is untreatable in non-AIDS patients but progression can be slowed down in AIDS patients
TRUE
| for AIDS patients, give antiretroviral + protease inhibitor
103
Poor prognostic sign in JC Virus PML
CD4
104
First recognized slow virus infection
Encephalitis lethargica
but the virus is still not identified!
105
True or False. Parkinsonian syndrome seen in survivors of Encephalitis Lethargica / somnolent-ophthalmoplegic encephalitis have Lewy bodies similar to idiopathic PD
False
| no Lewy bodies but with neurofibrillary changes
106
Rasmussen's Encephalitis is associated to which viruses and which autoantibody
CMV, HSV1
| anti-glutamine receptors3
107
What is a prion?
proteinaceous infectious particle that is devoid of nucleic acid, resists the action of enzymes that destroy RNA and DNA, fails to produce an immune response, and electron microscopically does not have the structure of a virus
108
PrP is normally encoded in
chromosome 20
109
True or False. An abnormally folded prion protein can act as a template for the conversion of normal PrP to PrPsc
True
110
How does a prion protein Prp acquire its infectivity?
change in the physical conformation in which its helical proportion diminishes and the proportion of the beta
pleated sheet increases
111
Another classification scheme proposed for Prions Disease is to base tion systems have been devised that
are based on both the presence of methionine (M) or
valine (V) at codon ?
129
112
EEG is SSE
changing over the course of the disease from one of diffuse and nonspecific slowing to one of stereotyped psuedoperiodic highvoltage slow- (1- to 2-Hz) and sharp-wave complexes on an increasingly slow and low-voltage background
113
MRI is SSE
hyperintensity of the lenticular nuclei on T2-weighted
and diffusion-weighted images in the basal ganglia and
cortex
114
CSF finding diagnostic of SSE
immunoassay of peptide fragments of normal brain
proteins, termed "14-3-3"
repeat this test up to 3x
115
Gerstmann-Straussler-Scheinker Syndrome
autosomal dominant , progressive cerebellar ataxia,
corticospinal tract signs, dysarthria, and nystagmus
+/- mild dementia
116
Fatal Insomnia
characterized by intractable insomnia, sympathetic overactivity, & dementia, leading to death in 7 to 15 months
- lesions mainly in the medial thalamic nuclei
- mutation in codon 178
117
Kuru histologic picture
noninflammatory loss of neurons and spongiform change throughout the brain, but predominantly in the cerebellar cortex, with astroglial proliferation and kuru plaques
118
Kuru symptomatology
afebrile, progressive cerebellar ataxia, with abnormalities of extraocular movements, weakness progressing to immobility, incontinence in the late stages, and death within 3 to 6 months
119
Vector of Zika Virus
Aedes
120
Zika virus can cause
microcephaly
| GBS
121
Most common bacterial meningitides
```
Streptococcus pneumoniae
Neisseria meningitides
group B streptococcus in neonates
Listeria monocytogenes
Haemophilus influenza
```
122
Seizures in meningitis are most associated with
H influenza
123
Most common bacterial menigitides in the neonates
E. coli
| group B streptococcus
124
One factor that predispose a patient to have bacterial meningitis
antecedent viral infections of the upper respiratory passages or infections of the lung
125
Rapid detioration in a patient with meningitis associated with petechial or purpuric rash
Meningococcemia
Echovirus serotype 9
Staphylococcus aureus
126
Meningitis + cranial nerve abnormalities
pneumococcal meningitis
127
Most significant factor in the pathogenesis of neonatal meningitis
maternal infection
128
Meningitis in splenectomized patients, most likely is caused by
Streptococcus pneumoniae
129
Meningitis after an ear infection or upper respiratory tract infection
H influenza
130
True or False. Infants with pneumococcal meningitis have the highest risk factor for developing subdural effusion
False
| regardless of bacterial type
131
the simplest method of demonstrating effusion in a child
transillumination of the skull
132
an indispensable part ofthe examination of patients with the symptoms and signs of meningitis or of any patient in whom this diagnosis is suspected
lumbar puncture
133
CSF pleocytosis in bacterial meningitis ranges from
250-10000 cells/ mm3
134
CSF red cells in meningitis are seen in
```
anthrax
Hantavirus
dengue
ebola
amebic
```
135
CSF protein in bacterial meningitis ranges from
100-500 mg/dL
136
CSF glucose in bacterial meningitis
137
CSF cultures in bacterial meningitis are usually positive in
70-90%
138
Blood cultures in bacterial meningitis are usually positive in
40-60%
139
Most sensitive test of demonstrating bacterial infection in the CSF
PCR
other tests CIE LPA RIA ELISA
140
CSF LDH of >35 mg/dL. Fungal, bacterial or viral?
