INFECTIONS OF THE NERVOUS SYSTEM

Question 1

> Greek word “___________” which means “stretch.”

Answer 1

tetanos

Question 2

Characteristics
- bacilli
- gram-positive
- Anaerobic
- spore-forming rods
- Spore is at one end (“terminal spore”)
- organism looks like tennis racket

Answer 2

Clostridium tetani

Question 3

Habitat - soil
MOT - Organism enters through traumatic breaks in skin
I/P:- 4-5 days up to 3 wks

Answer 3

Clostridium tetani

Question 3

> are the living organisms that live and feed on dead and decaying organisms

Answer 3

Saprophytes

Question 4

damages viable tissue surrounding infection & optimizes cond. for bacterial multiplication.

Answer 4

Tetanolysin

Question 5

• produces exotoxin,
• toxin blocks release of inhibitory neurotransmitters (glycine & γ-aminobutyric acid [GABA]) from spinal neurons.
• Excitatory neurons are unopposed & extreme muscle spasm (tetanus, spastic paralysis) results.

Answer 5

Pathogenesis

Question 5

> Tetanus neurotoxin
released upon cell lysis after bacterial growth under anaerobic cond. (e.g., in deep puncture wounds)
prevents presynaptic release of inhibitory neurotransmitters glycine & gamma-aminobutyric acid (GABA).

Answer 5

Tetanospasmin (or tetanus toxin)

Question 6

is a protease that cleaves proteins involved in the release of neurotransmitters.

Answer 6

Tetanus toxin (tetanospasmin)

Question 7

w/ neurotoxin known as ____________..
Results to spastic paralysis

Answer 7

tetanospasmin

Question 8

lockjaw

Answer 8

Trismus

Question 8

sardonic smile

Answer 8

Risus sardonicus

Question 9

Persistent back spasms

Answer 9

Opisthotonus

Question 10

highly fatal disease characterized by muscle spasms & convulsions.
Due To:

Answer 10

TETANUS NEONATORUM

Question 10

human globulin to neutralize toxin

Answer 10

tetanus immunoglobulin

Question 11

> Bulges, dents near the ends of the can, a leak from anywhere in the can, a crack in the glass of the jar and RUST (for jars – rust on the margins of the lid) are reasons to toss out cans automatically

Answer 11

Clostridium botulinum

Question 12

Characteristics
- bacillus
- gram-positive,
- Anaebrobic
- spore-forming

Habitat - soil
MOT - Organism & botulinum toxin transmitted in improperly preserved food.

Virulence Factors
- botulinum toxin
- 7 toxins ( types A to G)
- neurotoxic (affect nervous system - causes flaccid paralysis)

Answer 12

Clostridium botulinum

Question 13

the chief neurotransmitter of parasympathetic nervous system, the part of autonomic nervous system ( branch of peripheral nervous system) that contracts smooth muscles, dilates bld vessels, increases bodily secretions, & slows heart rate.

Answer 13

Acetylcholine

Question 13

• a protease (cleaves proteins involved in release of acetylcholine at myoneural junction), causing flaccid paralysis.

Answer 13

Botulinum toxin

Question 14

Toxin inhibits acetylcholine release leading to _______________ (cannot contract muscles).

Answer 14

flaccid paralysis

Question 15

• ingestion unpasteurized honey
• laccid paralysis (floppy baby)
• Can lead to sudden infant death syndrome(SIDS)
• > Death is due to resp paralysis

Answer 15

Infant – borne botulism

Question 15

• descending, flaccid paralysis (can cause respiratory failure)

Answer 15

Classical Botulism

Question 16

in which spores contaminate a wound, germinate, and produce toxin at the site

Answer 16

wound botulism

Question 17

> “_____________,” which induces a cell-mediated response that limits its growth.
in “_____________,”, M. leprae multiplies at the site of entry, usually the skin, invading and colonizing Schwann cells. The microbe then induces T-helper lymphocytes, epithelioid cells, and giant cell infiltration of the skin, causing infected individuals to exhibit large flattened patches with raised and elevated red edges on their skin. T

Answer 17

tuberculoid (paucibacillary)

Question 17

or Hansen’s Bacillus

Answer 17

Mycobacterium leprae

Question 17

> creates an environment that is antagonistic to botulism. It’s what scientists call “competitive exclusion.” Beneficial bacteria begin to acidify the food, a condition C. botulinum doesn’t like. Adding salt to a ferment also reduces C. botulinum’s ability to grow, and encourages beneficial bacteria to take over. There are also other “competitive factors” that beneficial bacteria and fungi create in smaller quantities to exclude pathogenic varieties.

