Micro CNS Infection – Flashcards

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question
what are the layers of the head from the bone in
answer
periosteum
epidermal space: filled with fat (only in spinal cord)
dura mater
subdural space: only space in pathology
acrachnoid mater: connected to pia with CT
subsrachnoid space: CSF
pia mater: openings for vessels to get into the brain
question
what are the three anatomical defenses of the CNS
answer
skill
blood-CSF barrier
BBB
question
what are the 3 layers of the BBB, describe the composition of each
answer
vessels: tight endothelial cells

Brain: tight parenchyma via pericytes, astocyte end feet, and miroglia

BM: fibronectin, proteins
question
what are the two types of junctions in the BBB, describe each
answer
adherin junctions: stablize cell-cell interactions in junctional zone

complex tight junctions: interaction of transmembrane proteins (non-polar so restricts polar)
question
what are the intracellular and extracellular enzymes associated with the BBB (6)
answer
monoamine oxidase (MAO)
y-glutamyl transpeptidase (y-GT)
alkaline phosphatase
peptidase
nucleotidases
cytochrome P450 enzymes
question
what are the six types of transport through the BBB
answer
receptor mediated transcytosis
absorptive transcytosis
influx carrier proteins
efflux transporters
transcellular lipophilic pathway
paracellular aquous pathway
question
what 4 substances are transported through the BBB in receptor mediated transcytosis
answer
LDL
Leptin
insulin
transferrin
question
what and how are things transported through absorptive transcytosis in the BBB
answer
cationization increases uptake of plasma proteins (like albumin)
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what uses carrier proteins to get through BBB (5)
answer
glucose
AA
purines
nucleotides
choline
question
what uses and how do efflux transporters of the BBB work
answer
energy dependent transport of AZT (asidothymidine)
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what uses and how does the trancellular lipophilic pathway through the BBB work
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lipid soluble molecules cross lipid part of epithelium (despite non-polar complex tight junctions)

this is how CNS drugs enter
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what uses and how does the paracellular aqueous pathway through the BBB work
answer
water soluble agents move between cells of BBB
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what cannot pass through the BBB (5)
answer
immune cells
antibodies
proteins
toxins
drugs
question
what can pass through the BBB (7)
answer
oxygen
ions
glucose
ETCH
small lipid soluble molecules
mannitol
question
what are the 10 ways to acquire bugs that can infect the CNS
answer
hematogenous
contagious infection
congenital defect
congenital infection across placenta
congenital infection in birth canal
trauma
neurosurgery
crawling up nerves
ingestion and dissemination
invasion
question
define hematogenous entry, what places do bugs with hematogenous entry go to in the CNS (3)
answer
capillary to meninges

choroid plexus, dural venous sinus, rarley cribiform plate
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what are the two modes of hematogenous entry to the CNS, give 5 examples of bugs that can do it
answer
macrophage transport and arthropod vector

HIV, intracellular organisms like TB, listeria, salmonella, brucella
question
what are 5 types of contagious infections that could lead to CNS contamination
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sinusitis, otitis media, dental work, mastoiditis
question
what are three congenital defects that could lead to CNS contamination
answer
CSF shunt
encephalocele (neural tube defect)
meningomyelocele: posterior neural tube defet
question
give examples of microbes that infect across the placenta (4 viruses, 2 bacteria, 2 plasmodiums)
answer
viruses: HSV, rubella, CMV, HIV
bacteria: syphilis, listeria
protozoa: plasmodium, toxoplasmosis
question
give 4 examples of mirobes that infect during birth in the canal
answer
E. coli, GBS, listeria, HSV
question
give 2 examples of microbes that crawl up nerves to the CNS
answer
HSV, rabies
question
give three examples of microbes that are ingested and disseminate into the CNS
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T. solium, E. histolitica, echinococcus granluosus
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give 4 examples of microbes that direct invade the CNS
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acanthemoba, magleria, balmuthia, systemic fungi
question
name the 9 CNS infections and where they infect
answer
osteomyelitis: skull or vertebral bone