Fungal or bacterial
141
The most specific and sensitive test for CSF
| otorrhea and rhinorrhea is the finding of
beta2-transferrin (tau), not found in fluids other than CS
142
empiric therapy for bacterial meningitis in 0-4 week old
Cefotaxime + ampicillin
143
empiric therapy for bacterial meningitis in 4-12 week old
3rd G Cephalosporin + ampicillin + dexamethasone
144
empiric therapy for bacterial meningitis in 3month - 50 years o ld
3rd G Cephalosporin + vancomycin
| +/- ampicillin
145
empiric therapy for bacterial meningitis in >50 years old
3rd G Cephalosporin + vancomycin + ampicillin
146
empiric therapy for bacterial meningitis in immunocompromised patient
ceftazidime + vancomycin + ampicillin
147
empiric therapy for bacterial meningitis with basilar skull fracture
3rd G Cephalosporin + vancomycin
148
empiric therapy for bacterial meningitis with head trauma, or post neurosurgery, CSF shunt
ceftazidime + vancomycin
149
antibiotic to add if Listeria monocytogenes is suspected
ampicillin
150
Duration of treatment in bacterial meningitis
10-14 days
151
Dexamethasone dose for bacterial meningitits in a child
0.15 mg/kg qid for 4 days
152
Dexamethasone dose for bacterial meningitits in an adult
10mg IV initial then 5mg q6 x 4 days
153
True or False. Patients with bacterial meningitis with evidence of cortical vein thrombosis should be started on anti-seizure drugs
True
154
this neurologic sequelae of bacterial meningitis was shown to have decreased with dexamethasone
sensorineural hearing loss
155
Prophylaxis for patients exposed to meningococcal meningitis
Ciprofloxacin
| Rifampicin mg q12 for adults; mg/kg q12 for children x 2 days
156
Prophylaxis for patients exposed to meningococcal meningitis >2 weeks
none
157
Osler triad
pneumococcal meningitis
pneumonia
endocarditis
158
What is Hurst Disease and which microorganism is it associated with?
Acute hemorrhagic leukoencephalitis
| Associated with Mycoplasma pneumoniae
159
Symptomatology of Mycoplasma pneumoniae encephalitis
```
Cerebellitis
Choreoathetosis
Seizures
Delirium
Hemiparesis
```
160
How to establish the diagnosis of Mycoplasma pneumoniae encephalitis?
1 culture from respiratory tract
2 IgG IgM antibodies, cold agglutinin in blood CSF
3 PCR dna in CSF
161
Treatment of Mycoplasma pneumoniae encephalitis
Macrolide
Or
Tetracycline
162
Meningoencephalitis in an immunocompromised individual taking the form of a rhombencephalitis
Listeria monocytogenes
163
Treatment of Listeria monocytogenes encephalitis
Ampicillin 2g IV q4
| + Gentamicin 5mg/kg IV in 3 divided doses
164
Bacteria causing Melioidosis
Burkhorderia pseudomallei
165
A diabetic patient came from vacation from Cambodia and Thailand had encephalitis. Most likely culprit is?
