Term
| Name the 4 ways microorganisms can enter the CNS |
|
Definition
1. Hematogenous spread 2. Direct implantation 3. Local extension 4. Transport along nerve axons |
|
|
Term
| What is the two bacterial organisms that can be transported along axons |
|
Definition
|
|
Term
| What is the most common way organisms are spread hematogenously |
|
Definition
|
|
Term
| What are two ways organisms are spread hematogenously? |
|
Definition
1. Arterial septic emboli 2. Retrograde through the veins of the face |
|
|
Term
| What is the most common method of direct implantation |
|
Definition
|
|
Term
| What are the two methods of direct implantation |
|
Definition
1. Trauma 2. Lumbar puncture |
|
|
Term
| Name the 4 methods of Local extension |
|
Definition
1. Mastoid or frontal sinusitis 2. Infected tooth 3. Osteomyelitis in spine or crainium 4. Surgerical site in spine or cranium |
|
|
Term
| What is acute pyogenic meningitis? |
|
Definition
| When bacteria infect the leoptomeninges & CSF |
|
|
Term
| What organism cause Acute Pyogenic meningitis in newborns? |
|
Definition
|
|
Term
| An infant or a child w/ Acute pyogenic meningitis is mostly likely to have what organism |
|
Definition
|
|
Term
| Adolescents & young adults get acute pyogenic meningitis from |
|
Definition
|
|
Term
| H. influenzae is no longer a big cause of Acute pyogenic meningitidis due to |
|
Definition
|
|
Term
| The elderly are suspectible to what two organism that cause acute pyogenic meningitidis |
|
Definition
| Listeria monocytogenes, S. pneumoniae |
|
|
Term
| You're most likely to find ______ & ______ in a immunosuppressed individual w/ acute pyrogenic meningitis |
|
Definition
| Klebsiella and anaerobic bacteria |
|
|
Term
| Give the gross characteristics of a Acute pyogenic meningitis infection |
|
Definition
1. Exudate w/in the meninges over the brain surface 2. Prominent over cerebrum near sagittal sinuses (s. pneumonia) 3. Enlargement of the meningeal vessels w/ pus along blood vessels 4. Ventriculitis (severe cases) |
|
|
Term
| Which organism is more prominent over the cerebrum near the sagitall sinus in acute pyogene meningitis |
|
Definition
|
|
Term
| In acute pyogenic meningitis what are the complications that can happen as a result of Phelbitis (inflammation of the veins) |
|
Definition
1. Focal celebritis 2. Venous occulsion 3. Cerebral infarction |
|
|
Term
| Where would you find neutrophils in acute pyogenic meningitis |
|
Definition
| Around the vessels & w/in the subarachnoid space |
|
|
Term
| What are the signs & symptoms of acute pyogenic meningitis |
|
Definition
1. Signs of infection (fever) 2. Headache, nuchal rigidity, clouding of consciousness, photophobia, irritability 3. Cloudy or purulent CSF leading to increased pressure, neutrophils, protein 4. Decrease glucose |
|
|
Term
| What's the outcome in a person that has Acute pyogenic meningitis |
|
Definition
1. If treated immediately no complications 2. fibrosis of leptomeninges in hydrocephalus 3. Exudates of S. pneumoniae predisposes to chronic adhesvie arachnoiditis 4. Lethal if untreated |
|
|
Term
| Define acute aspetic meningitis |
|
Definition
| Viral infection affecting the leptomeninges & CSF |
|
|
Term
| Which organisms are responsible for acute aseptic meningitis? |
|
Definition
| Enteroviruses: Echovirus, Coxsackie & nonparalytic poliomyeltis |
|
|
Term
| What are the histological findings in acute aseptic meningitis |
|
Definition
1. Swelling of the brain
2. Lymphocytes infiltrating the meninges |
|
|
Term
| What are the signs & symptoms of acute aseptic meningitis |
|
Definition
1. Signs of infection
2. Meningeal infection
3. Headache, nuchal rigidity, clouding of consciousness, photophobia, irritability |
