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neuro II > micro > Flashcards

micro Flashcards

1
Q

what type of genome does poliovirus have?

A

+ssRNA

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2
Q

what type of genome do polyoma viruses have?

A

circular dsDNA

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3
Q

what are the two human polyoma viruses and what do they cause?

A

BK: little disease, seen in urine of AIDS patients
JC: PML

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4
Q

where do replication and assembly occur for polyoma viruses?

A

both in nucleus

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5
Q

what are the T antigens?

A

early genes in polyoma virus replication: initiate DNA replication and responsible for transformation
small and large: immortalize cells
small and medium: transform cells

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6
Q

what is progressive multifocal leukoencephalopathy? what is the pathogenesis?

A

progressive demyelinating disease of CNS caused by JC virus

infects and lyses oligodendrocytes

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7
Q

what are the three main symptoms of PML?

A

clumsiness, progressive weakness, speech problems

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8
Q

how is PML treated in AIDS and transplant patients?

A

AIDS: optimize HAART therapy->50% mortality
transplant: alter (don’t halt) immunosuppressive therapy->still 80% mortality

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9
Q

what is Kuru? what is its presentation? how is it transmitted?

A

prion disease in Papua New Guinea transmitted by ritualistic cannibalism: “tremble with fear”

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10
Q

what is the primary and secondary presentation of Creutzfeldt-Jakob disease? how does it end?

A
  1. dementia and myoclonus
  2. ataxia/cerebellar dysfunction
    - akinetic mutism
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11
Q

what prion disease has been shown to be transmitted by dural grafts, corneal grafts, pituitary-derived hGH? which have short incubation?

A

Creutzfeldt-Jakob disease

dural and corneal grafts

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12
Q

how is variant Creutzfeldt-Jakob disease transmitted?

A

beef products and blood

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13
Q

which is more contagious and why: vCJD or CJD?

A

vCKD: also infects tonsils, spleen, lymph nodes, appendix

->diagnose by tonsil biopsy

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14
Q

what are the primary manifestations of vCJD? what is the end stage presentation?

A
  • anxiety and depression
  • sensory abnormalities, esp. visual late
  • akinetic mutism
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15
Q

what is required to get vCJD?

A

vCJD: methionine at codon 129

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16
Q

how is GSS disease contracted

A

familial, AD

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17
Q

what prion diseases show amyloid plaques?

A

GSS

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18
Q

what is the primary presentation of GSS?

A

gait abnormalities and ataxia

-no dementia

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19
Q

which prion disease actually rarely shows spongiform changes?

A

fatal familial insomnia

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20
Q

what is the presentation of FFI?

A

sleep disturbances and autonomic dysfunction

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21
Q

name the prion disease according to presentation: insomnia and autonomic dysfunction; dementia and myoclonus; ataxia and gait abnormalities; anxiety/depression/sensory abnormalities

A

FFI, CJD, GSS, vCJD

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22
Q

what bacteria cause meningitis in infants?

A

GBS, G- enteric bacilli, Listeria

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23
Q

what bacteria cause meningitis in children 3mo-2yr?

A

S. pneumo, Neisseia, H. flu type B

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24
Q

what bacteria cause meningitis in children >2?

A

Neisseria and S. pneumo

25
Q

what bacteria cause meningitis in immunocompromised?

A

Staph spp., G- enteric bacilli, Pseudomonas

26
Q

how should meningitis be empirically treated? what do they cover?

A
  1. dexamethasone 2. 3rd gen ceph for strep, Neisseria, H. flu 3. vanc for resistant strep and G-‘s 4. penicillin for Neisseria 5. ampicillin for listeria 6. doxycycline to cover RMSF and Lyme 7. acyclovir to cover herpes encephalitis
27
Q

what type of meningitis is splenic dysfunction a risk factor for?

A

Strep. pneumo

28
Q

what is choline binding protein?

