Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
60 Cards in this Set
- Front
- Back
|
Leading bacterial meningitis cause in elderly
|
Otitis, pneumonia
|
|
|
Leading bacterial meningitis cause in children/young adults
|
Meningococcus (neisseria)
|
|
|
Leading bacterial meningitis cause in infants/toddlers
|
H influenza
|
|
|
Leading bacterial meningitis cause in newborns/young infants
|
coliforms or
Group B strep (vaginal delivery) |
|
|
Chronic meningitis clinical presentation
|
insidious onset
Can obstruct CSF flow c/o granuloma & gliosis/fibrotic changes -> hydrocephalus May get infarct or necrosis |
|
|
Chronic meningitis lab/histo presentation
|
CSF: lymphocytic predominance
Granulomas may be present (Syphylis & toxoplasma a little different) |
|
|
Brain abcess typical location
source of infection? |
more often gray matter
septic encephalitis 2nd to heart (acute endocarditis, congenital valve defect) or lung (bronchiectasis or abcess) |
|
|
Tb infxn of brain
|
Immunosuppressed (AIDS)
Base of brain typically involved Tumor like mass = Tuberculoma May involve bone (Pott's disease) (most pt present w/ lung infxn - TB typically infects lung) tuberculoma = distinct mass in brain, granuloma = microscopic |
|
|
TB meningitis: CSF findings
onset other presentation |
CSF: lymphocytic pleocytosis (also: periphery has monocytosis)
Slow onset Obstructed CSF -> Hydrocephalus nuchal rigidity can be absent |
|
|
Fungus primarily infecting parenchyma
|
candida & cryptococcus
|
|
|
Fungus primarily causing vasculitis
|
mucor & aspergillus
|
|
|
Fungus primarily causing meningitis
|
cryptococcus, histoplasma, coccidiodes, blastomycoses
|
|
|
Fungus causing abcess
|
all fungus, esp. candida, nocardia, actinomyces
|
|
|
Soap bubbles (perivascular spaces or parenchymal cysts) is typical of
|
cryptococcus
|
|
|
Cyptococcus signs
|
CSF: few cells & high protein
India-ink + Immunocompromised patient see encapsulated yeast forms (soap bubbles in perivasculature or parenchyma) |
|
|
Petechial micro-hemorrhages on brain most likely caused by
|
Malaria (falciform)
|
|
|
Bug that likes peri-ventricular areas in brain
|
Toxoplasma gondii
Infects immune-compromised patients Necrosis & calcification & hydrocephalus well circumscribed "cyst-like" abcesses |
|
|
Acanthamoeba causes what diseases
|
GAE (Granulomatous Amebic Encephalitis)
Amebic keratitis |
|
|
Naegleria fowleri causes what diseases
|
PAM (Primary Amoebic Meningoencephalitis)
acute, fulminant |
|
|
Naegleria fowleri found where?
|
warm fresh water & soil
|
|
|
Cysticercosis bug
|
Taenia solium (tapeworm)
|
|
|
Taenia solium lifecycles
|
1) Eat undercooked meat with larval cysts -> larva excyst -> eggs in small intestine (Taeniasis)
2) Eat egg with embryo (fecal) -> encysted tapeworm in tissues -> cysticercosis (more serious, can get in brain = neurocysticercosis) |
|
|
Taenia solium histo
|
see cyst wall
|
|
|
Classic Rhabies histological
|
Perivascular cuffing (mononuclear cells surrounding)
Negri bodies |
|
|
Rhabies clinical/behavior
|
small touch -> convulsions/spasms (may stop breathing c/o laryngeal spasms)
mask-like face w/ abnormal jaw movements |
|
|
Rhabies patient history (classical case presentation)
|
Cave explorer
|
|
|
Herpes histological
|
Inclusion like bodies = Cowdry bodies (intranuclear bodies)
|
|
|
Herpes types and find commonly in
|
Type 1 is more common in children ("Above the waist - eye & mouth")
Type 2 more common in adults (50% in neonates of HSV + women) (Type 2: "Below the waist": genitial lesions) |
|
|
Slow progression in children & adults
intranuclear & intracytoplasmic inclusions fibrous gliosis & extensive myelin loss & atrophy of brain What is the disease? What causes this? |
SSPE (Subacute Sclerosing Pan-Encephalitis)
Mutated measles infection (Rubella, a paramyxovirus) |
|
|
Multifocal demylination w/ relentless progressive signs & symptoms
occurs in immunosuppressed late in course ill-defined patches of demylination abnormal inclusion-containing oligodendrocytes, and bizarre giant astrocytes |