|
|
Term
| What does the CSF look for an Acute aspetic meningitis infection |
|
Definition
| Lymphocytic pleocytosis, moderate protein elevation and normal glucosee |
|
|
Term
| What's the prognosis of acute aseptic meningitis? |
|
Definition
|
|
Term
| What are the causes of chemical meningitis |
|
Definition
1. Rupture of a cyst into the subarachnoid space
2. Introducing a chemical substance into the subarachnoid space |
|
|
Term
| What's the clinical presentation of chemical meningitis? |
|
Definition
1. Signs of infection
2. Meningeal irritation
3. Headache, nuchal rigidity, clouding of consciousness, photophobia
4 CSF: pleocytosis w/ neutrophils, moderate protein elevation and normal glucose |
|
|
Term
Brain abcesses arise by
HINT 3 |
|
Definition
1. Direct implantation
2. Local extension from sinuses
3. Hematogenous spread |
|
|
Term
| What are the predisposing factors for brain abscesses |
|
Definition
1. Cyanotic congential heart disease
2. Acute bacterial endocarditis
3. Chronic pulmonary state |
|
|
Term
| What microorganisms are the most common cause of brain abcesses |
|
Definition
1. Staphylococci
2. Streptococci |
|
|
Term
| What's the most common site of brain abcesses? What other sites can they arise from? |
|
Definition
| The frontal lobe is the most common site, they can arise in the parietal lobes & cerebellum |
|
|
Term
| Describe the how an abscess looks like |
|
Definition
| Central liquefactive necrosis surrounded by granulation tissue that leads to fibrosis and surrounded by gliosis |
|
|
Term
| How does the CSF look like? |
|
Definition
1. Increase pressure, protein & white blood cells
2. Normal glucose |
|
|
Term
| Loss of brain tissue in abscesses lead to |
|
Definition
| focal signs & increased intracranial pressure |
|
|
Term
| How does one get a subdural empyema? |
|
Definition
| Spreads from the sinuses or adjacent bones |
|
|
Term
| In subdural empyema, thrombophlebitis in veins can cause _____ |
|
Definition
|
|
Term
| What are the CSF finding of Subdural empyema |
|
Definition
1. Increased pressure, proteins & WBC
2. Normal glucose |
|
|
Term
| What are the clinical findings of subdural empyema and how is it treated? |
|
Definition
1. Fever, headache & nuchal rigidity
2. Surgical treatment |
|
|
Term
| What are the 4 causes of Chronic bacterial meningoencephalitis |
|
Definition
1. Tuberculosis
2. Mycobacteriosis
3. Syphilis
4. Borrelia burgdorferi |
|
|
Term
| What are the symptoms of tuberculosis |
|
Definition
1. Headache
2. Malaise
3. Mental confusion
4. Vomiting |
|
|
Term
| List the gross findings of T.B |
|
Definition
1. Fibrinous or gelatinous exudate in the subarachnoid space
2. White granules of the leptomeninges
3. Tuberculoma (intraparenchymal destructive masses composed of granulomas) |
|
|
Term
| What kind of stain do you use for T.B |
|
Definition
|
|
Term
| What are the characteristics of T.B. |
|
Definition
| Granulomas w/ caseous necrosis & langhan giant cells |
|
|
Term
| In respect w/ T.B what can result in a brain infarction? |
|
Definition
| Obliterative endateritis w/ intimal thickening & inflmmation of the vessels |
|
|
Term
| What are the areas that T.B can spread to and how do they spread to these areas |
|
Definition
| Choroid plexus or ependymal layer via the CSF |
|
|
Term
| What are the CSF findingds of T.B. |
|
Definition
1. Pleocytosis w/ macrophages and/or neutrophils
2. Increased protein
3. Glucose can be normal or reduced |
|
|
Term
| What are the complications of T.B in chronic bacterial meningoencephalitis |
|
Definition
| Serious complications is subarachnoid fibrosis, leading hydrocephalus |
|
|
Term
| Mycobacteriosis is caused by |
|
Definition