epidural abscess: epidural space

intramedullary abscess: medullary column of spinal cord

myelitis: infection of spinal cord

ventriculitis: ventrical infection

abscess: brain tissue infection

epidural abscess: dural or skill

encephalitis: brain tissue infection

subdural and dural empyema: surdural
or dural space infection

meningitis: meninges infection
question
what usually causes a brain abscess
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anaerobes or aerobes
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what is the reason epidural abscesses usually happen
answer
extension of local infection (like vertebral osteomyelitis)
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what is encephalitis, what are 2 symptoms
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brain tissue infection of the parenchyma

seizures, obtundation
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what is a subdural or dural emphyema, why does it normally happen (4)
answer
infection of subdural space

complication of meningitis in kids, complication of sinus infection, otitis media, mastoiditis in older kids and adults
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what is a subdural effusion
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sterile collection of fluid due to increased efflux or intravascular fluids from increased capillary wall
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what are the common causes of meningitis in adults and teens (2)
answer
s. pneumo, neisseria
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what are the 4 common causes of meningitis in the elderly
answer
S. pneumo, enterics, listeria, neisseria
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what are the signs of meningitis in an adult (11)
answer
headache, fever, coma, shock
confusion, dissorientation, seizure, neck stiffness
vomiting
photophobia
petechiae
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why is there vomiting in meningitis (3)
answer
brain stem irritation, increased IOP, inflammation
question
what is the ddx for meningitis in the elderly, why
answer
bladder infection - also causes confusion and disorientation

arthritis - causes stiff neck
question
what are the 3 causes of meningitis in premes
answer
E. coli, listeria, GBS
question
what are the 4 causes of meningitis at 1 mo
answer
GBS, E. coli, listeria, K. pneumo
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what are the 5 causes of meningitis at 1 yo
answer
GBS, E. coli, listeria, S. pneumo, neisseria
question
what are the 8 signs of meningitis in kids
answer
lethargy
insomnia
poor feeding
diarrhea
afebrile
cyanosis
progressive (1-2 weeks)
high mortality
question
what are the common causes of acute meningitis
answer
virus, S. pneumo, neissiera, influenza (kids)
question
what are the common causes of chronic meningitis (2)
answer
TB, fungi, virus, tubercle bacilli, syphilis

others: B. burgdorferi, leptospira, coccidioides immitis (fungi), lymphoma, metastasis

drugs: cyclosporine, NSAID
question
why is chronic meningitis chronic
answer
causes are fungi, intracellular bacteria, mycobacteria, and viruses which are slower in disease progression
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why is acute meningitis acute
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the causes are bacteria and protozoans which have virulence factors (like cell walls), toxins, and cytokines allowing them to cause immediate infection
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what are some clues that someone has acute meningitis rather than chronic (5)
answer
progressed quickly
lots of inflammatory markers
fever
irritability
purlent exudate
question
define aseptic meningitis, what is normally the cause, how is it determined
answer
no organism isolated
usually caused by a virus
usually have to determine with PCR or serology
question
what are some of the common viruses that cause aseptic meningitis (4)
answer
enteroviruses: eosackie, ECHO
Mumps
LCM
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what is a clue an aseptic meningitis is caused by an enterovirus
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seen in late summer through fecal-oral route
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what are 4 clues someone has aspetic meningitis rather than acute or chronic
answer
mild
self limiting
low mortality
increased lymphocytes
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what are the 4 causes of nosocomal meningitis or meningitis due to trauma
answer
S. pneumo, S. aureus, enterobacteriaceae, P. aerguinosa
question
what is the most common cause of meningitis in a patient with diabetes
answer
GBS
question
what is the most common cause of meningitis in someone who is immune compormized (3)
answer
cryptococcus neoformans (transferred from pidgeons or other birds)

cryptococcus gatti
question
if the meningitis came from a respiratory infection, what are the 3 most likley causes
answer
S. pneumo, neisseria, influenza
question
if the meningitis came from a GI infection what are the 3 most likley causes
answer
E. coli, strep agalactia, listeria
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what are the three physical exam test do to on a suspected meningitis patient
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neuro exam: sound, pain, and light responses

