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Clinical Neuroscience > Path- 4: Infections > Flashcards

Path- 4: Infections Flashcards

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1
Q

What is the most common way infections can enter the brain?

A

Hematogenous spread via arteries or veins

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2
Q

What type of mechanism of injury causes direct implantation of bugs tot he brain?

A

trauma

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3
Q

What does TORCH stand for that are the group of diseases that cause congential conditions?

A

Toxoplasmosis, Other (syphilis, varicella, mumps, parovirus and HIV), Rubella, CMV, Herpes

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4
Q

What is meningitis?

A

inflammatory process of leptomeninges and CSF

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5
Q

What is meningoencephalitis?

A

inflammation of meninges and brain parenchyma

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6
Q

What is the main cause of acute pyogenic meningitis?

A

bacteria

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7
Q

What is the main cause of aseptic meningitis?

A

viral meningitis

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8
Q

What is the main cause of chronic meningitis?

A

TB, spirochetes, cryptococcus

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9
Q

What is normal CSF pressure (in mmHg)?

A

10-18mmHg

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10
Q

When the pts lie on their side for an LP, what is the new pressure in the CSF?

A

20-30mmHg

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11
Q

What condition causes in increased in the IgG content of the CSF?

A

MS

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12
Q

What is the main causitive agent for acute pyogenic meningitis in neonates?

A

Strep. agalactiae

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13
Q

What other bugs cause acute pyogenic meningitis in neonates?

A

E. coli, Strep pneumo, Listeria monocytogenes

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14
Q

What is the main causitive agent for acute pyogenic meningitis in adolescents/young adults?

A

Neisseria meningitidis

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15
Q

What is the main causitive agent for acute pyogenic meningitis in IV drug users?

A

Staph aureus

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16
Q

What is the main causitive agent for acute pyogenic meningitis in children and adults?

A

Strep pneumo

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17
Q

What are the Sx of acute pyogenic meningitis?

A

headache, photophobia, irritability, nuchal rigidity, nausea, vomiting.

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18
Q

What is the CSF content on spinal tap in acute pyogenic meningitis?

A

cloudy CSF, increased pressure, increased neutrophils, increased protein, decreased glucose

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19
Q

What is waterhouse-fridreichsen syndrome?

A

results from meningitis-assocaited septicemia (N. meningiditis), it’s a hemorrhagic infarction of the ADRENAL glands, causes cutaneous petechiae, in kids.

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20
Q

What again is the main causitive agent of acute aseptic meningitis?

A

Viruses

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21
Q

What is the CSF content on spinal tap in acute aseptic meningitis?

A

CSF glucose normal, protein slightly elevated, lymphocytes present

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22
Q

What is the Tx of acute aseptic meningitis?

A

Nothing, it’s self-limiting.

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23
Q

What is the most common viral cause of acute aseptic meningitis?

A

enterovirus (polio, echovirus, coxackievirus)

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24
Q

What are the physiological changes in acute aseptic meningitis?

