Lecture 5: Infectious Disease Affecting the Nervous System Flashcards
1
Q
BBB
A
- allows passage:
a. water
b. some gases
c. lipid-soluble molecules
all by passive diffusion - selective transpor amino acids
- tight junctions create barrier
- prevents entry lipohillic potential neurotoxins and pathogen
- major consideration when choosing therapy
2
Q
P glycoprotein
A
gatekeeper of BBB
-can be an issue for abx
3
Q
Acute bacterial meningitis
A
rapidly developing bacterial infection of meninges
4
Q
Most dangerous form ABM caused by what pathogen?
A
Neisseria Meningitidis causes meningococcal meningitis
5
Q
Neissiera meningitis characteristic
A
aerobic, g(-) diplococcus
6
Q
Neissiera meningitis
transmission
prevalent where
prevention
A
t: person-person transfer of large droplet respiratory secretions
prevalent: where people are in close proximity for long periods time: jails, ,college dorms, military camps, etc
prevention: vaccine fo r kids and adults
- menveo, menacer, minenrix (with tetanus)`
7
Q
Streptococcus pnuemoniae
- characteristics
- causes what disease
- what %
- mortality % - prevention
A
causative agent for bacterial meningitis
- pairs or short chains
- causes pneumococcal meningitis as well as pneumonia
- 30% ABM cases
- high mortality rate 20-30% - VAX- pnemovax >64 yrs, prevanar 13 for < 5 years or > 64 years
8
Q
Pneumovax 23
A
> 64 years
9
Q
Prevnar 13
A
pneumococcal vaccine <5 yrs or > 64 yrs
10
Q
Haemophilus inlufenzae type B
A
- once most prevalent species causing bacterial meningitis in american children but now there ic vaccine
- less than 40 cases of homophiles meningitis in US
- VACCINE
11
Q
Pathogenic steps leading to meningitis
A
- organism disseminates, rash appears
bright red patches -> blue black spots - once in blood, organisms pass BBB
- meninges becomes inflamed
- pressure on spinal cor and brain casue fever and stiff neck
- N/V/
- sensitivity to bright light
- can die within hours
* petechaie and purpura
12
Q
3 organisms causing Meningitis
A
- haemophilus influenzae
- streoptoccus pnemoniae
- neissieria meningitis
13
Q
ABM IS MEDICAL EMERGENCY (4)
A
- early dx and tx are crucial to prevent disabilities and death
- seriousness demands tx before results of diagnostic tests are known
- IV OF PENICILLIN, CEFOTAXIME, CEFTRIAXONE
- vaccines exist but no single vaccine provides immunity to all forms of meningitis
14
Q
Clinical presentation meningitis
A
- HA
- Stiff neck
- fever
- altered mental status
- coma
- brudzinski’s sign and kernels sign
15
Q
Brudzinski’s sign
A
if head is pulled upward, legs will pull inward
16
Q
Listerioris
waht pathogen
transmission
A
- causes by listeria monoctyogenes
- eating contaminated food
- contaminated with feces
- contamintied animal products like cold cuts and soft cheeses - psychotrophic: cold tempereatures do not affect growth
17
Q
Listeria monocytogenes characteristics
A
gram (+) rod or coccobacilli
psychotrophic
18
Q
Clinical presentationif listerosis
incubaiton
sx
special pop (3)
A
- 2-6 week incubation
- most healthy people don’t experience sx
- menigitis in immunocompromised can cause coma, mental status change - affects pregnant women, immunocompromised, elderly
- can infect fetus and cause miscarriage or still birth - 45% mortality if it gets into bloodstream
19
Q
Meningoencephalitis sx (5)
A
- stiff neck
- HA
- fever
- delerium
- coma
20
Q
Tx listeriosis
A
- 2 week antibiotic tx
- ampicillin or penicillin PLUS gentamicin - delay in tx assoc. with poor outcomes
- longer course tx for immunocompromised
21
Q
prevention listeriosis
A
- throtoughly cook raw food
2. wash hands, knives, cutting boards
22
Q
Listeria -> brain/meninges (4)
A
- ingested
- invades epithelium cells in GI
- moves in and between cells useing hot cell actin tail formaiton
- invades macrophages to get into blodstread wheret can cross BBB
23
Q
Tetanus
pathogen
complications
A
- clostridium tetani
- causes hyperactive muscles contractions
- toxin tetanospasmin inhibits compounds needed to inhibit muscle contraction
- uncontrolled muscle contraction
24
Q
clostridium tetani characteristic
A
causes tetanus
aerobic gram (+) endospore-forming
25
Sc tetanus intoxicaiton
1. develop rapidly
2. trismus (lockjaw): spasms jaw muscles, clenching of teeth
3. Opisthotonus invokes muscles spasms that cause an arching of back
4. spasmodis inhalation and seizures in diaphragm and rib cage- reduce ventilation
26
Trismus
lockjaw
27
Opisthotonnus
muscle spasms causing arching of back
28
Tx tetanus (3)
1. sedative
2. muscle relaxant
3. penicillin
29
Tetanus prevention
toxoid used in tx and vaccination
1. DTap for kids
2. Tdap 11-12 ys
3. Tdap or Td at 10 year intervals fo adults
30
Clostridium botulism pathogen charcteristics(4)
1. spore forming
2. anaerobe
3. G (+) rod
4. causes botulism
31
C. boutlism complications
produces dealdly exotoxin
- attack nervous system
- flaccid paralysis
32
Botulism tx
large doses antitoxins can neutralize toxin if treated early
-most outbreaks due to home-canned foods or foods eaten cold
*boiling deserts toxin
33
Botulism toxin affects in body (4)
1. inhibits release acetylcholine
2. nerve impulses can't pass snypase
