Term
| what are the layers of the head from the bone in |
|
Definition
periosteum
epidermal space: filled with fat (only in spinal cord)
dura mater
subdural space: only space in pathology
acrachnoid mater: connected to pia with CT
subsrachnoid space: CSF
pia mater: openings for vessels to get into the brain |
|
|
Term
| what are the three anatomical defenses of the CNS |
|
Definition
skill
blood-CSF barrier
BBB |
|
|
Term
| what are the 3 layers of the BBB, describe the composition of each |
|
Definition
vessels: tight endothelial cells
Brain: tight parenchyma via pericytes, astocyte end feet, and miroglia
BM: fibronectin, proteins |
|
|
Term
| what are the two types of junctions in the BBB, describe each |
|
Definition
adherin junctions: stablize cell-cell interactions in junctional zone
complex tight junctions: interaction of transmembrane proteins (non-polar so restricts polar) |
|
|
Term
| what are the intracellular and extracellular enzymes associated with the BBB (6) |
|
Definition
monoamine oxidase (MAO)
y-glutamyl transpeptidase (y-GT)
alkaline phosphatase
peptidase
nucleotidases
cytochrome P450 enzymes |
|
|
Term
| what are the six types of transport through the BBB |
|
Definition
receptor mediated transcytosis
absorptive transcytosis
influx carrier proteins
efflux transporters
transcellular lipophilic pathway
paracellular aquous pathway |
|
|
Term
| what 4 substances are transported through the BBB in receptor mediated transcytosis |
|
Definition
LDL
Leptin
insulin
transferrin |
|
|
Term
| what and how are things transported through absorptive transcytosis in the BBB |
|
Definition
| cationization increases uptake of plasma proteins (like albumin) |
|
|
Term
| what uses carrier proteins to get through BBB (5) |
|
Definition
glucose
AA
purines
nucleotides
choline |
|
|
Term
| what uses and how do efflux transporters of the BBB work |
|
Definition
| energy dependent transport of AZT (asidothymidine) |
|
|
Term
| what uses and how does the trancellular lipophilic pathway through the BBB work |
|
Definition
lipid soluble molecules cross lipid part of epithelium (despite non-polar complex tight junctions)
this is how CNS drugs enter |
|
|
Term
| what uses and how does the paracellular aqueous pathway through the BBB work |
|
Definition
| water soluble agents move between cells of BBB |
|
|
Term
| what cannot pass through the BBB (5) |
|
Definition
immune cells
antibodies
proteins
toxins
drugs |
|
|
Term
| what can pass through the BBB (7) |
|
Definition
oxygen
ions
glucose
ETCH
small lipid soluble molecules
mannitol |
|
|
Term
| what are the 10 ways to acquire bugs that can infect the CNS |
|
Definition
hematogenous
contagious infection
congenital defect
congenital infection across placenta
congenital infection in birth canal
trauma
neurosurgery
crawling up nerves
ingestion and dissemination
invasion |
|
|
Term
| define hematogenous entry, what places do bugs with hematogenous entry go to in the CNS (3) |
|
Definition
capillary to meninges
choroid plexus, dural venous sinus, rarley cribiform plate |
|
|
Term
| what are the two modes of hematogenous entry to the CNS, give 5 examples of bugs that can do it |
|
Definition
macrophage transport and arthropod vector
HIV, intracellular organisms like TB, listeria, salmonella, brucella |
|
|
Term
| what are 5 types of contagious infections that could lead to CNS contamination |
|
Definition
| sinusitis, otitis media, dental work, mastoiditis |
|
|
Term
| what are three congenital defects that could lead to CNS contamination |
|
Definition
CSF shunt
encephalocele (neural tube defect)
meningomyelocele: posterior neural tube defet |
|
|
Term
| give examples of microbes that infect across the placenta (4 viruses, 2 bacteria, 2 plasmodiums) |
|
Definition
viruses: HSV, rubella, CMV, HIV
bacteria: syphilis, listeria
protozoa: plasmodium, toxoplasmosis |
|
|
Term
| give 4 examples of mirobes that infect during birth in the canal |
|
Definition
| E. coli, GBS, listeria, HSV |
|
|
Term
| give 2 examples of microbes that crawl up nerves to the CNS |
|
Definition
|
|
Term
| give three examples of microbes that are ingested and disseminate into the CNS |