A

Brain swelling, mild leptomeninges infiltration

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25
What causes drug-induced aseptic meningitis?
NSAIDs, antibiotics
26
What is the CSF content on spinal tap in Drug-induced aseptic meningitis?
glucose normal, neutrophils present, increased CSf protein
27
What causes brain abscesses?
variety of routes, often from primary infected site int he heart (endocarditis), lungs, teeth or bones.
28
What are the msot common abcteria to cause brain abscesses?
Strep and staph
29
True or false: cerebral abscesses are destructive lesions
True
30
What is the pathological findings to abscesses?
Central liquefactive necrosis surrounded by a fibrous cap, often in frontal or parietal lobes or the cerebellum, have progressive focal deficits
31
True or False: Brain abscesses do not cause an increase in ICP
False
32
What is seen on CT's for a brain abscess that organizes?
Collagen deposition around a ring enhancing lesion
33
What types of Tx's are there to decrease the lethality of brain abscesses to < 10%?
Surgerya nd antiobiotics
34
How can one get subdural empyema?
bacteria and fungi can spread to subdural space --> subdural empyema
35
What are the Sx of subdural empyema?
Febrile, headaches, neeck stiffness, if untreated --> coma, CSF profile similar to abscesses
36
What are extradural abscesses commonly assocaited with?
Osteomyelitis (of the adjacent bone)
37
What are the Sx of chronic bacterial meningoencephalitis from TB?
headaches, malaise and confusion, vomiting
38
What is the CSF like on bacterial meningoencephalitis from TB?
moderate pleocytosis, proteins are very high, glucose slightly decreased or normal.
39
Where is the fibrous exudate from the subarachnoid space usually located?
at the base of the brain, obliterating the cisterns and encasing the CN's
40
What are the most serious problem with chronic bacterial meningoencephalitis from TB?
arachnoid fibrosis (causing hydrocephalus) and obliterative endarteritis (causing arterial occlusion)
41
What causes neurosyphilis?
Tertiary syphilis
42
What are the major forms of meningovascular neurosyphilis?
Paretic and tabes dorsalis
43
What is meningovascular neurosyphilis?
Chronic meningitis involving th ebase of the brain, spinal leptomininges and cerebral convexitis. May cause oliterative endarteritis (Heubner arteritis)
44
What is paretic neurosyphilis?
Invasion of the brain by T. pallidum, progressive loss of mental and physical fxns with mood alterations
45
What causes Tabes dorsalis?
damage by the spirochete to the sensory nerves in the dorsal roots, causing locomotor ataxia and sense of position, loss of pain sensation
46
Physical exam of a Tabes dorssalis pt will reveal what anomaly?
+ Rhomberg's sign
47
What causes neuroborreliosis?
Borrelia burgorferi (Lyme disease)
48
What are the Sx of neuroborreliosis?
aseptic meningitis, facial nerve palsies, mild encephalopathy, polyneuropathies
49
What are the most characteristic features of viral meningoencephalitis?
perivascular and parenchumal mononuclear cell infiltration
50
Intrauterine viral infections from Rubella may cause what in the baby?
Congenital malformations
51
Many years after the viral infection may cause what?
Slowly progressive degenerative diseases
52
What is the virus that is an important cause of epidemic encephalitis, especially in tropical regions, and is spread by arthopods?
Arbovirus
53
What are the Sx to arthropod-borne viral meningoencephalitis?
Szrs, confusion, delirium, stupor and coma
54
What are the CSF findings to arthropod-borne viral meningoencephalitis?
slight increase in pressure, initually a neurtrophilic pleocytosis which rapidly converts to lymphocytes, proteins are increased, glucose is normal
55
What are the ages to HSV1 encephalitis?
any age, but most common in kids and young adults
56
What are the Sx to HSV1 encephalitis?
mood and memory changes
57
Where are the encephalitis regions for HSV1?
Begins in temporal lobes and orbital hyri of frontal lobes
58
What are the neurological complications to HSV2 infections?
meningitis
59
What happens in the neonate if mom has a HSV2 infection?
~50% develop severe encephalitis
60
What are the clinical progression to shingles?
painful vascular skin eruptions that are usually self limiting, but may cause a persistent postheerapetic nerualgia syndrome
61
What are the rare CNS complications to VZV infections?
granulomatous arteritis
62
Who gets CMV infections?
Fetuses and immunosupressed
63
What happens if a kid is infected inutero with CMV?
Periventricular necrosis --> progresses to microcephaly and periventricular calification or severe hemorrhagic necrosis
64
What are the clinical Sx of poliomyelitis?
meningeal irritation, CSF similar to aseptic meningitis, anterior horn destruction (hyporeflexia, muscle atrophy)
65
What happens in late "postpolio" syndrome?
progressive weakness, decreased muscle mass and pain
66
What does rabies cause?
Severe encephalitis, transmitted by rabid animals
67
What is the pathogenesis to rabies?
Virus enters CNS in ascending fashion --> goes along PNS around wound site --> incubation 1-3 mo --> advances to extreme hypersensitivity to pain + szrs + foaming of mouth --> death by resp failure
68
What happens in HIV meningoencephalitis?
dementia, mental slowing, memory loss, mood disturbances, ataxia, bladder/bowel incontincence, szrs.
69
What special cells are present in HIV meningoencephalitis?
microglial nodules with multinucleated giant cells
70
What is vacuolar myelopathy?
spinal cord disorder in 20-30% of AIDS pts in the US. Sx similar to subacute combined degeneration (B12 dieficiency)
71
What are the Sx to the HIV pts with inflammatory myopathy?
proximal weakness, pain, icnreased serum CK
72
What are the CNS problems with AIDS in kids?
microcephaly with mental retardation, motor development delay, CALCIFICATION of small and large vessels and parenchyma within the basal ganglia
73
Are you
still awake?
74
I
am not.
75
Progressive Multifocal Leukoencephalopathy (PML) is caused by what viral agent?
JC polyomavirus
76
Which cells are infected with JC polyomavirus?
oligodendrocytes (they get glassy inclusiuons)
77
What are the Sx to PML?
abnormal speech and vision, ataxia and dementia, demyelination
78
How can you test for JC papovavirus in PML?
immunoperoxidase stain for a Dx of PML
79
What are the Sx of Subacute Sclerosing Panencephalitis?
cognitive decline, spasticity of limbs and szrs
80
What causes Subacute Sclerosing Panencephalitis?
happens months or years after initial infection with MEASLES
81
What are the clinical findings in Subacute Sclerosing Panencephalitis?
myelin degeneration, viral inclusions of oligodendrocytes and neurons, inflammation of white and grey matter with neurofibrillary tangles. VERY RARE B/C OF VACCINATION.
82
Who typically gets fungal meingoencephalitis?
immunosupressed pts
83
Who are the major players to fungal meingoencephalitis?
candida albicans, mucor, aspergillus, cryptococcus neoformans (obstructive chronic meningitis)
84
What causes vasculitis in fungal meingoencephalitis?
mucor, aspergillus and hemorrhagic infarct (w/subsequent sepsis with infectious agents)
85
What causes the parenchymal invasions with fungal meingoencephalitis?
granulomas or abscesses, occur with most organisms but Candida and cryptococcus are most common
86
What causes cerebral toxoplasmosis?
T. Gongii
87
What pt's get cerebral toxoplasmosis?
AIDS
88
What is the timespan for cerebral toxoplasmosis?
evolves over 1-2 weeks, focal or diffuse
89
What are the clinical findings for cerebral toxoplasmosis?
ring enhancing lesions, multiple abscessses with areas of necrosis, may occur in fetus
90
What does naegleria sp. cause?
rapidly fatal necrotizing encephalitis
91
What does acanthamoeba cause?
Chronic granulomatous meningoencephalitis
92
Prion diseases are from the abnormal form of which protein?
Prion protein (PrP) lfoleeoleloloelofelfoefleofelfoloelfoelefololeoleoeflefoelfelfoelfolollolololololoololololololololololololololol
93
What are the main changes that occur in prion diseases?
Spongiform changes (in the vacuoles in neurons and glia), injured neurons shrivel and become hyperchromatic
94
What are the Sx of prion diseases?
Main1 is progressive dementia (esp with Creutzfeld-Jacob disease)
95
What is fatal familial insomnia?
fatal familial insomnia.
96
Who are those CRAZY ASS people eating shit that they shouldnt be eating because theyre so super crazy and adjdawdnwunawdunhhwef?
Kuru

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