B&b Week 3 Lecture 6

Front 1

What does the blood brain barrier(BBB) separate?

Back 1

CNS from blood

Front 2

What is unique about the capillaries in the brain?

Back 2

Endothelial cell lined, this prevents substances from entering the brain.

Lack pinocytotic vessicles so little vessicular transport.

Front 3

Which parts of the brain do not have a BBB?

Back 3

Pituitary gland, pineal gland, area postrema, some parts of the hypothalamus
(allows feedback of hormone levels)

Front 4

What can get through the BBB easily?

Back 4

Lipid soluble molecules.
Nicotine, ethanol, heroin

Front 5

What molecules are transported across the BBB?

Back 5

D glucose and neutral amino acids

Front 6

Why is the CNS considered 'immune priveleged'?

Back 6

T and B lymphocytes and macrophages are rarely encountered in the CNS.

Front 7

What are some diseases where the BBB gets breached?

Back 7

meningitis, encephalitis, vasculitis, ms, anoxic/ischemic and traumatic insults

Front 8

What are the two steps when the BBB gets breached?

Back 8

1. increased permeability to water and proteins leading to edema.
2. accumulation of inflammatory cells

Front 9

What is essential for leukocyte adhesion and extravasation?

Back 9

CAMS (Cell Adhesion Molecules)

Front 10

What are some examples of CAMS?

Back 10

Intercellular Adhesion Molecule-1 (ICAM1), Vascular Cell adhesion Molecule 1 (VCAM1), E-selectin, P-selectin, and Platelet Endothelial Cell Molecule -1 (PECAM-1)

Front 11

When do CAMS get induced?

Back 11

CAMS get induced on cerebral EC by inflammatory cytokines produced by lymphocytes and macrophages in inflammation (Tumor Necrosis Factor alpha, Interferon gamma and interleukin 1beta)

Front 12

Which CAMS are specific for adhesion of lymphocytes?

Back 12

ICAM1 and VCAM1

Front 13

Which CAMS are specific for transendothelial migration of the lymphocytes?

Back 13

ICAM1, E-selectin and PECAM1

Front 14

What can exposure to Interferon gamma induce in cerebral endothelial cells?

Back 14

Expression of Class II MHC

Front 15

When do cerebral endothelial cells express de novo or upregulate expression of costimulatory molecules (B7, CD40, Lymphocyte function associated antigen-3(LFA3))?

Back 15

Exposure to Interferon gamma, tumor necrosis factor alpha, lnterleukin 1 beta and bacterial lipopolysaccharide.

Front 16

What are some Infectious diseases that can affect the CNS?

Back 16

Meningitis (infection of meninges)
Meningoencephalitis (infection of brain and meninges)
Infections secondary to trauma
Viral Infections
Prion Disease
HIV releated

Front 17

What does meningitis usually refer to?

Back 17

Acute purulent bacterial meningitis, inflammatory reaction in the subarachnoid space characterized by an exudate of polymorphonuclear and mononuclear leukocytes with deposition of fibrin

Front 18

What pathologic changes are seen in meningitis?

Back 18

Necrosis of vessel walls with associated thrombosis. Ependymitis, inflammation of lining of ventricles.

Front 19

What organisms are commonly responsible for meningitis?

Back 19

Pneumococcus(Adults and Kids), Hemophilus influenzae(Kids), Meningococcus (epidemics)

Front 20

Where are these organisms normally found?

Back 20

Normal flora of naso-pharynx.

Front 21

What may precede meningitis?

Back 21

Naso-pharyngitis, middle ear infection

Front 22

What are some causes of meningoencephalitis?

Back 22

Tuberculosis, Fungal, Syphillis

Front 23

Tuberculous Meningoencephalitis is always secondary to a primary foci elsewhere in the body (T or F?)

Back 23

T

Front 24

Multinucleated giant cells are frequent in TB of the brain? T or F

Back 24

F this distinguishes these lesions from other TB foci

Front 25

What is tuberculous meningoencephalitis characterized by?

Back 25

meningitis, severe vasculitis and inflammation of the brain and cranial and spinal nerves

Front 26

Name 3 types of syphilitc brain disease?

Back 26

Paretic neurosyphilis
Tabetic neurosyhphilis
meningovascular neurosyphilis

Front 27

Which one damages the cranial and spinal nerves exclusively(esp posterior roots of the lumbar column)?

Back 27

Tabetic neurosyphilis

Front 28

What are two types of fungal brain infections?

Back 28

mucormycosis, cryptococcosis

Front 29

What are two broad categories of viral disease?

Back 29

Acute (immunity and elimination results)
Latent, chronic and slow (viruses persist despite host immune response)

Front 30

What are some types of acute viral infections?

Back 30

poliomyelitis, smallpox, arthropod borne (arbor), mumps, coxsackie

Front 31

What are some of the chronic, latent and slow types?

Back 31

Herpes simplex, varicella zoster

Front 32

What is subactute Sclerosing panencephalitis?

Back 32

SSPE is a relatively rare chronic destructive disease
-infants and children without immune deficiency
-caused by measles virus

Front 33

What is Progressive multifocal leukoencephalopathy PML ?

Back 33

-rare, fatal, chronic, progressive
-debilitated patients with immunosuppression
-JC virus
-inflammatory and semi-neoplastic response

Front 34

What two diseases when acquired prenatally can cause infectious in the brain?

Back 34

Congenital rubella infection
Cytomegalic inclusion disease

Front 35

What is prion disease?

Back 35

Successive formation of an abnormal isoform of the normal prion protein found in cell membranes of nerve cells .
Prions multiply by converting normal cellular prion proteins into pathogenic ones.

Front 36

What are two types of prion disease?

Back 36

Kuru, Creutzfeldt-Jakob disease (CJD)

Front 37

What is the Aids Dementia Complex?

Back 37

Direct infection of the brain by HIV1. Causes multi cell encephalitis, white matter pallor, reactive gliosis, vacuolation, behavioral , motor and cognitive deficits