Ihi Tb4 Cns Infection

Front 1

what are the key signs of meningitis?

Back 1

1. headache, 2. fever, 3. stiff neck, 4. Kernig sign, 5. brudzinski sign, 6. photophobia

Front 2

What does the CSF look like in bacterial meningitis?

Back 2

↑ WBC and protein, neutrophils, ↓ glucose

Front 3

what does the CSF look like in fungal meningitis?

Back 3

↑ WBC and protein, mononuclear cells and neutrophils, ↓ glucose

Front 4

what does the CSF look like in viral meningitis?

Back 4

↑ WBC and protein, mononuclear cells and neutrophils, NORMAL glucose

Front 5

what bacteria causes meningitis in <5 yoa?

Back 5

H. meningitis

Front 6

What bacteria causes meningitis in child/adolescent?

Back 6

N. meningitis

Front 7

What is the most common cause of bacterial meningitis?

Back 7

S. pneumoniae

Front 8

what are the 3 complications of meningitis?

Back 8

1. ICP = CN6 palsy and papilledema, 2. vasculitis = focal signs and CN palsys, 3. hydrocephalus

Front 9

what is the treatment of bacterial meningitis?

Back 9

antibiotics AND steroids

Front 10

what type of seizure would occur due to bacterial meningitis?

Back 10

complex-partial because the temporal lobes are so vulnerable to injury

Front 11

what are the common viral organisms that cause meningitis?

Back 11

1. arbovirus, 2. enterovirus, 3. herpes virus, 4. mumps, 5. measles

Front 12

what are the key signs of encephalitis?

Back 12

1. fever, 2. headache, 3. subacute mental status change - confused, 4. seizures (temporal lobe), 5. hemiparesis

Front 13

what is the most common sporadic viral encephalitis?

Back 13

HSV 1

Front 14

where does HSV-1 love to go?

Back 14

temporal lobe = amnesia or complex partial seizures

Front 15

what is the presentation of herpes encephalitis?

Back 15

headache usually first followed by subacute mental status changes, parital simple and partial complex seizures (temporal lobe) and fever

Front 16

what does the EEG show in herpes encephalitis?

Back 16

diffuse slowing and periodic lateralizing epileptiform discharges bilaterally in the temporal lobes

Front 17

what would a biopsy show in herpes encephalitis?

Back 17

intranuclear inclusions in neurons and glia = cowdry type A

Front 18

What is the treatment of herpes encephalits?

Back 18

acyclovir

Front 19

what is a potential complication of herpes encephalitis?

Back 19

Kluver-busy syndrome = hyperoral, hyper sexual

Front 20

how long does the amnesia go back in herpes encephalitis?

Back 20

2 years

Front 21

what are the common types of infectious organisms that cause CNS abscess?

Back 21

bacterial and fungi

Front 22

what are the common sites for CNS abscesses?

Back 22

brain: frontal lobe via sinuses; temporal lobe via ear; posterior fossa via ear; multiple = hematogenous spread; and spine - cervical via retropharyngeal infection/osteomyelitis

Front 23

what population is at risk for epidural or intradural abscess?

Back 23

IV drug users - staph is the organism

Front 24

what are the general signs of CNS abscess?

Back 24

localized pain, fever, erythema/edema

Front 25

What are the signs that would tell us an abscess is in the brain?

Back 25

progressive symptoms of headache, N&V, confusion, FOCAL SIGNS and seizures; all symptoms are related to location

Front 26

What are the signs that would tell us an abscess is in the spinal cord?

Back 26

progressive radicular pain, para/tetraparesis to plegia; hemisection syndrome to transverse section syndrome

Front 27

how can we tell a radiculopathy vs. myelitis?

Back 27

radiculopathy will have dermatome or myotome distribution and decreased reflexes; a melitis will have decreased sensation and motor and increased reflexes and babinski below level of the lesion

Front 28

how do you treat a CNS abscess?

Back 28

antibiotics, drainage, antiepiletic drugs to prevent seizures

Front 29

what are the symptoms of prion disease?

Back 29

rapidly progressive dementia, ataxia and myoclonus

Front 30

where does TB love to go?

Back 30

base of the brain

Front 31

what is a tuberculoma?

Back 31

a space occupying lesion composed of fibrotic tissue, caseous necrosis and rimmed by granulomatous inflammation. Only seen in immunocomponent hosts

Front 32

what is a tuberculous abscess?

Back 32

an abscess that contains pus w/wo granulomatous inflammation at the periphery. Seen in immunocompromised host

Front 33

which TB lesion occurs in immunocompromised patients?

Back 33

tuberculous abscess

Front 34

which TB lesion occurs in immunocompetent patients?

Back 34

tuberculoma

Front 35

what occurs 1-2 years after initial infection with syphilis?

Back 35

syphilitic meningitis - basically a lymphoplasmocytic meningitis

Front 36

what occurs 5-7 years after initial infectino with syphilis?

Back 36

meningovascular syphilis - obliterative enarteritis = strokes

Front 37

what is a gumma?

Back 37

a space occupying lesion with central necrosis and rimmed by granulomatous inflammation that occurs at the surface of the cortex, associated with syphilis

Front 38

what is general paresis?

Back 38

parenchymatous syphilis characterized by cortical atrophy with thickened leptomeninges, with neuronal loss, gliosis, microglial proliferation and lymphocytic infiltration

Front 39

what is tabes dorsalis?

Back 39

parenchymatous syphilis characterized by selective degeneration of the dorsal nerve roots, dorsal root ganglia and dorsal column = decreased sensory and weakness; secondary wallerian degeneration with demeylination!

Front 40

which 2 fungi cause meningitis?

Back 40

cryptococcus and coccidiodes

Front 41

which 2 fungi cuase infarction?

Back 41

aspergillus and zygomycetes

Front 42

what fungi is associated with diabetes?

Back 42

mucor - nasal mucor that can affect the bottom of the frontal lobe

Front 43

what type of damage does malaria cause?

Back 43

diffuse cerebral injury

Front 44

what type of damage does toxoplasmosis cause?

Back 44

focal injury at the gray/white jxn

Front 45

what type of damage does cysticercosis causes?

Back 45

classically presents with seizures

Front 46

what protozoa classically presents with seizures?

Back 46

cysticercosis

Front 47

which viral infections are associated with demyelination?

Back 47

HIV encephalopathy and progressive multifocal leukoencephalopathy

Front 48

where does CMV love to go?

Back 48

diffuse in the brain

Front 49

where does arbovirus love to go?

Back 49

diffuse in the brain

Front 50

where does rabies love to go?

Back 50

purkinje cells, hippocampal pyramidal cells and specific nuclei

Front 51

where dose herpes simplex love to go?

Back 51

temporal lobe

Front 52

where does herpes zoster love to go?

Back 52

dorsal roots and cerebellum

Front 53

what CNS disease does measle virus cause?

Back 53

subacute sclerosing panencephalitis

Front 54

what CNS disease does JC virus cause?

Back 54

progressive multifocal leukoencephalopathy - demyelinating

Front 55

what CNS disease does HIV cause?

Back 55

HIV encephalitis, vacuolar myelopathy with microglail nodules, giants cells = leads to dementia

Front 56

what population is affected by subacute sclerosing panencephalitis?

Back 56

teens who were infected in measles when they were <1 yoa