|
Definition
| T. solium, E. histolitica, echinococcus granluosus |
|
|
Term
| give 4 examples of microbes that direct invade the CNS |
|
Definition
| acanthemoba, magleria, balmuthia, systemic fungi |
|
|
Term
| name the 9 CNS infections and where they infect |
|
Definition
osteomyelitis: skull or vertebral bone
epidural abscess: epidural space
intramedullary abscess: medullary column of spinal cord
myelitis: infection of spinal cord
ventriculitis: ventrical infection
abscess: brain tissue infection
epidural abscess: dural or skill
encephalitis: brain tissue infection
subdural and dural empyema: surdural
or dural space infection
meningitis: meninges infection |
|
|
Term
| what usually causes a brain abscess |
|
Definition
|
|
Term
| what is the reason epidural abscesses usually happen |
|
Definition
| extension of local infection (like vertebral osteomyelitis) |
|
|
Term
| what is encephalitis, what are 2 symptoms |
|
Definition
brain tissue infection of the parenchyma
seizures, obtundation |
|
|
Term
| what is a subdural or dural emphyema, why does it normally happen (4) |
|
Definition
infection of subdural space
complication of meningitis in kids, complication of sinus infection, otitis media, mastoiditis in older kids and adults |
|
|
Term
| what is a subdural effusion |
|
Definition
| sterile collection of fluid due to increased efflux or intravascular fluids from increased capillary wall |
|
|
Term
| what are the common causes of meningitis in adults and teens (2) |
|
Definition
|
|
Term
| what are the 4 common causes of meningitis in the elderly |
|
Definition
| S. pneumo, enterics, listeria, neisseria |
|
|
Term
| what are the signs of meningitis in an adult (11) |
|
Definition
headache, fever, coma, shock
confusion, dissorientation, seizure, neck stiffness
vomiting
photophobia
petechiae |
|
|
Term
| why is there vomiting in meningitis (3) |
|
Definition
| brain stem irritation, increased IOP, inflammation |
|
|
Term
| what is the ddx for meningitis in the elderly, why |
|
Definition
bladder infection - also causes confusion and disorientation
arthritis - causes stiff neck |
|
|
Term
| what are the 3 causes of meningitis in premes |
|
Definition
|
|
Term
| what are the 4 causes of meningitis at 1 mo |
|
Definition
| GBS, E. coli, listeria, K. pneumo |
|
|
Term
| what are the 5 causes of meningitis at 1 yo |
|
Definition
| GBS, E. coli, listeria, S. pneumo, neisseria |
|
|
Term
| what are the 8 signs of meningitis in kids |
|
Definition
lethargy
insomnia
poor feeding
diarrhea
afebrile
cyanosis
progressive (1-2 weeks)
high mortality |
|
|
Term
| what are the common causes of acute meningitis |
|
Definition
| virus, S. pneumo, neissiera, influenza (kids) |
|
|
Term
| what are the common causes of chronic meningitis (2) |
|
Definition
TB, fungi, virus, tubercle bacilli, syphilis
others: B. burgdorferi, leptospira, coccidioides immitis (fungi), lymphoma, metastasis
drugs: cyclosporine, NSAID |
|
|
Term
| why is chronic meningitis chronic |
|
Definition
| causes are fungi, intracellular bacteria, mycobacteria, and viruses which are slower in disease progression |
|
|
Term
| why is acute meningitis acute |
|
Definition
| the causes are bacteria and protozoans which have virulence factors (like cell walls), toxins, and cytokines allowing them to cause immediate infection |
|
|
Term
| what are some clues that someone has acute meningitis rather than chronic (5) |
|
Definition
progressed quickly
lots of inflammatory markers
fever
irritability
purlent exudate |
|
|
Term
| define aseptic meningitis, what is normally the cause, how is it determined |
|
Definition
no organism isolated
usually caused by a virus
usually have to determine with PCR or serology |
|
|
Term
| what are some of the common viruses that cause aseptic meningitis (4) |
|
Definition
enteroviruses: eosackie, ECHO
Mumps
LCM |
|
|
Term
| what is a clue an aseptic meningitis is caused by an enterovirus |
|
Definition
| seen in late summer through fecal-oral route |
|
|
Term
| what are 4 clues someone has aspetic meningitis rather than acute or chronic |
|