3. no muscle contraciton
4. flaccid paralysis
34
Botulism variants (3)
1. wound botulism, when wound infected with c. botulism
2. infant botulism AKA floppy baby, when infant fed honey
3. minute doses botulism toxin can treat movement disorders, wrinkles, hyperhidrosis, migraine
35
Leprosy
pathogen
transmission
incubation
Hansen disese
1. mycobacterium leprae
2. spread through nasal secretions
3. 3-6 year incubation
36
Mycobacterium Leprae characteristsis
1. obligate
2. intracellular parasite
3. acid fast abacilli
37
Complications leprosy
1. multibacjilliary or lepramatous leprosy, tumor-like lepromas form
on skin and respiratory tract
- numbless and muscle weakness
- thickening peripheral nerves
- can lead to disability
38
Damage to peripheral nerves from leprosy
1. leads to deformities
| - twisting of limbs, curlings of fingers, loss facial features, glaucoma/blindness
39
efforts to eradicate leprosy
WHO
dapsone
rifampicin
clofazimine
40
Viral (aseptic meningitis)
1. viruses cause asceptic meningitis
2. most caused by enteroviruses
3. viral menignitis MILDER than bacterial
41
Tx viral meningitis
best rest, fluids, more mild than bacterial
42
Viral encephalitis
1. consequence primary or secondary infeciton
2. encephalitis imflammaiont of brain
3. many viral causes
4. some cases due to herpes virus
- can occur in newborns of passed through brith
43
transmission enteroviruses
most likely respiraroty secretions
44
Secondary encephalitis
results from viral infection that first occurs elsewhere in the body
can be a late virus that reactivates and travels to brain
ex) VZV, measles, mumps, german measles
45
Arboviral encephalitis
1. primary viral infection
2. tx arthropods
- zoonosis-transmitted between animal host to humans by arthropods
3. most NOT transmitted person-person
4. many forms transmitted by mosquitoes and ticks
46
Arboviral encephalitis sx
1. pain head and neck
2. convulsion
3. coma
47
Arboviral complication
1. paralysis
| 2. mental disorders
48
West nile fever
1. many infected people remain asymptomatic or are ill for a few days
2. rarely can lead to encephalitis or meningitis
3. can results in permanent neurological effects or death
4. no vaccin or treatment
49
Zika Virus
1. transmitted by mosquitoes
2. transmitted mother-child
3. transmitted sexually
4. 80% asymptomatic
5, 20% develop rash, joing paint, conjunctivitis
50
Rabies in animal
1. furrious rabies
- wide eyes
- drooling
- unprovokes attacked
2. dumb rabies
- docile, lethargic
3. wild animals are vaccinated with inoculated dog food and fish meal
51
Rabies transmission
enters through human skin wound, contaminated with bodily fluid from an infected animal
1. incubation 6days-1year
- depends on location of entry and amount of virus entering body
52
Rabies Sx (7)
1. tinglins, burning, coldness at bite side
2. fever, HA, increased muscle tension
2. alert, aggressive
4. paralysis
5. brain degeneration
6. hydrophobia
7. death from respiratory paralysis
53
Rabies tx
Post exposure immunizaiton can be doe immediate after exposure
54
Polio virus
may be next eradicated
55
Abortive poliomyelitis sx
HA, nausea, sore throat
1% passe thorugh bloodstream to meninges
56
nonparalytic poliomyelitis sx (3)
fever, HA, stiff neck
57
Paralytic poliomyelitis
paralysis arms, legs, body trunk, facial muscles, tongue, diapragh
58
Postpolio syndrome PPS
Patient's who have recovered form polio can sometimes experience symptoms again
- reactivation viruts
- autoimmune reactiom
59
Trivalent vaccines
contain all 3 strains poliovirus
60
Cryptococcosis
```
complication
pathogen (2)
sx (3)
dx (2)
tx (2)
```
1. fungal lung disease
2. can cause mepningo-ecephalitis in immuno compromoised
3. Crypto. Neiforomans and C. gattii
4. sx: HA, fever, change in mental status
5. dx: spinal tap, MRI
6. Tx: amphocetriun B and fluconozole
61
Coccidiomycosis
pathogen (2)
sx (2)
dx(2)
tx
fungal disease affecting CNS
1. valley fever
2. c immitis, c posadasii
3. Sx: flu-like, can cause menigitis
4. dx: spinal tap
5. Tx: ampoceterin B
62
Primary amoebic meningoencephalitis
pathogen
pathogenesis
tx
1. caused by Naegleria Fowleri
2. rare: 95% die within 4-5 days
3. inhaled from swimming in warm water
4. amoeba enters nose and swims ups to the brain along olfactory tracts
5. tx with limited success
63
Tyrpanosomiasis
1. disease caused by 2 species of trypanosoma
64
African sleeping sickness
Pathogen
pathogenesis
1. trypanosoma Brucei
2. t: tstes fly
- chancre forms at bite site
- paraside invade blood stream and enter CNS
65
T. brucei variants and their disease (2)
1. T. brucei gambiense
- chronic
- fever, HA, change in sleep patterns and behavior, wasting, coma when parasites enter brain
2. T. brucei rhodesience
- more acute, high fever, rapid coma, death
66
Toxoplasmosis
```
pathogen
complication
transmission
special population
tx
```
1. toxoplasma gondii
2. cause encephalitis in immunocompromised patients
3. t: to him and via contaminated pork, before, lamb
- domestic cats acquire it from birds or rhodens
4. can cross through placenta
- lead to hearing loss, mental disability, lesions in the retina causing blindness
4. tx: trimethoprim/sulamethox