PML (Progressive Multifocal Leukencephalopathy)
Papova viruses JC & SV40 |
|
|
periventricular necrosis & calcification (see on x-ray)
histo: inclusions in ependymal & subependymal inclusions |
CMV
(Note: similar to Hodgkin's except R-S cell is double-nucleated: nucleoli enlarged, Hodgkins rare to involve brain - mostly lymphatic) |
|
|
HIV signs meningoencephalitis signs
|
dementia, ataxia, bladder/bowel incontinence, peripheral neuropathy, microcephaly, developmental delay
|
|
|
HIV + histo
|
perivascular infiltration by lymphocytes & giant cells
|
|
|
Viral encephalitis common features
|
Gross: meningeal hyperemia, congestion, small hemorrhages
Micro: meningial inflamm, perivascular CUFFING, neuronophagia, microglial NODULES, inclusions CSF: lymphocytic pleocytosis, moderate protein elevation, normal sugar |
|
|
PML viruses causing
|
Papova Viruses JC & SV40
|
|
|
Prion diseases histo
|
see plaques
not much inflammation just destruction of neural tissue |
|
|
Prion diseases
|
Rapid onset of dementia (like Alzheimer's but fast)
|
|
|
Neurosyphilis imaging signs
|
gummas (mass effects)
a ring enhancing lesion clinical presentation is similar to Alzheimers |
|
|
Neurosyphilis histo
|
lots of macrophages (microglial cells)
may see spirochetes inside w/ special stain see microgial rod cells on silver stain |
|
|
Neurosyphilis spinal cord manifestations
|
tabes dorsalis (lose axons & myelin in dorsal column & roots)
|
|
|
Neurosyphilis sensory disturbances
other clinical signs |
Argyll-Robertson pupil (accommodate but no constriction to light)
locomotor ataxia, dementia, loss of DTR (reflexes) |
|
|
Guillon-Barre syndrome: what is it?
|
(aka Acute Inflammatory Demyelinating Polyradiculopathy)
Demyelinating peripheral neuropathy |
|
|
Guillon-Barre syndrome signs/presentation
how to confirm |
Weakness in extremities (i.e. legs) that is ascending, CN involvment (esp. facial)
Confirm w/ CSF: see elevated protein & minimal cells (minimal pleocytosis) |
|
|
Weakness in extremities (i.e. legs) that is ascending, CN involvment (esp. facial)
Confirm w/ CSF: see elevated protein & minimal cells (minimal pleocytosis) |
Guillon-Barre syndrome signs/presentation
how to confirm |
|
|
Guillon-Barre syndrome treatment
|
Plasma phoresis
|
|
|
Neurosyphilis CSF findings
|
VDRL positivity and FDA
protein elevated but not many inflammatory cells can do PCR as well |
|
|
Periventricular plaques indicates
|
MS
|
|
|
MS commonly affects what neural tissue
|
periventricular tissue
Optic nerve/Chiasm Brainstem & cerebellum Spinal cord (CNS c/o Oligo but not Schwann) |
|
|
MS findings
|
Depleted oligodendroglia
Increased macrophages & CD4+ lymphocytes Monocytes myelin loss Reactive astrocytes Loss of axons |
|
|
Classic MS presentation
|
Pt w/ neuropathies separated in time by months or years
& different anatomical parts of body age is 15-50 |
|
|
Prognostic markers in MS
|
1) Progression of disease from onset of symptoms (spread in body)
2) Motor & Cerebellar signs 3) Short interval btwn relapses 3) Poor recovery from relapses 4) Multiple lesions (T2 MRI) |
|
|
CSF w/ increased protein, mild leukocytosis, & oligoclonal bands is indicative of?
|
MS (not diagnostic - other diseases can cause too)
|
|
|
Encephalomyelitis
|
|
|
|
Acanthamoeba causes what diseases
|
GAE (Granulomatous Amebic Encephalitis)
Amebic keratitis |
|
|
Naegleria fowleri causes what diseases
find where |
PAM (Primary Amoebic Meningoencephalitis)
acute, fulminant Warm freshwater & soil |
|
|
GAE (Granulomatous Amebic Encephalitis) caused by
|
Acanthamoeba
|
|
|
PAM (Primary Amoebic Meningoencephalitis) cause by what bug?
|
Naegleria fowleri
|
|
|
Amebic Keratitis caused by what bug?
|
Acanthamoeba
|
|
|
Toxoplasmosis signs
|
Aids or in utero pt
Necrosis & Calcification Hydrocephalus |
|
|
Albuminocytological dissociation:
What is it? When do you see it (what disease)? |
elevated protein with minimal pleocytosis
see in Guillain-Barre syndrome (Acute Inflammatory Demeylinating Polyradiculopathy) |