Definition
mild
self limiting
low mortality
increased lymphocytes |
|
|
Term
| what are the 4 causes of nosocomal meningitis or meningitis due to trauma |
|
Definition
| S. pneumo, S. aureus, enterobacteriaceae, P. aerguinosa |
|
|
Term
| what is the most common cause of meningitis in a patient with diabetes |
|
Definition
|
|
Term
| what is the most common cause of meningitis in someone who is immune compormized (3) |
|
Definition
cryptococcus neoformans (transferred from pidgeons or other birds)
cryptococcus gatti |
|
|
Term
| if the meningitis came from a respiratory infection, what are the 3 most likley causes |
|
Definition
| S. pneumo, neisseria, influenza |
|
|
Term
| if the meningitis came from a GI infection what are the 3 most likley causes |
|
Definition
| E. coli, strep agalactia, listeria |
|
|
Term
| what are the three physical exam test do to on a suspected meningitis patient |
|
Definition
neuro exam: sound, pain, and light responses
brudzinski's sign: resistance to bending neck forward
kernig sign: resist straightening bent knee |
|
|
Term
| what are the three contraindications to a LP |
|
Definition
| tumor, impending herniation, brainstem changes |
|
|
Term
|
Definition
CT first (to check for contraindications)
insert needle between L3 and L4
take 3-4 tubes
priority specimine to the lab |
|
|
Term
| where are the three LP tubes sent |
|
Definition
| chemistry, microbiology, hematology |
|
|
Term
| what are the 4 things checked for in a chemistry LP tube, what are the normal values |
|
Definition
glucose: 2/3 BG, 40-70 in adult, 60-80 in kid
protein: 15-45
lactic acid
LDH: isoenzyme 3 is viral |
|
|
Term
| what are the 4 tests done on a micro LP tube |
|
Definition
staining
capsule serology
culture
PCR |
|
|
Term
| what are the 6 stains done on a micro LP tube sample |
|
Definition
acridine orange
gram stain
AFB
fungal stain
lactophenol cottom blue (fungi)
india ink (cryptococcus) |
|
|
Term
| what are the capsules you should check for in the capsule serology of a micro LP tube sample (10) |
|
Definition
S. pneumo
HIV
GBS
neisseria
A, B, C, Y
W135
E. coli K-1 |
|
|
Term
| what three tests are done on a hematology LP tube |
|
Definition
cell count (normal: 0-5 wbc/dl)
cell differential
color |
|
|
Term
| what does red LP sample mean (3) |
|
Definition
| hemorrhage, bad tap, tumor |
|
|
Term
| what does yellow LP sample mean (3) |
|
Definition
| xanthoma, hemorrhage, bilirubin |
|
|
Term
| what are 4 finginds in a LP sample that suggest sepsis |
|
Definition
PMN increase
glucose decrease
protein leak out and increase
lactic acid increase (anaerobic bacteria) |
|
|
Term
| what are 5 signs of a bacterial infection in a LP |
|
Definition
increased pressure, WBC, PMN, protein
decreased glucose |
|
|
Term
| what are 3 signs of a viral infection in a LP |
|
Definition
normal pressure
increased lymphocytes
normal glucose |
|
|
Term
| what are 3 sgns of a fungal infection in a LP |
|
Definition
increased lymphocytes
increased protein
low glycose |
|
|
Term
| what are 3 signs of a TB infection in a LP |
|
Definition
increased lymphocytes
increased protein
low glucose |
|
|
Term
| explain how and why someone would become infected with meningococci (include 5 virulence factors in this story) |
|
Definition
| viral URI stops cilia so meningococci can stick to the respiratory epitheloum wia fimbrae, pili, polysaccharide capsule, biofilms, and with the help of IgA protease |
|
|
Term
| explain how meningococci get from colonizing on the respiratory epithelium to the CNS |
|
Definition
1. migrate through the epithelium to the blood
2. cause leaky capillaries, transport on macrophages, or move through endothelial cells to get into the blood
3. evade the immune system in the blood
4. enter CSF through transcytosis or through endothelial cells |
|
|
Term
| what are two microbes that just go through endothelial cells to get into the blood, not needing to cause leaky capillaries or use macrophages |
|
Definition
|
|
Term
| unlike other CNS infecters, listeria does not use transcytosis through endothelial cells to get into the CSF, what does it do |
|
Definition