brudzinski's sign: resistance to bending neck forward

kernig sign: resist straightening bent knee
question
what are the three contraindications to a LP
answer
tumor, impending herniation, brainstem changes
question
how is a LP done
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CT first (to check for contraindications)

insert needle between L3 and L4

take 3-4 tubes

priority specimine to the lab
question
where are the three LP tubes sent
answer
chemistry, microbiology, hematology
question
what are the 4 things checked for in a chemistry LP tube, what are the normal values
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glucose: 2/3 BG, 40-70 in adult, 60-80 in kid

protein: 15-45

lactic acid

LDH: isoenzyme 3 is viral
question
what are the 4 tests done on a micro LP tube
answer
staining
capsule serology
culture
PCR
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what are the 6 stains done on a micro LP tube sample
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acridine orange
gram stain
AFB
fungal stain
lactophenol cottom blue (fungi)
india ink (cryptococcus)
question
what are the capsules you should check for in the capsule serology of a micro LP tube sample (10)
answer
S. pneumo
HIV
GBS
neisseria
A, B, C, Y
W135
E. coli K-1
question
what three tests are done on a hematology LP tube
answer
cell count (normal: 0-5 wbc/dl)
cell differential
color
question
what does red LP sample mean (3)
answer
hemorrhage, bad tap, tumor
question
what does yellow LP sample mean (3)
answer
xanthoma, hemorrhage, bilirubin
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what are 4 finginds in a LP sample that suggest sepsis
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PMN increase
glucose decrease
protein leak out and increase
lactic acid increase (anaerobic bacteria)
question
what are 5 signs of a bacterial infection in a LP
answer
increased pressure, WBC, PMN, protein
decreased glucose
question
what are 3 signs of a viral infection in a LP
answer
normal pressure
increased lymphocytes
normal glucose
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what are 3 sgns of a fungal infection in a LP
answer
increased lymphocytes
increased protein
low glycose
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what are 3 signs of a TB infection in a LP
answer
increased lymphocytes
increased protein
low glucose
question
explain how and why someone would become infected with meningococci (include 5 virulence factors in this story)
answer
viral URI stops cilia so meningococci can stick to the respiratory epitheloum wia fimbrae, pili, polysaccharide capsule, biofilms, and with the help of IgA protease
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explain how meningococci get from colonizing on the respiratory epithelium to the CNS
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1. migrate through the epithelium to the blood
2. cause leaky capillaries, transport on macrophages, or move through endothelial cells to get into the blood
3. evade the immune system in the blood
4. enter CSF through transcytosis or through endothelial cells
question
what are two microbes that just go through endothelial cells to get into the blood, not needing to cause leaky capillaries or use macrophages
answer
neisseria, listeria
question
unlike other CNS infecters, listeria does not use transcytosis through endothelial cells to get into the CSF, what does it do
answer
uses listeriolysin O to get into the cytoplasm and move on actin
question
what are 2 ways potential CNS infectors evade the immune system when they are traveling in the blood
answer
capsules inhibit opsonization by C3b and immunoglobulins (alternative and classic complement pathways)

evade filtration by spleen and macrophages
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what are 4 microbes that have a capsule and can evade opsonization as they travel in the blood to the CNS to infect
answer
S. pneumo, influenza, neisseria, E. coli
question
once the meningitis microbe gets into the aubarachnoid space and begins to multiply, what are the three main complications its presence causes
answer
immune activation
cotytoxic edema
vasogenic edema
question
what are the 4 immune responses meningitis causes
answer
inflammation
leukocytosis
complements (C5a, C3a, IL-8)
macrophage inhibitory proteins (MIP)
question
how does meningitis cause cytotoxic edema
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water flows through BBB causing edema in the brain, increased pressure from water compresses vessels and causes ischemia
ischemia decreases ATP causing Na to accumulate and thus water inside the cells causing swelling and Ca to accumulate activating phospholupases and releases arachidonic acid leading to ROS and infarction
question
how does meningitis cause vasogenic edema
answer
endothelium increases in permeability and lets plasma proteins and water (not through AQP4) into ECF