A

virulence factor for S. pneumo, important for crossing BBB in meningitis

29
Q

how is meningococcal meningitis diagnosed? how is it cultured

A

rapid latex agglutination test on CSF

on chocolate agar

30
Q

how does Neisseria escape the immune system?

A

phase variation: turn off capsule on invasion of mucosal cells, turn back on in bloodstream

31
Q

what causes the fever and rash of meningococcemia?

A

endotoxin: LPS

32
Q

how can individuals exposed to Neisseria be prophylactically treated?

A

1 pill of ciprofloxacin

rifampin

33
Q

how is H. flu cultured?

A

chocolate agar

34
Q

why does type B H. flu cause meningitis?

A

has antiphagocytic polyribotol capsule

35
Q

what is used to treat H. flu meningitis? what is it commonly resistant to?

A

3rd gen cephalosporin

ampicillin resistant

36
Q

why is a gram stain of CSF not very useful in ruling out bacterial meningitis?

A

Listeria doesn’t gram stain well, intracellular

37
Q

diarrhea/abdominal discomfort may precede meningitis caused by what bacteria?

A

listeria

38
Q

what is the treatment of listeria?

A

ampicillin

39
Q

which cryptococcus species causes meningitis primarily in HIV and which accounts for most of fungal meningitis in healthy individuals?

A

HIV: neoformans
healthy: gatii

40
Q

what type of fungus is cryptococcus?

A

encapsulated yeast

41
Q

what is the disease progression of fungal infection to meningitis?

A

initially asymptomatic pulmonary infection

chronic infection leads to meningitis

42
Q

how can cryptococcus be diagnosed in lab?

A

yeast with halos on India ink

43
Q

how is cryptococcus meningitis treated?

A

amphotericin B and flucytosine

44
Q

how is meningitis due to Exserohilum rostratum treated?

A

IV voriconazole for 3 months

45
Q

what characteristically causes necrosis of temporal lobe? what CSF finding indicates necrosis? how can it be visualized? how is it treated?

A

HSV-1 encephalitis, RBC’s in CSF, not usually seen on CT, acyclovir

46
Q

which flaviviridae cause encephalitis? what is the genoma?

A

+ssRNA

West Nile, St. Louis, and Japanese encephalitis

47
Q

what is the most common cause of arboviral pediatric encephalitis in US? how does it present? what type of virus is it?

A

La Crosse virus
seizures and focal neurological signs
bunyavirus

48
Q

what is the genome of bunyaviridae? how is it different from influenza?

A

segmented -ssRNA

replication in cytoplasm, mRNA’s not spliced

49
Q

what is the genome of rabies virus?

A

enveloped, non-segmented -ssRNA

bullet-shaped

50
Q

exaggerated gag reflex is a sign of what disease?

A

rabies

51
Q

what virus uses ambisense replication?

A

Lymphocytic Choriomeningitis Virus (LCMV)->arenavirus

52
Q

how is LCMV spread?

A

aerosolized from rodent excreta/saliva

53
Q

how does a brain abscess show up on CT? how is it treated?

A

ring-enhancing lesion with surrounding edema

3rd gen cephalosporin and metronidazole to cover Bacteroides fragilis

54
Q

what is the primary cause of spinal epidural abscess? what is the major sign and key feature?

A

S. aureus (90%)
point tenderness, esp. to touch
key feature: worse pain on lying down

55
Q

how does RMSF cause encephalitis?

A

attacks vascular endothelium: systemic vasculitis attacks brain parenchyma causing confusion, seizures, focal deficits

56
Q

how is RMSF treated? Lyme disease?

A

doxycycline for both, ceftriaxone for Lyme disease

57
Q

what are two presentations of neurosyphilis? how is it treated?

A

general paresis, tabes dorsalis (dorsal column demyelination)
high dose IV penicillin

58
Q

how does TB affect the brain? where is most severe? what is a common complication?

A

chronic granulomatous meningitis, esp. severe at base of brain; thickened basal meninges cause entrapment of CN’s

neuro II (5 decks)

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