| uses listeriolysin O to get into the cytoplasm and move on actin |
|
|
Term
| what are 2 ways potential CNS infectors evade the immune system when they are traveling in the blood |
|
Definition
capsules inhibit opsonization by C3b and immunoglobulins (alternative and classic complement pathways)
evade filtration by spleen and macrophages |
|
|
Term
| what are 4 microbes that have a capsule and can evade opsonization as they travel in the blood to the CNS to infect |
|
Definition
| S. pneumo, influenza, neisseria, E. coli |
|
|
Term
| once the meningitis microbe gets into the aubarachnoid space and begins to multiply, what are the three main complications its presence causes |
|
Definition
immune activation
cotytoxic edema
vasogenic edema |
|
|
Term
| what are the 4 immune responses meningitis causes |
|
Definition
inflammation
leukocytosis
complements (C5a, C3a, IL-8)
macrophage inhibitory proteins (MIP) |
|
|
Term
| how does meningitis cause cytotoxic edema |
|
Definition
water flows through BBB causing edema in the brain, increased pressure from water compresses vessels and causes ischemia
ischemia decreases ATP causing Na to accumulate and thus water inside the cells causing swelling and Ca to accumulate activating phospholupases and releases arachidonic acid leading to ROS and infarction |
|
|
Term
| how does meningitis cause vasogenic edema |
|
Definition
endothelium increases in permeability and lets plasma proteins and water (not through AQP4) into ECF
increased fluid displaces the brain and causes herniation
usually follows or is a result of cytotoxic edema |
|
|
Term
| what microbes usually cause sepsis with meningitis (7) |
|
Definition
pyogenic encapsulated bacteria: S. pneumo, neisseria, infleunza, monocytogenes (kids and old ppl)
nosocoma: enterobacteriaceae, S. aureus, S. pneumonia |
|
|
Term
| when microbes infect the CNS they cause and inflammatory response, what is activated (10) |
|
Definition
PMN
lymphocytes
astroccytes
microgili
cytokines: IL-1, 6, 8, TNF-a
NO
prostaglandins |
|
|
Term
| what does the immune response elicted by meningitis cause to happen in the brain tissue(6) |
|
Definition
necrosis
thrombi
bleeding
edema
increased IOP
herniation |
|
|
Term
| how does the antibiotic treatment for meningitis effect the CNS |
|
Definition
antibiotic enters CSF and causes rupture of bacterium
bacterial fragments stimulate even greater cytokine response
increasing neutrophils, vessel leakage, and edema |
|
|
Term
| what are the two cryptococci that attack CNS, what type of patient |
|
Definition
immune compormised or HIV pt
C. neoformans: comes from pidgeons and birds
C. gatti |
|
|
Term
| neisseria meningitidis: shape, stain type, 3 adherence mechanisms, 5 virulence factors |
|
Definition
gram negative diplococci kidney shape
adhere with pilli, opa, opc
defent with IgA protease, porin protein (inhibits degranulation), capsule, endotoxins on LOS, bind to epithelium |
|
|
Term
| how is n. meningitidis transmitted / how is transmission helped out (5) |
|
Definition
aerosol
enhanced by URI, stress crowding, confinment
increase susceptability with complement defect |
|
|
Term
| what is the incubation time of n. minigitidis |
|
Definition
|
|
Term
| what are the main symptoms of n. meningitis (5) |
|
Definition
| headache, fever, disorientation, petechial rash (maculopapular), nucal rigidity |
|
|
Term
| besides the 5 main symptoms of n. meningitidis, what are the other 10 other symptoms |
|
Definition
vascular collapse
shock
pulmonary insufficiency
waterhouse friderichsen
deafness
blindness
speech loss
mental changes
gangrene
90% mortality in untreated and 10% in treated |
|
|
Term
| what is waterhouse friderichsen |
|
Definition
| invasion of DIC, hemorrhage, and adrenal collapse and damage |
|
|
Term
| what microbes often cause waterhouse friderichen in meningitis (11) |
|
Definition
S. pneumo
GAS
n. meningitidis
n. gonorrhea
E. coli
klebsiella
influenza B
salmonella
pasturella
acinetobacter
plesiomonas shifelloides |
|
|
Term
| H. influenza: shape, stain type, 5 virulence factors |
|
Definition
gram negative rod