increased fluid displaces the brain and causes herniation

usually follows or is a result of cytotoxic edema
question
what microbes usually cause sepsis with meningitis (7)
answer
pyogenic encapsulated bacteria: S. pneumo, neisseria, infleunza, monocytogenes (kids and old ppl)

nosocoma: enterobacteriaceae, S. aureus, S. pneumonia
question
when microbes infect the CNS they cause and inflammatory response, what is activated (10)
answer
PMN
lymphocytes
astroccytes
microgili
cytokines: IL-1, 6, 8, TNF-a
NO
prostaglandins
question
what does the immune response elicted by meningitis cause to happen in the brain tissue(6)
answer
necrosis
thrombi
bleeding
edema
increased IOP
herniation
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how does the antibiotic treatment for meningitis effect the CNS
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antibiotic enters CSF and causes rupture of bacterium
bacterial fragments stimulate even greater cytokine response
increasing neutrophils, vessel leakage, and edema
question
what are the two cryptococci that attack CNS, what type of patient
answer
immune compormised or HIV pt
C. neoformans: comes from pidgeons and birds
C. gatti
question
neisseria meningitidis: shape, stain type, 3 adherence mechanisms, 5 virulence factors
answer
gram negative diplococci kidney shape

adhere with pilli, opa, opc

defent with IgA protease, porin protein (inhibits degranulation), capsule, endotoxins on LOS, bind to epithelium
question
how is n. meningitidis transmitted / how is transmission helped out (5)
answer
aerosol
enhanced by URI, stress crowding, confinment
increase susceptability with complement defect
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what is the incubation time of n. minigitidis
answer
1-3d
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what are the main symptoms of n. meningitis (5)
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headache, fever, disorientation, petechial rash (maculopapular), nucal rigidity
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besides the 5 main symptoms of n. meningitidis, what are the other 10 other symptoms
answer
vascular collapse
shock
pulmonary insufficiency
waterhouse friderichsen
deafness
blindness
speech loss
mental changes
gangrene
90% mortality in untreated and 10% in treated
question
what is waterhouse friderichsen
answer
invasion of DIC, hemorrhage, and adrenal collapse and damage
question
what microbes often cause waterhouse friderichen in meningitis (11)
answer
S. pneumo
GAS
n. meningitidis
n. gonorrhea
E. coli
klebsiella
influenza B
salmonella
pasturella
acinetobacter
plesiomonas shifelloides
question
H. influenza: shape, stain type, 5 virulence factors
answer
gram negative rod

encapsulated, polyribotol phosphate, pili, IgA protease, LPS
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how is H. influenza spread (3)
answer
URI
epiglottitis
translocation to blood
question
how does H. influenza invade the immune system in the blood
answer
capsule
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what are the conditions only type B influenza causes (3)
answer
meningitis, epiglottis, bacteremia
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what are the conditions all types of influenza cause (4)
answer
otitis media, sinusitis, tracheobronchitis, pneumonia
question
how is influenza treated
answer
it isnt, get the vaccine
question
Strep pneumonia: shape, stain type, 5 virulence factors
answer
gram positive diplococci

encapsulated, pneumolysin, teichoic acid, peptidoglycan, phosphotidal choline
question
what microbe has phosphotidal choline, what does it do
answer
strep pneumo
translocation assistance
question
what microbe has pneumolysin, teichoic acid, and peptidoglycan? what do they do
answer
strep pneumo
damage cilia, kill inflammatory cells, enhance evasion, recruit inflammatory cytokines
question
how is S. pneumo spread, who is it more likley to infect (5)
answer
routes from URI or LRTI (nosocomial pneumonia)

asplenic, sickle cell, HIV, amaglobulinemia, and elderly patients
question
what are the signs of s. pneumo meningitis (2)
answer
bacteremia
high mortality
question
how is s. pneumo meningitis treated
answer
it isn't, get multivalent vaccine
question
listeria monocytogenes: shape, stain type, 3 virulence factors
answer
gram positive coccobacilli

intracellular resistants
escape from M cell phagosome via lysis into cytoplasm
flagella
question
how is listeria monocytogens transmitted, who does it infect most (3)
answer
contaminated food (unpasturized milk, lunch meat, fruits and veggies)

infants, elderly, immune compormised
question
how do we defent against listeria monocytogens, where does it like to go in the body
answer
liver and spleen then to blood

