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Neuro 1 > Infections of the Nervous System > Flashcards

Infections of the Nervous System Flashcards

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1
Q

Meningitis

A

Infection of the coverings of the brain

Particularly the leptominges (arachnoid and pia)

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2
Q

Acute and subacute/chronic meningitis

A

Acute - bacterial

Subacute/chronic - myco/fungal

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3
Q

Meningococal clinical feature

A

Rash

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4
Q

W-F syndrome

A

N. menin mostly

Speticiemia with rash and necrotic adrenals

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5
Q

Lab findins in bacterial meningitis

A

Increased protein and WBCs (neutrophl) and decreased glucose

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6
Q

Most adults form of meningitis

A

S. pnuemo

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7
Q

Nsocomial mening

A

Gram positive bugs (skin)and gram negative rods

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8
Q

Bacterial meningitis gross

A

Swollen cortex with congested vessels and visible exudae

Can have subdural effusion that can become empyema

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9
Q

Penumo, TB locations

A

Pneumo - convexities

TB - base brain

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10
Q

Bac meningitis microscopic

A

Acute inflammation of leptomeninges extending into the parenchymal vessles sometimes

Venous thrombosis, infarction in neonates

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11
Q

Bacterial menin mortalities and complications

A

Worse in neonates

Cerebral edema and herniation
INfarction
Hydrocephalus
Subdural effusions and empyemas

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12
Q

Mycobacterial meningitis

A

Basilar - hydrocephalus and cranial nerve deficitis

CHronic

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13
Q

Viral mening

A

Enterovirus
Inflammation only lymphocytes
Use PCR and IgM

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14
Q

Cryptococcus

A

Most commin in US
Most often basilar
Slimy film with huge capsule
Varible inflammation

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15
Q

Epidemic/sporadic/ immunosuppressed viral enceph

A

Epi - arbo/entero
Sporadic - HSV, rabies
Immuno - PML

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16
Q

Epidemic vial enceph diagnosis

A

Incubation less than 1 week

Use PCR or IgM

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17
Q

Microscopic and gross viral encepha

A

Gross - not very helpful

Microscopic - chronic inflammation, neuronophagia and microglial nodules

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18
Q

HSV

A 
Most common sporadic
If over 3 mos, frontal and temporal
Neonates - panencephalitis 
Olfactory seizures 
MRI will higlight frontotemporal invovlement

Asymmetric

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19
Q

HSV microscopic

A

Will have neuronophagia and microglial nodules PLUS inclusions

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20
Q

Outcomes of HSV

A

Worse in non-neonatal

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21
Q

Rabies progression

A

Incubation of 10days-1year in skeletal muscle and crawls to reach spinal cord

Prodrome - flu like symtpoms and pain

Acute neurologic dz - furous or dumb

Terminal - death and coma

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22
Q

Rabies gross and microscopic

A

Gross- normal

Micropsopic - negri bodies (purkinje cells) and minimal inflammation

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23
Q

Diagnosis and tx of rabies

Study These Flashcards
A

Mostly clinical history

Passive antibody and rabies vaccine prior to symptoms…after, just symptomatic therpay

24
Q

PML

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A

Cause by JC reactivation

Focal neurologic deficits

25
PML diagnosis
MRI findings of white matter disruption...CSF PCR
26
PML gross and microscopic
Asymmetric gray lesions in white matter Foci of demyelination...bizarre astrocytes
27
Tx and prognosis of PML
Death Supportive, maybe HAART therapy
28
Absecess
Most through local extension, some through hematoenous
29
Bacterial absecess
Anaerobes, mixed infections Immunocomprosimed - nocardia, mycobacteria, listeria
30
Aspergillus abscess
Love blood vessels, normally from lung infection, small angles and thin
31
Zygomycetes abscess
Usually orbitofrontal Poorly controlled DM Looks like balloon animal Rhizopus, mucor, absidia
32
PAM
Primary amebic meningoencephalitis (Naegleria fowelri) | 48-72 hours and death
33
Granulomatous amebic encephalitis
Acanthamoeba or balamuthia | Heme spread from lung infections
34
Toxoplasma
Associated with HIV or neonates...risk of infection most in last trimester but damage greatest in 1st
35
Toxoplasma appearance
Cysts and tachyzoites...can immunostain Mononuclear inflammation
36
Lyme dz
Borrelia burgdorferi Ixodes tick Northern regions
37
Lyme dz clinical
Can cause Bell's palsy...skin target rash...meningitis like Stage 1 - flu like smyptoms 2 - systemic 3 - chronic
38
Lyme dz diagnsosi
ELISA screening with west blot
39
Herpes zoster symtpoms
1st - preherpetic neuralgies (pain, itching in dermatome) 2nd - vesicular rash
40
Ramsay hunt syndrome
Facial paralysis associated with zoster...has a motor compoenent
41
Herpes zoster tx
Use zostavax as a vaccine
42
Spinal cord and brain HIV
``` Vacuolar myopathy (just like B12) HAND - HIV-associated neurocog disorders...dementia ```
43
HIV-associated ementia pathology
Monocytes/macrophages cross BBB | Leukoencephalopathy, with classic multinucleated giant cells
44
Neurosyphilis
Men>Women Insidious attnetion disorders progress Atrophic brain with thickend meninges Will see some infllamtion
45
Tabes dorsalis
Chronic involvement of DRG Lighting pain and loss of painproprioception Shuffling, broad-based gait Argyll-Robertson pupil - small accomdates, but doesn't react to light
46
Tabes dorsalis microscopic
Lose posterior column fibers
47
Testing for neurosyphilis
Early all might be positive...late, may be falsely negative CANNOT culture
48
Prion dzs
PrPsc alters PrPc conformation Auto dom
49
Most common prions
CJD and vCJD (mad cow)
50
Prion dz pathology
Neuronal loss with glial proliferation NO inflammation Spongiform change
51
CJD clinical
Rapid mental eterioration Myoclonus Six phenotypes based on codon 129 in the PRNP gene (methionine and valine)
52
CJD lab studies
14-3-3 protein in CSF Tau (CSF) These are not good
53
CJD imaging
Sporadic - basal ganglia | Variant - thalamus
54
CJD diagnositc
``` 2 of 4: Myoclonus Visual/cerbeellar distrubs Pyramid/extrapyramidal dysfunction Akinetic mutism ``` Atepyical EEG or pos 14-4-4 Others ruled out
55
vCJD symptoms
Psych symptoms Ataxia Upward gaze paresis is unique
56
vCJD neuropath
Amyloid plaques with spongiform changes | Can use tonsillar biopsy
57
Prion prognosis
No tx...vCJD - 14 mos, sCJD - 4-5 months

Neuro 1 (22 decks)

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