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55 Cards in this Set

  • Front
  • Back
Inflammation of meningies and brain?
meningoencephalitis
Most common route of viral infection to brain? what others?
Blood, then peripheral nerves, then olfactory nerve
Target cells of viral encephalitis?
neurons and oligodendroglia to cause demyelination
Presentation of meningitis?
stiff neck with headache
Presentation of encephalitis?
stick neck with headache AND altered state of consciousness
What is unique about HSV encephalitis?
It affects the temporal lobe and patient may present with hallucinations or bizzare behaviors
What is the spectrum of conscienceness?
pretains anywhere from lethargy to coma, depending on severity of encephalitis
What is pleocytosis and how does it pertain to encephalopathy?
it is elevated WBC in a body fluid. in this caes, pleocytosis in CSF with low/normal glucose indicates viral encephalitis
Peripheral WBC counts with viral encephalitis?
variable or normal
mumps and measles peak during what season?
winter and spring
Arthropod borne encephalitis peaks when?
summer, when ticks come out
Rhabdovirus virion structure?
bullet shaped, causes rabies; ss negative RNA
Replication of rhabdovirus?
like paramyxo (brings its own polymerase to synthesize mRNA in the cytoplasm)
Rhabdovirus antigens?
G(angster) spikes and nucleocapsid protein
What does the nucleocapsid protein induce and what is this used for?
complement fixation antibodies used for diagnosis, not protection
inclusion bodies pathognomonic for rabies?
Negri bodies
What are negri bodies?
aggregates of helical nucleocapsids
Rhabdovirus: lysis or budding?
budding bullets
Mode of transmission for rhabdoviruses?
bite of a dog
aerosol of a BAT
Why are rabies more common in males?
because they are more likely to be exposed to it
Vaccination rules for potential rabid bite?
observe cat/dog for ten days. if no symptoms occur in the animal, then do not vaccinate
What occurs during rhabdovirus incubation?
viral replication at inoculation site, muscle, and connective tissue and migration into peripheral nerves
How long is rhabdovirus incubation?
18-60 days, up to a year or more even!
Prodrome symptoms of rabies?
nonspecific malaise/fever with pain/tingling at wound site
What is the pain/tingling at wound site after rabies bite?
arrival at the spinal ganglion
When is rhabdovirus infection irreversible?
when it finally reaches the spinal ganglion during prodrome
What is hydrophobia?
rabid, hyperactive patient has pharyngeal spasms when the patient swees water and has difficulty swallowing.
What is dumb rabies?
when rabid patient has no hyperactivity and only paralysis; coma and death occur
Most common presentation of acute neurologic phase of rabies after prodrome?
80% have periods of hyperactivity aka furious rabies where thrashing around with extreme agitation occur.
Treatment of rabies?
1) wound cleansing with 70% EtOH and debridement
2) HRIG (human rabies immunoglobulin) 5 doses over 4 weeks
The only vaccine that is effective post-exposure?
HRIG
Most common cause of sporadic encephalitis in US?
HSV1 in adults
Principal target of HSV1 encephalitis?
temporal loves -- craziness + hallucinations!
most common diagnostic tools for HSV encephalitis?
CSF then EEG, then CT/MRI then biopsy
Treatment of HSV?
Acyclovir, but still has 40% mortality
What disease commonly reaches the brain but doesn't always exhibit encephalopathy?
Measles; 50% without CNS symptoms have abnormal EEGs
How does measles cause CNS symptoms?
direct damage during infection! think about it, CSF has not much immune response

Also post-infection encephalitis
What is the disease process of post-infection encephalitis?
sensitization of the infected person to myelin; occurs with other infections too!
What is subacute sclerosing panencephalitis?
SSPE is caused by measles and super rare.
Presentation of SSPE?
insidious progressive behavrioral deterioration; potential myoclonic seizure
Diagnosis of SSPE?
EEG or Measles IgG in CSF
How is SSPE caused?
usually a child before 2 and it is caused by defective mutatns of measles virus arising in the brain; NOT transmitted.
What causes transmissible spongiform encephalopathies?
prions
what is a prion?
a normal host protein in an altered conformation that yields it resistant to proteases and has a tendency to form plaques
Why is one prion so terrible?
it is able to change normal copies of the same protein into the pathogenic conformation
What gene is implicated in TSE?
PrP gene
Cannibals that eat brains get this
Kuru - TSE and death within a year after a 30 year incubation period
Kuru causes disease in what?
brain and reticuloendothelial system
Kuru-like disease with a more worldwide distribution?
cruetzfeld-Jakob disease
Kuru vs Creutzfeld-Jakob disease?
CJD has a more worldwide distribution and only an incubation period of 18 months vs 30 years!
What is an inherited form of Creuzfeld-Jakob?
Gerstmann-Straussler-Scheinker Syndrome = the mutant form of prion protein is inherited
What do you get from scraping wool off of fences?
Scrapie! The disease of sheep that gives you CJ-like disease
What is the medical term for mad cow disease?
bovine spongiform encephalopathy
What is Bovine Spongiform Encephalopathy?
scrapie that transmitted to cattle
Variant Creutz-Jakob Disease?
linked to bovine spongiform encephalopathy but most people are under 45, which is younger than CJD