CMI
question
e. coli: shape, staining, how to identify it, 2 virulence factors
answer
gram negative rod
lactose fermentor on MacConkey agar

virulence: K1 capsule, type 1 fimbrae (in uropathogenic e. coli) allowing deep tissue invasion
question
how is E. coli transmitted most often, to who
answer
contamination from colon to birth canal in premes and neonates
question
what are our defenses against E. coli
answer
PMN do immature migration, diapedesis, degranulation, and killing
question
[image]
answer
gram negatie rod
E. coli
MacConkey agar
lactose fermentation
question
[image]
answer
gram negative diplococci
neisseria meningitidis
question
[image]
answer
gram negative rod
H. influenza
question
[image]
answer
listeria monocytogens
question
[image]
answer
peticheal maculopapular rash
caused by neisseria meningitidis
question
[image]
answer
strep pneumo
alpha hemolysis mucoid colonies
question
[image]
answer
strep pneumo
diplococci
anti phagocytic capsule
question
[image]
answer
subarachnoid with inflammatory cells
question
[image]
answer
neisseria meningitidis
question
what are 4 cultures done on a LP sample
answer
optochin test
bile salt susceptability
quellung reaction
india ink
question
optochin test: how is it done, what does it test for, how can you tell, what test does it combine with
answer
similar to antibiotic susceptibility disc effusion
standard for identifying strep pneumo
other strep are resistant and will grow right up to the disc

after do cAMP test to determine GBS presence
question
what does the bilt salt susceptability test test for, how
answer
strep pneumo lyses quickly
question
how is the quellung reaction done, what does it detect for
answer
mix anti serum with microbe causes capsules to swell
question
what does india ink test for, how can you tell
answer
cryptococcus. capsule cannot be penetrated so there is halo effect
question
what blood tests would you do on a suspected meningitis patient (4)
answer
CBC
blood culture
UA- antigen detection
serology
question
why is it difficult to make vaccine for microbes with a capsule
answer
T independent antigen. need more than polysaccharide to make vaccine because they are conjugated to a protein that needs T dependent response
question
what illnesses does Cryptococcus begin with usually before meningitis
answer
respiratory infection causes acute meningitis
question
what is a LOS, what microbe has it, what does it do
answer
N. meningitidis has one

lipid oligosaccharide layer: same as LPS but with less carbs. has same endotoxin effects as LPS damaging capillaries and causing emboli
question
what are the polysaccharide capsule serotypes for N. meningitidis, which are covered by vaccine
answer
A, C, Y, W-136 (conjugate vaccune types)
8 (no vaccine but common in bug)
question
what is the most common meningitis causing bug that causes maculopapular petechial rash
answer
N. meningitidis
question
what microbes other than E. coli can show up on macConkey agar, why do they turn color
answer
klebsiella and enterobacteri