| Mycobacterium avium-intracellulare |
|
|
Term
| Who is at greatest risk for Mycobacterium avium |
|
Definition
|
|
Term
| How does mycobacterium avium present? |
|
Definition
|
|
Term
| What are the charateristics of meningovascular neurosyphilis? |
|
Definition
| Chronic meningitis w/ Obliterative endareritis |
|
|
Term
| Describe Paretic neurosyphilis w/ brain invasion by spirochetes |
|
Definition
1. Loss of neurons, w/ microglial proliferation
2. Progressive loss of physical & mental function
3. Psychotic presentation w/ delusions of grandeur and terminating in severe dementia |
|
|
Term
|
Definition
1. Spirochete damage to the dorsal root sensory nerve w/ axonal and myelin damage
2. Sensory disturbances, locomotor ataxia, loss of pain results in skin & joint damages (charcot joints) |
|
|
Term
| What is Neuroborreliosis? What is it caused by |
|
Definition
| Lyme disease, caused by Borrelia burgdorferi transmitted by ticks |
|
|
Term
| what are the symptoms of lyme disease |
|
Definition
Neurological symptoms variable
1. Aspetic meningitis
2. Mild encephalopathy
3. Nerve palsy
4. Focal microglial proliferation |
|
|
Term
| What are the 8 causes of viral meningitis |
|
Definition
1. Arthropood borne viral encephalitis
2. HSV type I
3. HSV type II
4. Varicella-Zoster Virus
5. Cytomegalovirus
6. Poliomyelitis
7. Rabies
8. HIV |
|
|
Term
| How does arthropod borne viral encephalitis present |
|
Definition
1. Seizures
2. Confusion
3. Delirium
4. Stupor
5. coma |
|
|
Term
| What are the 6 viruses that cause Arthropod-born viral encephalitis |
|
Definition
1. Eastern Equine
2. Western Equine
3. West Nile
4. St. Louis
5. California
6. Venezuelan |
|
|
Term
| How does HSV-1 encephalitis present? |
|
Definition
| Hemorrhagic & necrotizing encephalitis w/ Cowdry intranuclear viral inclusion bodies in neurons & glia |
|
|
Term
| How severe is HSV 1 encephalitis in the temporal lboes & orbitofrontal gyri |
|
Definition
|
|
Term
| Where are you most likely to see HSV-2 encephalitis |
|
Definition
| neonates borne to women w/ HSV 2 infections |
|
|
Term
| In the immunosuppressed Varicella Zoster causes |
|
Definition
| Necrotizing encephalitis and granulomatous arteritis |
|
|
Term
| What's the most common opportunistic pathogen in AIDS patients |
|
Definition
|
|
Term
| Give the characteristics of a viral meningitis CMV infection |
|
Definition
1. Periveentricular necrosis
2. Microencephaly
3. Periventricular calcifications |
|
|
Term
| CMV in AIDS patients present in 2 ways, what are they |
|
Definition
1. Subactue encephalitis w/ microglial nodules
2. Periventricular encephalitis w/ characteristic viral inclusion bodies |
|
|
Term
| Polio affect which neurons? What happens as a result of this? |
|
Definition
| LMN that lead to muscle atrophy and inflammation in the anterior horns |
|
|
Term
| Death from polio results from |
|
Definition
| Paralysis of the respiratory muscles |
|
|
Term
| How does rabies get to the brain? |
|
Definition
| Peripheral nerves from the bite of the wound |
|
|
Term
| what are the characteristics of rabies |
|
Definition
| Widespread neuronal necrosis & inflammation in the basal ganglia, midbrain and medulla |
|
|
Term
| What parts of the brain does rabies affect? |
|
Definition
| Basal ganglia, midbrain and medulla |
|
|
Term
| where are you most likely to find negri eosinophilc inclusion bodies due to rabies |
|
Definition
| Hippocampus and purkinje cells |
|
|
Term
| What are the symptoms of rabies |
|
Definition
| extraordinary excitability, hydrophobia and flaccid paralysis |
|
|
Term
| What are the 5 conditions caused by HIV |
|
Definition
1. Aspetic meningitis
2. Encephalitis
3. Vacuolar myelopathy
4. Cranial & peripheral neuropathies & myopathies