encapsulated, polyribotol phosphate, pili, IgA protease, LPS |
|
|
Term
| how is H. influenza spread (3) |
|
Definition
URI
epiglottitis
translocation to blood |
|
|
Term
| how does H. influenza invade the immune system in the blood |
|
Definition
|
|
Term
| what are the conditions only type B influenza causes (3) |
|
Definition
| meningitis, epiglottis, bacteremia |
|
|
Term
| what are the conditions all types of influenza cause (4) |
|
Definition
| otitis media, sinusitis, tracheobronchitis, pneumonia |
|
|
Term
|
Definition
|
|
Term
| Strep pneumonia: shape, stain type, 5 virulence factors |
|
Definition
gram positive diplococci
encapsulated, pneumolysin, teichoic acid, peptidoglycan, phosphotidal choline |
|
|
Term
| what microbe has phosphotidal choline, what does it do |
|
Definition
strep pneumo
translocation assistance |
|
|
Term
| what microbe has pneumolysin, teichoic acid, and peptidoglycan? what do they do |
|
Definition
strep pneumo
damage cilia, kill inflammatory cells, enhance evasion, recruit inflammatory cytokines |
|
|
Term
| how is S. pneumo spread, who is it more likley to infect (5) |
|
Definition
routes from URI or LRTI (nosocomial pneumonia)
asplenic, sickle cell, HIV, amaglobulinemia, and elderly patients |
|
|
Term
| what are the signs of s. pneumo meningitis (2) |
|
Definition
|
|
Term
| how is s. pneumo meningitis treated |
|
Definition
| it isn't, get multivalent vaccine |
|
|
Term
| listeria monocytogenes: shape, stain type, 3 virulence factors |
|
Definition
gram positive coccobacilli
intracellular resistants
escape from M cell phagosome via lysis into cytoplasm
flagella |
|
|
Term
| how is listeria monocytogens transmitted, who does it infect most (3) |
|
Definition
contaminated food (unpasturized milk, lunch meat, fruits and veggies)
infants, elderly, immune compormised |
|
|
Term
| how do we defent against listeria monocytogens, where does it like to go in the body |
|
Definition
liver and spleen then to blood
CMI |
|
|
Term
| e. coli: shape, staining, how to identify it, 2 virulence factors |
|
Definition
gram negative rod
lactose fermentor on MacConkey agar
virulence: K1 capsule, type 1 fimbrae (in uropathogenic e. coli) allowing deep tissue invasion |
|
|
Term
| how is E. coli transmitted most often, to who |
|
Definition
| contamination from colon to birth canal in premes and neonates |
|
|
Term
| what are our defenses against E. coli |
|
Definition
| PMN do immature migration, diapedesis, degranulation, and killing |
|
|
Term
|
Definition
gram negatie rod
E. coli
MacConkey agar
lactose fermentation |
|
|
Term
|
Definition
gram negative diplococci
neisseria meningitidis |
|
|
Term
|
Definition
gram negative rod
H. influenza |
|
|
Term
|
Definition
|
|
Term
|
Definition
peticheal maculopapular rash
caused by neisseria meningitidis |
|
|
Term
|
Definition
strep pneumo
alpha hemolysis mucoid colonies |
|
|
Term
|
Definition
strep pneumo
diplococci
anti phagocytic capsule |
|
|
Term
|
Definition
| subarachnoid with inflammatory cells |
|
|
Term
|
Definition
|
|
Term
| what are 4 cultures done on a LP sample |
|
Definition
optochin test
bile salt susceptability
quellung reaction
india ink |
|
|
Term
| optochin test: how is it done, what does it test for, how can you tell, what test does it combine with |
|
Definition
similar to antibiotic susceptibility disc effusion
standard for identifying strep pneumo
other strep are resistant and will grow right up to the disc
after do cAMP test to determine GBS presence |
|
|
Term
| what does the bilt salt susceptability test test for, how |
|
Definition
| strep pneumo lyses quickly |
|
|
Term
| how is the quellung reaction done, what does it detect for |
|
Definition
| mix anti serum with microbe causes capsules to swell |
|
|
Term
| what does india ink test for, how can you tell |
|
Definition
| cryptococcus. capsule cannot be penetrated so there is halo effect |
|
|
Term
| what blood tests would you do on a suspected meningitis patient (4) |
|
Definition
CBC
blood culture
UA- antigen detection
serology |
|
|
Term
| why is it difficult to make vaccine for microbes with a capsule |
|
Definition