lactose fermentation changes pH and turns on indicator
question
define encephalitis
answer
inflammation of the cerebral cortex
question
what is the most common cause of encephalitis in the US and how does it get into the CNS
answer
HSV-1
travels along CN5
question
what are the rhabdoviruses that cause encephalitis (3)
answer
lyssa
rabies - sanskirt rhabas
polio - myelitis
question
what are the bacteria that cause encephalitis (3)
answer
borrelia burdgorferi - lyme
treponema pallidum - syphilis
leptospiral interrogans
question
what are the ameoba that cause encephalitis (3)
answer
freshwater ameoba
ancathamoeba/balmuthia - granulomatous encephalitis
nagleria fowleri
question
what are the parasites that cause encephalitis (6)
answer
toxoplasmosis gondii
taenia - flat worms (cysticerosis)
malaria - p. falciprum
tryanosomiasis- African SS (T. brucei)
echinoccus granulosus
toxacara canis/cati
question
what are the non-rhabdoviruses that cause encephalitis (12)
answer
HSV1, HSV2, VZV, CMV, HIB
enterovirus: ECHO, pareco, cosackie
arboviruses: west nile, california, EEE, WEE, St. louis
question
what are the causes of brain abscess
answer
trauma or surgery
infected emboli
osteomyelitis from neighboring area (otitis, mastoiditis)
bacteria - aerobe and anaerobe
fungal opportunists
question
what fungal opportunist likes to cause brain abscess
answer
zygomycetes: rhizopus
question
what are the two types of zygomycetes: rhizopus, describe them
answer
septate: spores made in little colored sacs

aseptate: one large sac with spores
question
what are some general signs of encephalitis (4), which distinguish it from meningitis (3)
answer
headahce, neck pain, nausea, vomiting

impaired conciousness, ABNORMAL BEHAVIOR, seizures (LESS than meningitis)
question
when you suspect encephalitis, what labs should you do
answer
LP: lymphocytes, glucose, protein
serology: acute and convalescent sera
question
in general, what is the prognosis of encephalitis
answer
good with supportive treatment
self limiting
question
what is another name for lyssa virus
answer
greek for lud violent
question
lyssa virus: shape, genome type, how to identify
answer
bullet shape
-RNA
may look like inclusions on EM
question
what are two other names for rabies
answer
sanskirt rhabas
to do violence
question
what are 7 things that carry rabies
which is the most common in us and in world
answer
Bats in US
dogs in world

cats, racoons, skunks, foxes, coyotes, cattle
question
what does the fox say
answer
rabies rabies rabies....
question
how is rabies transmitted(3)
answer
saliva, inhalation, organ transplant (not a common screen and indetectably clinically in early stages)
question
how does rabies cause damage
answer
binds to ACh in muscle ganglioside
question
what does rabies do while it is incubating, how long can this occur
answer
weeks to years
travels from site to dorsal root ganglion on nerve
question
how long does it take for rabies to reach the brain, what parts does it go to first, what is this stage called when it arrives
answer
prodromal: 2-10 days
cerebellum, purkinje, hippocampus
then back to the peripherial nerves
question
what symptoms arrive in the prodromal stage of rabies, why
answer
because at the end the virus travels back down the neaves (face first) and causes inability to swallow and spasms
question
how long does it take for neurological symptoms of rabies to appear, what type of condition does it cause
answer
2-7d
encephalitis like
question
what are 7 neurological symptoms of rabies
answer
seizure
confusion
headache
fever
hyperactivity
paralysis
degeneration of neurons
question
how do you know when someone with rabies is infectious, what stage is this, how do they spread it
answer
neurological stage symptoms
saliva and eyes are carrying virus
question
why does someone with rabies usually die, how long does it take
answer
0-14d
cardiac failure, hypotension, secondary infection
question
why does rabies move faster symptom wise in the prodromal phase than in incubation, what is the exception to this
answer
it can crawl faster on those nerves (200-400 mm/d vs 12-24 mm/d in periphery)

