new material for Final Flashcards
(28 cards)
Progressive loss of mental and physical functions caused by invasion of Treponema pallidum into the CNS:
neurosyphilis
Neurosyphilis - 4 chief manifestations:
- asx neurosyphilis
- meningovascular syphilis
- paretic syphilis
- tabes dorsalis
Meningovascular syphilis:
characterized by perivascular inflammation in the brain
Paretic syphilis:
result of widespread parenchymal invasion by spirochetes and resultant inflammatory changes that cause individual brain cell death and brain atrophy
Tabes dorsalis:
- slowly progressive degenerative form of syphilis involving the posterior columns and posterior roots,
- results in damage to sensory nerves in dorsal roots
- produces ataxia, loss of pain sensation/proprioception
MC presentation of meningovascular syphilis:
Stroke syndrome in a relatively young adult, involving the middle cerebral artery or branches of the basilar artery; freq involves base of brain and may result in cranial nerve palsies
Paretic syphilis usu occurs how long after exposure?
20-30 yrs as a result of progressive meningoencephalitis, resultant ongoing loss of cortical function
Paretic syphilis is characterized by:
- tissue invasion with spirochetes
- chronic perivascular and meningeal inflammatory changes
- meningeal fibrosis
MC sx of paretic syphilis:
- personality change (33%)
- ataxia (28%)
- stroke (23%)
- ophthalmic sx (17%)
Neurosyphilis often results in the formation of meningeal granulomas, called:
gummas - well-circumscribed, non-cancerous mass of granulation tissue resulting from a cell-mediated immune response to Treponema, tertiary stages.
Gummas are MC found in:
LIVER
also found in brain/dura, heart, skin, bone, testes
Several hours after tx of early stage syphilis, pts may undergo febrile reaction called:
Jarisch-Herxheimer reaction
Progressive multifocal leukoencephalopathy (PML) is caused by:
JC virus (polyomavirus family)
rare, progressive, demyelinating dz -> loss of oligodendrocytes
Subacute sclerosing panencephalitis (SSPE) is a rare complication of _______ that can develop from ____ years after the initial infx.
measles (rubeola)
1 to 20+
The only change in the CSF profile of SSPE is a marked elevation in a specially ordered CSF immunoglobulin:
Rubeola IgG Antibody
Poliovirus is an RNA virus that is transmitted:
- through the oral-fecal route
* ingestion of contaminated water
After a period of viremia, poliovirus becomes ________ and produces destruction of the motor neurons in the anterior horn and brainstem, leading to ____________.
neurotropic
flaccid paralysis
Zoonotic dz that is transmitted via saliva of animals:
Rabies virus
- severe HA
- irritability
- muscle spasm
- inc saliva production
- hydrophobia
Diagnostic finding for rabies:
Negri bodies - round/oval inclusion bodies
100% diagnostic, found in 20% of cases
Complicated syndrome of different nervous system and mental status symptoms, frequency inc with advancing effects of HIV disease, particularly as CD4+ cell counts decrease:
AIDS dementia complex (ADC)
Unusual, often fatal, two-phase encephalopathy characterized by fever, vomiting, fatty infiltration of the liver and swelling of the kidneys and brain:
Reye’s syndrome
- post-viral (VZV)
- NOT contagious
- assoc w/aspirin use
An infx of the brain d/t infx by a prion:
Spongiform encephalopathy
- Kuru
- CJD
Related spongiform encephalopathies that are invariably fatal brain diseases with unusually long incubation periods measured in years:
mad cow dz (BSE)
variant Creutzfeld-Jakob dz (vCJD)
Most prevalent neurologic disorder in terms of morbidity and mortality:
cerebrovascular dz - 3rd leading cause of death in US (particularly stroke)