| T independent antigen. need more than polysaccharide to make vaccine because they are conjugated to a protein that needs T dependent response |
|
|
Term
| what illnesses does Cryptococcus begin with usually before meningitis |
|
Definition
| respiratory infection causes acute meningitis |
|
|
Term
| what is a LOS, what microbe has it, what does it do |
|
Definition
N. meningitidis has one
lipid oligosaccharide layer: same as LPS but with less carbs. has same endotoxin effects as LPS damaging capillaries and causing emboli |
|
|
Term
| what are the polysaccharide capsule serotypes for N. meningitidis, which are covered by vaccine |
|
Definition
A, C, Y, W-136 (conjugate vaccune types)
8 (no vaccine but common in bug) |
|
|
Term
| what is the most common meningitis causing bug that causes maculopapular petechial rash |
|
Definition
|
|
Term
| what microbes other than E. coli can show up on macConkey agar, why do they turn color |
|
Definition
klebsiella and enterobacteri
lactose fermentation changes pH and turns on indicator |
|
|
Term
|
Definition
| inflammation of the cerebral cortex |
|
|
Term
| what is the most common cause of encephalitis in the US and how does it get into the CNS |
|
Definition
|
|
Term
| what are the rhabdoviruses that cause encephalitis (3) |
|
Definition
lyssa
rabies - sanskirt rhabas
polio - myelitis |
|
|
Term
| what are the bacteria that cause encephalitis (3) |
|
Definition
borrelia burdgorferi - lyme
treponema pallidum - syphilis
leptospiral interrogans |
|
|
Term
| what are the ameoba that cause encephalitis (3) |
|
Definition
freshwater ameoba
ancathamoeba/balmuthia - granulomatous encephalitis
nagleria fowleri |
|
|
Term
| what are the parasites that cause encephalitis (6) |
|
Definition
toxoplasmosis gondii
taenia - flat worms (cysticerosis)
malaria - p. falciprum
tryanosomiasis- African SS (T. brucei)
echinoccus granulosus
toxacara canis/cati |
|
|
Term
| what are the non-rhabdoviruses that cause encephalitis (12) |
|
Definition
HSV1, HSV2, VZV, CMV, HIB
enterovirus: ECHO, pareco, cosackie
arboviruses: west nile, california, EEE, WEE, St. louis |
|
|
Term
| what are the causes of brain abscess |
|
Definition
trauma or surgery
infected emboli
osteomyelitis from neighboring area (otitis, mastoiditis)
bacteria - aerobe and anaerobe
fungal opportunists |
|
|
Term
| what fungal opportunist likes to cause brain abscess |
|
Definition
|
|
Term
| what are the two types of zygomycetes: rhizopus, describe them |
|
Definition
septate: spores made in little colored sacs
aseptate: one large sac with spores |
|
|
Term
| what are some general signs of encephalitis (4), which distinguish it from meningitis (3) |
|
Definition
headahce, neck pain, nausea, vomiting
impaired conciousness, ABNORMAL BEHAVIOR, seizures (LESS than meningitis) |
|
|
Term
| when you suspect encephalitis, what labs should you do |
|
Definition
LP: lymphocytes, glucose, protein
serology: acute and convalescent sera |
|
|
Term
| in general, what is the prognosis of encephalitis |
|
Definition
good with supportive treatment
self limiting |
|
|
Term
| what is another name for lyssa virus |
|
Definition
|
|
Term
| lyssa virus: shape, genome type, how to identify |
|
Definition
bullet shape
-RNA
may look like inclusions on EM |
|
|
Term
| what are two other names for rabies |
|
Definition
sanskirt rhabas
to do violence |
|
|
Term
what are 7 things that carry rabies
which is the most common in us and in world |
|
Definition
Bats in US
dogs in world
cats, racoons, skunks, foxes, coyotes, cattle |
|
|
Term
|
Definition
|
|
Term
| how is rabies transmitted(3) |
|
Definition
| saliva, inhalation, organ transplant (not a common screen and indetectably clinically in early stages) |
|
|
Term
| how does rabies cause damage |
|
Definition
| binds to ACh in muscle ganglioside |
|
|
Term
| what does rabies do while it is incubating, how long can this occur |
|
Definition
weeks to years
travels from site to dorsal root ganglion on nerve |
|
|
Term
| how long does it take for rabies to reach the brain, what parts does it go to first, what is this stage called when it arrives |
|
Definition