5. Progressive multifocal leukoencephalopathy |
|
|
Term
| What are the symptoms of HIV-1 Aseptic meningitis |
|
Definition
| mild aseptic meningitis w/ some demyleination |
|
|
Term
| What are the symptoms of HIV-1 encephalitis |
|
Definition
1. Insidous mental slowing
2. Memory loss
3. Mood disturbances |
|
|
Term
| What does HIV-1 encephalitis progress to? |
|
Definition
| Motor abnormalities, ataxia, bowel & bladder incontinence |
|
|
Term
| What are the histological characteristics of HIV-1 encephalitis |
|
Definition
| Multinucleated giant cells and mylein damaged w/ gliosis |
|
|
Term
| Vaculolar myelopath is found in what percentage of autopsied AID patients |
|
Definition
|
|
Term
| What does vacuolar myelopathy resemble? |
|
Definition
| subacute combined degeneration of posterior and lateral column of the SC |
|
|
Term
| Progressive multifocal Leukoencephalopathy is the infection of ______ caused by __ |
|
Definition
| oligodendrocytes caused by the JC virus |
|
|
Term
| Progressive multifocal leukoencephalopathy causes irregular ______ destruction w/ multifocal and progressive ________ symptoms |
|
Definition
|
|
Term
| In progressive Multifocal Leukoencephalopathy you expect to find |
|
Definition
| Inclusion bodies w/in oligodendrocyte nuclei |
|
|
Term
| Name the fungal infections of the CNS that disseminate through the hematogenous route |
|
Definition
| Asperigillus, mucormycosis, candida and cryptococcus |
|
|
Term
| Name the fungal infections that spread to the CNS after cutaneous or pulmonary infection |
|
Definition
| Histoplasma, coccidodes, blastomyces |
|
|
Term
| Which fungal organisms cause a vascular thrombosis and become septic? |
|
Definition
| Aspergillus & mucormycosis |
|
|
Term
| These organisms cause parenchymal invasion |
|
Definition
| Candida albicans and cryptococcus neoformans |
|
|
Term
| Which fungus causes Chronic meningitis |
|
Definition
|
|
Term
| Cryptococcus neoformans cause accumulation of gelatinous material w/ chronic _______ _____ & small ___________ cyst |
|
Definition
| inflammatory cells & intraparenchymal cyst |
|
|
Term
| Cryptococcus neoformans may provoke reactive connective tissues w/ obstruction of the |
|
Definition
|
|
Term
| Name the 3 protozans involved in the infection of the brain |
|
Definition
| Toxoplasma, Amebiasis and trypanonsomiasis |
|
|
Term
|
Definition
| subacute focal lesions and infantile cerebritis |
|
|
Term
| What two ambeiasis cause brain infections? |
|
Definition
| Naegleria and Acanthamoeba |
|
|
Term
|
Definition
| rapid necrotizing encephalitis |
|
|
Term
|
Definition
| Chronic granulomatous meningoencephalitis |
|
|
Term
| What's the cause of typhus and rocky mountain spotted fever |
|
Definition
|
|
Term
| cryptococcus neoformans can cause |
|
Definition
| Parenchymal invasoin and vasculitis |
|
|
Term
| candida albicans can cause |
|
Definition
|
|
Term
| Spongioform encephalopathies are caused by |
|
Definition
|
|
Term
| What are the characteristics of Spongioform encephalopathies |
|
Definition
1. No inflammatory infiltrate
2. Small, apparently empty vacuoles
3. Advance: Severe neuronal loss, prominent gliosis, "kuru" plaques of extracellular aggregated proteins |
|
|
Term
| What changes occur in the prion protein that causes them to aggregate |
|
Definition
| The go from an alpha helix to protease-resistance beta-plated sheet which causes accumulation of protein aggregates |
|
|
Term
| How do you transmitt creutzfeld-Jacob disease (CJD) |
|
Definition
| Electrodes, GH & corneal transplants |
|
|
Term
| What are the symptoms of CJD |
|
Definition
| Suble memory loss w/ rapid progression to severe dementia w/ death in 7 months |
|
|
