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Neuropatyhu of Infections
3.19.07
58
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Not Applicable
03/19/2007

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Term
What are the major diseases caused by bacteria, fungi?
Definition
meningitis, cerebritis & cerebral abscess
Term
In what will untreated cerebritis result?
Definition
tissue necrosis and walling of the necrotic area by reactive astrocytes and fibroblasts which form an ABSCESS
Term
What is a brain abscess?
Definition
a space occupying lesnion which can mimick a tumor
Term
What is cerebritis
Definition
bacteria invaded PARENCHYMA and reaction consists of infiltration by PMS, lymphocytes, and macrophages
Term
what usually accompanies cerebritis?
Definition
leptomeningitis
Term
What is leptomeningitis
Definition
invasion of SUB Arachnoiid space by bacteria--causing a reaction of infiltrations by polymorphonuclear leucocytes, lymphocytes, and macrophages
Term
What are glial nodules?
Definition
local collections of inflammatory and reactive cells such as microglia, astrocytes, and macrophages. Found in viral invasions
Term
What precipitates the formation of a glial nodule?
Definition
a viral invasion of the brain parachyma
Term
what type of encephalitis causes tissue tissue necrosis/abscess formation?
Definition
never virus--always bacteria
Term
when do nuclear inclusions form?
Definition
in viral encephalitis, never bacteria
Term
what is neurophagia
Definition
neurons infected by viruses that are phagocytoses by microglia
Term
what disease do we see neurophagia in?
Definition
polio
Term
Is phagocytosis of individual cells seen in cerebritis caused by a virus? a bacteria?
Definition
viral cerebritis only
Term
What is viral meningoencephalitis?
Definition
viruses that infect the subarachnoid space
Term
What is the major disease caued by viruses in the CNS?
Definition
meningoencephalitis
Term
What is one major feature that helps to explain the varied syndromes associated with viral attacks?
Definition
viruses often exhibit cellular TROPISMS
Term
What are 2 general ways HIV can cause CNS disease?
Definition
direct infection of neural tissues and by increasing the host's susceptibility to opportunistic infection
Term
Is spongiform encephalopathy "infectious?"
Definition
"Yes"
Term
what is the only direct route to the CNSS?
Definition
`Through the olfactory epithelium
Term
What is the most common route of infection?
Definition
hematogenous spread from other sites
Term
Where are the only lymphatics in the CNS? Why is this important?
Definition
The cNS has no lymphatic system, lymphatics are present in the spinal epidural space. These for a possible route for the production of spinal epidural abscesses from infection of the retropharyngeal or retroperitoneal spaces
Term
In regards to cell speficity, where do poliomyelitis and progressive multifocal leukoencephalopathy specify?
Definition
anterior horn neurons and oligodendrocytes respectively
Term
What produce CSF?
Definition
the choroid plexus
Term
where is it produced?
Definition
within the lateral, third and fourth ventricles
Term
how is CSF reabsorbed?
Definition
in the arachnoid villi along the superior sagitall sinus
Term
What are host factors for increasing the risk of CNS infection?
Definition
immunodeficiency, diabetes, infections, age, genetic factors
Term
What is meningitis?
Definition
invation of the parachyma by viruses causing selective cell death
Term
What is cerebritis
Definition
invation of parachyma by bacteria, fungi
Term
What is myelitis
Definition
inflammation of the spinal cord
Term
what is vetriculitis
Definition
inflammation of the ventricular system. Most often a result of extension of a meningitis, rupture of an absess, or intro of pathogens by iatrogenic means
Term
what are abscesses?
Definition
abscesses occur in the brain parenchyma as evolution of untreated cerebritis. may also occur in potential spaces such as the epidurla space.
Term
What are the most common causes of acute bacterial meningitis?
Definition
e.coli, h. influenzae, n. meningitides, and pneumococcus
Term
HOw do bacteria reach the brain in acute bacterial meningitis?
Definition
by hematogenous dissemination, following infection of neighboring stuctures
Term
What happens when bacteria invade in an acute bacterial meningitis?
Definition
pus accumulates, along with PMNs
Term
As an acute bacterial meningitis ages, what are the cellular difference?
Definition
PMNs become less abundant and are replaced with plasma cells, lymphocytes, and macrophages, injesting necrotic debris
Term
what is the most common complication of acute meningitis?
Definition
development of hydrocephalus--this is a result from the prolif of connective tissue in the subarachnoid space leading to fibrosis of the leptomeninges and obliteration of the subarachnoid space
Term
what are the most common causes of meningitis?
Definition
ECHO, coxsackie, herpies, mumps, EBV
Term
Are most viral infections self limiting?
Definition
yes
Term
what are the major histo features of viral encephalitis?
Definition
microglial nodules and perivascular lymphocytic infiltrates
Term
What are most common causes of chronic meningitis?
Definition
TB, fungi
Term
What are pathological changes of chronic meningitis?
Definition
subarachnoid space opacified due to an exudate (like in acute bacterial meningitis) but these change are greater around the base of the brain
Term
Since there is TB related chronic meningitis, are there granulomas?
Definition
yes
Term
what are the major complications of chronic meningitis?
Definition
hydrocephalus due to the ongoing inflammatory response, and cerebral infarction resulting from inflammation and subsequent obstruction of blood vessels.
Term
What is a tuberculoma?
Definition
a circumscribed intraparenchymal mass caused by a TB infection
Term
what is tabes dorsalis?
Definition
locomotor ataxia--degeneration of te spinal dorsal colums and roots. loose both axons and myelin in dorsal roots.
Term
what are the most common manifestation of Lyme disease?
Definition
meningitis and cranial neuropathies
Term
what are the direct effect of AIDS?
Definition
HIV directly infects macrophages and microglia
Term
what are major opportunistic viruses in HIV?
Definition
cytomegalovirus, cryptoneoformans
Term
What causes PML?
Definition
The JC virus
Term
What does the JC virus infect (what has been directly proven)?
Definition
oligodendrocytes
Term
What is a prion?
Definition
polypeptide with a similar confimation to native proteins but an alpha helix (normal) has been changed to a beta pleat (abnormal)--confirmational change. Abnormal causes diseases such as creutzfeldt-Jakob Disease (CJD) and Fatal insomnia.
Term
What diseases have prions been implicated in?
Definition
Diseases such as creutzfeldt-Jakob Disease (CJD) and Fatal insomnia.
Term
Are some CJD hereditary?
Definition
yes--10%
Term
Besides genes, what are 3 ways of getting CJD?
Definition
contaminated dural grafts, contaminated brain electrodes used for cortical recording, injections of extracts of growth horomone from human pituitary), and blood transfusion.
Term
What does the "protein only hypothesis" state?
Definition
the transmissibility of CJD works because the pathological prion protein serves as a template for the conversion of the normally soluable prion to a proteinase K resistant aggregate of insoluable prion protein which is toxic to the neurons.
Term
How do chloropromazine and mepacrine act to prevent prion pathogenisis?
Definition
They inhibit the invitro conversion of normal prion protein to pathological prion conformations
Term
Who gets most CNS fungal infections?
Definition
immunocomprimised pts.
Term
How are most fungal infections spread to the CNS?
Definition
via hematogenous spread
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