prodromal: 2-10 days
cerebellum, purkinje, hippocampus
then back to the peripherial nerves |
|
|
Term
| what symptoms arrive in the prodromal stage of rabies, why |
|
Definition
| because at the end the virus travels back down the neaves (face first) and causes inability to swallow and spasms |
|
|
Term
| how long does it take for neurological symptoms of rabies to appear, what type of condition does it cause |
|
Definition
|
|
Term
| what are 7 neurological symptoms of rabies |
|
Definition
seizure
confusion
headache
fever
hyperactivity
paralysis
degeneration of neurons |
|
|
Term
| how do you know when someone with rabies is infectious, what stage is this, how do they spread it |
|
Definition
neurological stage symptoms
saliva and eyes are carrying virus |
|
|
Term
| why does someone with rabies usually die, how long does it take |
|
Definition
0-14d
cardiac failure, hypotension, secondary infection |
|
|
Term
| why does rabies move faster symptom wise in the prodromal phase than in incubation, what is the exception to this |
|
Definition
it can crawl faster on those nerves (200-400 mm/d vs 12-24 mm/d in periphery)
if bitten on face it can get to CNS faster because it is closer |
|
|
Term
| what labs should you do on someone with suspected rabies |
|
Definition
saliva, serum, LP, brain, and skip biopsy testing
PCR for RNA |
|
|
Term
| why can you do a skin test for rabies and where |
|
Definition
| cutaneous nerves at base of follicles in cervical region may contain a few viruses |
|
|
Term
| what are two diagnostic signs for rabies |
|
Definition
negri bodies in purkinje cells on autopsy
little antibody (hidden in nerves) |
|
|
Term
|
Definition
wash wound to reduce viral load
passive immunization: hyper immune gamma globulin IM around wound
killed diploid cell vaccine (5 doses over 28 d) |
|
|
Term
| why do we give someone the vaccine ..after.. they have rabies?? |
|
Definition
| we cannot wait for active immune response. antibodies and CMI will be too slow |
|
|
Term
|
Definition
|
|
Term
| what are three general conditions polio causes |
|
Definition
initial GI infection
meningitis/encephalitis causes neuro signs
guillain barre |
|
|
Term
| what are the three ways polio presents neurologically |
|
Definition
paralytic polio: leg paralysis
bilbar polio: respiratory muscle paralysis
post polio: recourrance of paralysis years later due to slow deterioration of the nerves |
|
|
Term
|
Definition
| autoimmune damage to myelin sheath following infection |
|
|
Term
| what are the two types of polio vaccines and what are they made of |
|
Definition
salk: killed vaccine
sabin: live attenuated vaccine |
|
|
Term
| why would you use the sabin polio vaccine, why not |
|
Definition
better antibody response
could revert to wild type, mild GI infection |
|
|
Term
| explain the clinical presentation of B. burdgorferi |
|
Definition
1. erythema margins
2. dissemination to heart and brain (meningitis, neuritis)
3. autoimmune arthritis |
|
|
Term
| leptospira interrogans transmission |
|
Definition
| animal urine gets into skin break |
|
|
Term
| leptospira interrogans pathogenesis |
|
Definition
| toxicemia due to dying of bug and presence of endotoxin similar to more severe forms of endotoxicemia but shorter and less severe |
|
|
Term
| what are the initial symptoms of leptospira interrogans |
|
Definition
flu like
abdominal pain
jaundice |
|
|
Term
| what are the severe stage symptoms of leptospira interrogans |
|
Definition
meningitis
wheil's disease |
|
|
Term
| what is wheil's disease, what causes it |
|
Definition
| renal and liver failure caused in severe leptospira ictero infection |
|
|
Term
| where is granulomatous encephalitis found, where does it infect, prognosis |
|
Definition
well water
can cause eye infection that have potential for encephalitis
slow development, often fatal |
|
|
Term
| what infection does nagleria fowleri mimic, what is the prognosis |
|
Definition
bacterial like meningitis
rapid progression, fatal in 1-2wks |
|
|
Term
| how is a brain abscess detected |
|
Definition
|
|
Term
| how is a brain abscess treated |
|
Definition
|
|
Term