Answer 17

Fermenting foods

Question 18

Which of the following food items is most frequently associated with infant botulism? (A) Corn syrup (B) Canned infant formula (C) Liquid multivitamins (D) Honey (E) Jarred baby food

Answer 18

ANSWER IS “D”

Question 19

affects the skin and peripheral nerves

Answer 19

hansen's disease (leprosy)

Question 19

> has the longest doubling time (at 13 days of doubling time in the mouse footpad.[12]) of all known bacteria and has thwarted every effort at culture in the laboratory > Also found in armadillos.

Answer 19

Mycobacterium leprae

Question 20

- Aerobic, acid-fast rods. - Cannot be cultured in vitro. - Optimal growth at less than body temperature, so lesions are on cooler parts of body, such as skin, nose, & superficial nerves. - Grows in peripheral nervous system

Answer 20

Mycobacterium leprae or Hansen’s Bacillus

Question 21

more likely to transmit; higher numbers of organisms than tuberculoid

Answer 21

lepromatous form

Question 21

2 forms of leprosy:

Answer 21

1. Tuberculoid 2. lepromatous

Question 22

Nodular, multibacillary, patchy sensory loss, leonine face, clawed hands,saddle nose, (-) in lepromin test w/ strong antibody response

Answer 22

LEPROMATOUS (CUTANEOUS FORM)

Question 23

- destructive lesions d/t cell-mediated response to organism. Damaged fingers is d/t to burns & other trauma, bec. nerve damage causes loss of sensation.

Answer 23

tuberculoid leprosy

Question 23

- cell-mediated response is lost; large numbers of organisms appear in lesions & bld. No toxins or virulence factors are known.

Answer 23

lepromatous leprosy

Question 24

- delayed type of hypersensitive reaction - first described by mitsuda in 1919 - used as antigens may be of human origin or armodillo derived

Answer 24

LEPROMIN TEST

Question 25

(Etiologic Agents) Neisseria meningitidis Listeria monocytogenes Mycobacterium Tuberculosis

Answer 25

ACUTE MENINGITIS (BACTERIAL)

Question 26

(Etiologic Agents) Cryptococcus neoformans

Answer 26

GRANULOMATOUS MENINGITIS (FUNGAL )

Question 27

– Inflammation /infection of brain parenchyma

Answer 27

ENCEPHALITIS

Question 28

- Inflammation /infection of leptomeninges (pia & arachnoid)

Answer 28

MENINGITIS

Question 28

- Inflammation /infection of brain & spinal cord

Answer 28

ENCEPHALOMYELITIS

Question 29

– inflammation of brain & meninges

Answer 29

MENINGOENCEPHALITIS

Question 29

– inflammation of spinal cord

Answer 29

MYELITIS

Question 30

E.Agent - High risk – children 6 to 12 mons - Newborn – most common is E.coli Other causes: : Grp B Streptococci & : Listeria monocytogenes

Answer 30

ACUTE BACTERIAL MENINGITIS

Question 31

- Older infants & children - * majority due to Haemophilus influenzae type b. - Children 1 mon. Of age & adults community-acquired meningitis: * Most common due to Streptococcus pneumonia * followed by Neisseria meningitidis

Answer 31

ACUTE BACTERIAL MENINGITIS

Question 32

- causes gonorrhea, neonatal conjunctivitis (ophthalmia neonatorum), pelvic inflammatory disease (PID), Disseminated gonococcal infection - also known as the gonococcus (plural, gonococci). - Portal of Entry - GENITAL TRACT

Answer 32

1. Neisseria gonorrhoeae

Question 32

- causes meningitis and meningococcemia - also known as meningococcus (plural, meningococci) - Portal of Entry - RESPIRATORY TRACT

Answer 32

2. Neisseria meningitidis

Question 33

CHARACTERISTIC > Gram-negative > bacteria > nonmotile; > diplococcus, like kidney bean; > piliated - can cause meningitis & other forms of meningococcal disease > encapsulated

Answer 33

Neisseria meningitidis

Question 34

> Large polysaccharide capsule. One of the three classic encapsulated pyogenic bacteria (Streptococcus pneumoniae and H. influenzae are the other two).