if bitten on face it can get to CNS faster because it is closer
question
what labs should you do on someone with suspected rabies
answer
saliva, serum, LP, brain, and skip biopsy testing
PCR for RNA
question
why can you do a skin test for rabies and where
answer
cutaneous nerves at base of follicles in cervical region may contain a few viruses
question
what are two diagnostic signs for rabies
answer
negri bodies in purkinje cells on autopsy
little antibody (hidden in nerves)
question
how is rabies treated
answer
wash wound to reduce viral load
passive immunization: hyper immune gamma globulin IM around wound
killed diploid cell vaccine (5 doses over 28 d)
question
why do we give someone the vaccine ..after.. they have rabies??
answer
we cannot wait for active immune response. antibodies and CMI will be too slow
question
how is polio transmitted
answer
fecal oral
question
what are three general conditions polio causes
answer
initial GI infection
meningitis/encephalitis causes neuro signs
guillain barre
question
what are the three ways polio presents neurologically
answer
paralytic polio: leg paralysis
bilbar polio: respiratory muscle paralysis
post polio: recourrance of paralysis years later due to slow deterioration of the nerves
question
what is guillan barre
answer
autoimmune damage to myelin sheath following infection
question
what are the two types of polio vaccines and what are they made of
answer
salk: killed vaccine
sabin: live attenuated vaccine
question
why would you use the sabin polio vaccine, why not
answer
better antibody response

could revert to wild type, mild GI infection
question
explain the clinical presentation of B. burdgorferi
answer
1. erythema margins
2. dissemination to heart and brain (meningitis, neuritis)
3. autoimmune arthritis
question
leptospira interrogans transmission
answer
animal urine gets into skin break
question
leptospira interrogans pathogenesis
answer
toxicemia due to dying of bug and presence of endotoxin similar to more severe forms of endotoxicemia but shorter and less severe
question
what are the initial symptoms of leptospira interrogans
answer
flu like
abdominal pain
jaundice
question
what are the severe stage symptoms of leptospira interrogans
answer
meningitis
wheil's disease
question
what is wheil's disease, what causes it
answer
renal and liver failure caused in severe leptospira ictero infection
question
where is granulomatous encephalitis found, where does it infect, prognosis
answer
well water

can cause eye infection that have potential for encephalitis

slow development, often fatal
question
what infection does nagleria fowleri mimic, what is the prognosis
answer
bacterial like meningitis
rapid progression, fatal in 1-2wks
question
how is a brain abscess detected
answer
CT
MRI
question
how is a brain abscess treated
answer
antimicrobials
drainage
question
who does toxoplasmosis infect (3)
answer
congenital
immune compormised
old people
question
how is toxoplasmosis transmitted (3)
answer
inhalation/ingestion of oocyte (reproductive form)
ingestion of bradyzoite (cyst in food)
congenital transmission of trachyzyoites
question
what are 3 signs of non congenital toxoplasmosis
answer
eye isgns
calcified ring lesions on MRI
hydrocephalus
question
what are 3 sigs of congenital toxoplasmosis
answer
blindness
deafness
retardation
question
how is toxoplasmosis detected
answer
IgG/IgM
IgM can be used for identification because few people have it
question
how is toxoplasmosis treated
answer
anti-parisitic
question
explain the two different ways T. solium can infect people
answer
consuming encysted larvae in undercooked meat and they mature in intestines

ingest egg and larvae migrate to tissue and encyst (neurocysteriosis can be fatal)
question
what brain conditions can T. solium cause and why
answer
encephalitis: because of the neurocysteriosis

abscess: the body cannot get rid of cyst so it walls it off with a lesion
question
what symptoms does T. solium cause (6)
answer
diarrhea, abdominal pain, weight loss, eosinophilia, neurocysteriosis, abscess
question
how is malaria falciprum transmitted
answer
female anopheles mosquito
question
how does falciprum cause problems
answer
RBC membrane becomes sticky and adheres to capillary walls
question
what are the two types of african sleeping sickness, their locations, and duration, their carriers
answer
trypanosome brucei gambinese: west africa. slow infection (mo - y). cow and human

trypanosome brucirhiodesiense: east africa, rapid progression (wk-mo). sheep lion, cattle
question
what transfers african sleeping sickness between carriers
answer
tsetse fly
question
what does T. bruci do after the tsetse fly bites you
answer
enters blood then CNS
question
what are the 4 phases of african sleeping sickness and their signs
answer
initial: cancher at bite site