Burkholderia pseudomallei causing melioidosis
166
Diagnositc test for melioidosis
Culture of organism from any body site
| CSF pharynx blood urine or sputum
167
Treatment of melioidosis
1 intensive phase: Ceftazidime IV x 10-14days
| 2 eradication phase: cotrimoxazole +/- doxycycline
168
Diagnostic test for Legionella encephalitis
Urine antigen
| Culture of blood CSF
169
Treatment for Legionella encephalitis
Levofloxacin
Moxifloxacin
Azithromycin
Rifampicin
170
Microorganism responsible for cat scratch disease
Bartonella henselae
171
Catscratch fever symptomatology
Unilateral axillary/cervical adenopathy
Encephalopathy
High fever
Seizures or status epilepticus
In AIDS: focal cerebral vasculitis, neuroretinitis
172
Catscratch fever diagnostic workup
PCR o silver staining from excised lymph node
173
Catscratch fever first line of treatment
Azithromycin or
| Doxycycline
174
Hemorrhagic inflammatory spinal fluid formula
| Necrosis of vessels
Bacillus anthracis
175
Treatment of anthrax
Ciprofloxacin +
Clindamycin or
Rifampin or
Meropenem
176
Acute meningoencephalitis
Papilledema
Increaee ICP
After drinking raw milk
Brucellosis
177
Diagnostic workup for brucellosis
Blood CSF antibody titers
178
Treatment of Brucellosis
Doxycyline +
Streptomycin or
Gentamicin or
Rifampin
179
Microorganism responsible for Whipple's Disease
Tropheryma whipplei
180
```
Slowly progressive dementia
Supranuclear ophthalmoplegia
Ataxia
Seizure
Nystagmus
Oculomasticatory movemebts / myorhtyhmja
```
Likely diagnosis? Microorganism that caused this?
Whipple Diseas
| Tropheryma whipplei
181
Treatment for Whipple Disease
Penicillin or Ceftriaxone x 2 weeks then
| TMP-SMX or or doxycycline or tetracycline x 1yr
182
Subdural empyema usually originates from
frontal or ethmoid sinuses
183
Subdural empyema pathogenesis
1 direct extension through bone & dura
| 2 spread from septic thrombosis of venous sinuses (superior longitudinal sinus
184
Most common causative bacteria in subdural empyema
Streptococci (nonhemolytic & viridans)
185
Empyema that follows meningitis in children tends to localize on the
undersurface of the temporal lobe
186
Empiric treatment for subdural empyema
3rd generation cephalosporin + metronidazole
187
Empiric treatment for epidural abscess
cephalosporin + vancomycin
188
The most commonly involved sinuses in septic thrombophlebitis
transverse
cavernous
petrous
189
Transverse sinus septic thrombophlebitis
usually follows a middle ear, mastoid, or petrous bone chronic infection
190
True or false.
| Anticoagulation is the mainstay of treatment of septic thrombophlebitis
False
| high doses of antibiotics
191
Septic Cavernous Sinus Thrombophlebitis is usually secondary to
ethmoid, sphenoid, or maxillary sinuses infection
192
True or False.
| brain abscess is always secondary to bacteremia and a bacterial focus elsewhere in the body
False.
| a small proportion is iatrogenic
193
Brain abscess originating from the ear usually are located in
2/3 inferomedial temporal lobe
194
Metastatic abscesses from hematogenous spread are
| usually situated in
the distal territory of the middle cerebral arteries
195
Most common cardiac congenital anomaly to develop brain abscess
Tetralogy of Fallot
196
Most common organism causing bacterial cerebral abscess
virulent streptococci
197
2 stages in the pathogenesis of TB meningitis
1 bacterial seeding of the meninges and subpial regions of the brain with tubercle formation
2 rupture of one or more of the tubercles and the discharge of bacteria into the subarachnoid space
198
Histopathologic finding in meningeal tubercles
central zone of caseation surrounded by epithelioid cells and some giant cells, lymphocytes, plasma cells, and connective tissue
199
TB PCR sensitivity
80%
200
The single most effective drug in TB
isoniazid
201
HREZ dose in adults
5-10-15-20 mg/kg/day
202
HREZ dose in children
10-15-15-20 mg/kg/day
203
Dexamethasone dose in TB meningitis
0.4mg/kg/day x 1 week then taper 3-6 weeks
204
Sarcoidosis is
represents an exaggerated cellular immune response to a limited class of antigens or autoantigens
205
mainstay of treatment of sarcoidosis
steroids
206
Causative agent of neurosyphilis
Treponema pallidum
207
The initial event in neurosyphilis is
meningitis
208
CSF changes in neurosyphilis in order
cells - protein - gamma globulins
209
Principal Types of Neurosyphilis 8
```
Asymptomatic neurosyphilis
meningeal syphilis
meningovascular syphilis
paretic neurosyphilis
tabetic neurosyphilis
syphilitic optic atrophy
spinal syphilis
syphilitic nerve deafness vestibulopathy
```
210
Treatment of neurosyphilis
-IV penicillin G 18-24M u/day x 10-14 days
211
Most common form of neurosyphilis
meningovascular syphilis