Answer 34

Neisseria meningitidis

Question 34

- epithelial lining of the nasopharynx normally serves as a barrier to bacteria. - pathogenic strains may invade the bloodstream and cause systemic illness after an incubation period of two to ten days

Answer 34

NEISSERIA MENINGITIDIS

Question 35

- BACTERIA – other name : meningococcus. - transient flora of nasopharynx. - Gr (-), coffee bean-shaped or kidney-shaped diplococcus

Answer 35

NEISSERIA MENINGITIDIS

Question 36

> _____________ are distinguished by their propensity to evoke acute neutrophilic inflammation and “pus.” - bacteria capable of causing local purulent inflammation or generalized infection (pyemia, sepsis).

Answer 36

pyogenic bacteria

Question 37

- infection of ear

Answer 37

otitis media

Question 37

- s/s : begins in throat - enters bldstream causing bacteremia - goes into meninges causing meningitis - In susceptible persons, pathogenic strains may invade the bloodstream

Answer 37

Neisseria meningitidis

Question 38

is defined as adrenal gland failure due to bleeding into the adrenal glands, commonly caused by severe bacterial infection

Answer 38

Waterhouse - Friderichsen syndrome (WFS)

Question 39

- May coalesce & form larger hemorrhagic lesions - Purpuric rash - Progress to massive disseminated intravascular coagulopathy, - Waterhouse-Friderichsen syndrome = w/ destruction of adrenal glands

Answer 39

Neisseria meningitidis

Question 40

> Granulomatosis infantiseptica is caused when a pregnant individual is infected with ____________________, which often occurs because the individual eats contaminated food.

Answer 40

Listeria monocytogenes

Question 41

is a bacterial pathogen that can survive at refrigerated temperatures.(it often contaminates soft cheeses, deli meats, hot dogs, milk, salads, fruits, and vegetables. ) rash will develop up to seven days after birth. Granulomatosis infantiseptica can also cause nodules to develop internally, specifically over the liver and spleen.

Answer 41

Listeria monocytogenes

Question 42

- Gr (+) bacilli; - slender, short, gram-positive rods - facultative - do not form spores - cold-loving - asymptomatic to Mild s/s; - usually infects immunocompromised.

Answer 42

Listeria monocytogenes

Question 43

– InIA (for Attachment and invasion)

Answer 43

Internalin A

Question 44

– InIF (for Attachment and invasion) - surface protein w/ specific relevance for infection of host brain

Answer 44

Internalin F

Question 45

– LLO (For Lysis of vacuoles) - enables to escape into the cytosol upon internalization

Answer 45

Listeriolysin O

Question 46

(for cell to cell spread)

Answer 46

ActA

Question 47

– LLO - (cell to cell spread) - has ability to damage plasma membrane of host cells

Answer 47

Listeriolysin O

Question 48

- Can grow in CNS & placenta. (transplacental transmission) - If pregnant, can lead to stillbirth or spontneous abortion

Answer 48

Listeria monocytogenes

Question 49

- w/ formation of granulomas - Chronic type - Common cause: Mycobacterium tuberculosis & Cryptococcus neoformans. - W/ remission & relapses

Answer 49

GRANULOMATOUS MENINGITIS

Question 50

- > Pathogenesis—Granulomas and caseation mediated by cellular immunity (i.e., macrophages and CD4-positive T cells - [delayed hypersensitivity]). Cord factor (trehalose mycolate) correlates with virulence. No exotoxins or endotoxin. Suppression of cell-mediated immunity increases risk of reactivation and dissemination.

Answer 50

GRANULOMATOUS MENINGITIS: Tuberculous meningitis

Question 51

- Etiologic Agent: Fungus - Caused by Cryptococcus neoformans > MOT: inhalation of fungus fr. Envt. > Infection spreads fr. Lung into bld affecting CNS - s/s: headache, N&V,loss of vision & other neurologic findings. - DX: direct exam of CSF - TX: amphotericin B & flucytosine for 4 to 8wks Lifelong maintenance is required.

Answer 51

GRANULOMATOUS MENINGITIS

Question 52

- Cryptococcus neoformans - a yeast found worldwide. - abundant in soil containing bird droppings - Its spores are inhaled.

Answer 52

GRANULOMATOUS MENINGITIS: Cryptococcal meningitis