haemolymphatic: fever, rash, headache

winterbottom sign: large cervical nodes

neurological phase: lethargy, confusion, convlusions, impaired speech
question
what is the tx and prevention for T. bruci
answer
perscription anti worm
vector control
no vaccine
question
toxacara canis/cati aka, once in body what does it do
answer
ingest egg, larvae migrate to brain and other organs
dog/cat round worm
question
echinoccus granulosus: carriers, tranamission, what they do in body
answer
sheep and dog
humans ingest egg and larvae migrate and form haydatid cyst which causes pressure and anaphylaxis
question
what three viral diseases cause slow neurological degeneration
answer
subacute sclerosing panecephalitis (SSPE)
progressive multifocal leuco encephalopathy
congenital rubella
question
what causes subacute sclerosing panencephelitis
answer
measles cause damage to myelin and cause encephalitis
question
what causes progressive multifocal leuco-encephalptathy, in who
answer
JC virus in compormised
question
what is a prion, what are some chemical characteristics
answer
PrPc is turned into PrPsc by PrPsc in cytoplasm (not cell surface)
B pleated sheet (not alpha)
globular
disease causing fibrils
protease resistant
question
what do prions do
answer
cause plaque in the brain
question
what are the 3 types of creutzfeldt jakob disease, what causes each
answer
familail: autosomal dominant mutation in PrP gene (long latency)

sporadic

V-CJD: acquired from eating cow with BSE (short laltency)
question
what is the cause of gerstmann straussler disease
answer
PrP gene mutation
question
what is the cause of fatal insonmia
answer
PrP gene mutation
question
how does c. tetani cause damage
answer
tetanospasmin toxin
question
how is C. tetani transmitted
answer
spores in soil get into open wounds
question
MOA tetaospasmin toxin
answer
blocks release of inhibitor neurotransmitters (GABA, glycine)
question
wat are 5 signs of toxoplasmin toxin
answer
muscle rigidity
spasm
lock jaw
autonomic dysfunction
question
how is C. tetani prevented and treated
answer
active and passibe immunity
no tx
question
how does C. botulinium cause damage
answer
botulism toxin
question
how is C. botulinium transmitted
answer
food, heroin, injections, soil, inhalation (terrorism)
question
what are 4 signs of botulism toxin
answer
vision issues
speech issues
restlessness
paralsis
difficulty swallowing
question
C. botulinium tx
answer
antitoxin
question
how do dinoflagellates cause damage
answer
ciguatera toxin
question
dinoflagellate transmission (4)
answer
snaller, groupr, sea bass, and barracuda hich eat dinoflagellates
question
ciguatera toxin MOA
answer
interfers with Na movement
question
7 signs of ciguatera toxicity
answer
numbness around mouth, lips, arms, legs
nausea
vomiting
muscle pain
muscle weakness
headache
dizzy
tachycardia
question
what does PANDAS stand for
answer
pediatric atoimmune neurophsychiatric disease associated with streptococci
question
what is the cause of PANDAS
answer
post strep caused cross reactivity to brain tissue (rheumatic hypersensitivity)
question
what are 7 signs of PANDAS
answer
emotional
OCD
depression
agression
disruptive behavior
attention defcit
tourettes
question
what are 6 mushrooms that cause CNS symptoms
answer
aminita
fly agatic
brain mushroom
false moreles
death cap
destorying angel
question
what are 6 wild berries that cause CNS symproms, describe some
answer
poke weed /black night shade: leafted green shrub with purple berries on pink stems

bittersweet: clusters of red orange betties

lilley of the valley

daphine

belladonna
question
what are 9 house plants that cause CNS symptoms
answer
milstone
philodendron
pothos
bulbs: tulips, narcissus, iris
diffenbachia
poinsettia
easter lilly
question
image:890158|center}
answer
aseptate
question
[image]
answer
B. burdgorferi
question
[image]
answer
belladona
question
[image]
answer
lilly of the valley
question
[image]
answer
negri body
question
[image]
answer
negri body
question
[image]
answer
neurocysteriosis T. solium
question
[image]
answer
septate
question
[image]
answer
pokeweed blacknight shade
question
[image]
answer
T. brucei
question
[image]
answer
T. solium cysts
question
[image]
answer
T. solium
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