| who does toxoplasmosis infect (3) |
|
Definition
congenital
immune compormised
old people |
|
|
Term
| how is toxoplasmosis transmitted (3) |
|
Definition
inhalation/ingestion of oocyte (reproductive form)
ingestion of bradyzoite (cyst in food)
congenital transmission of trachyzyoites |
|
|
Term
| what are 3 signs of non congenital toxoplasmosis |
|
Definition
eye isgns
calcified ring lesions on MRI
hydrocephalus |
|
|
Term
| what are 3 sigs of congenital toxoplasmosis |
|
Definition
blindness
deafness
retardation |
|
|
Term
| how is toxoplasmosis detected |
|
Definition
IgG/IgM
IgM can be used for identification because few people have it |
|
|
Term
| how is toxoplasmosis treated |
|
Definition
|
|
Term
| explain the two different ways T. solium can infect people |
|
Definition
consuming encysted larvae in undercooked meat and they mature in intestines
ingest egg and larvae migrate to tissue and encyst (neurocysteriosis can be fatal) |
|
|
Term
| what brain conditions can T. solium cause and why |
|
Definition
encephalitis: because of the neurocysteriosis
abscess: the body cannot get rid of cyst so it walls it off with a lesion |
|
|
Term
| what symptoms does T. solium cause (6) |
|
Definition
| diarrhea, abdominal pain, weight loss, eosinophilia, neurocysteriosis, abscess |
|
|
Term
| how is malaria falciprum transmitted |
|
Definition
| female anopheles mosquito |
|
|
Term
| how does falciprum cause problems |
|
Definition
| RBC membrane becomes sticky and adheres to capillary walls |
|
|
Term
| what are the two types of african sleeping sickness, their locations, and duration, their carriers |
|
Definition
trypanosome brucei gambinese: west africa. slow infection (mo - y). cow and human
trypanosome brucirhiodesiense: east africa, rapid progression (wk-mo). sheep lion, cattle |
|
|
Term
| what transfers african sleeping sickness between carriers |
|
Definition
|
|
Term
| what does T. bruci do after the tsetse fly bites you |
|
Definition
|
|
Term
| what are the 4 phases of african sleeping sickness and their signs |
|
Definition
initial: cancher at bite site
haemolymphatic: fever, rash, headache
winterbottom sign: large cervical nodes
neurological phase: lethargy, confusion, convlusions, impaired speech |
|
|
Term
| what is the tx and prevention for T. bruci |
|
Definition
perscription anti worm
vector control
no vaccine |
|
|
Term
| toxacara canis/cati aka, once in body what does it do |
|
Definition
ingest egg, larvae migrate to brain and other organs
dog/cat round worm |
|
|
Term
| echinoccus granulosus: carriers, tranamission, what they do in body |
|
Definition
sheep and dog
humans ingest egg and larvae migrate and form haydatid cyst which causes pressure and anaphylaxis |
|
|
Term
| what three viral diseases cause slow neurological degeneration |
|
Definition
subacute sclerosing panecephalitis (SSPE)
progressive multifocal leuco encephalopathy
congenital rubella |
|
|
Term
| what causes subacute sclerosing panencephelitis |
|
Definition
| measles cause damage to myelin and cause encephalitis |
|
|
Term
| what causes progressive multifocal leuco-encephalptathy, in who |
|
Definition
|
|
Term
| what is a prion, what are some chemical characteristics |
|
Definition
PrPc is turned into PrPsc by PrPsc in cytoplasm (not cell surface)
B pleated sheet (not alpha)
globular
disease causing fibrils
protease resistant |
|
|
Term
|
Definition
| cause plaque in the brain |
|
|
Term
| what are the 3 types of creutzfeldt jakob disease, what causes each |
|
Definition
familail: autosomal dominant mutation in PrP gene (long latency)
sporadic
V-CJD: acquired from eating cow with BSE (short laltency) |
|
|
Term
| what is the cause of gerstmann straussler disease |
|
Definition
|
|
Term
| what is the cause of fatal insonmia |
|
Definition
|
|
Term
| how does c. tetani cause damage |
|
Definition
|
|
Term
| how is C. tetani transmitted |
|
Definition
| spores in soil get into open wounds |
|
|
Term
|
Definition
| blocks release of inhibitor neurotransmitters (GABA, glycine) |
|
|
Term
| wat are 5 signs of toxoplasmin toxin |
|
Definition
muscle rigidity
spasm
lock jaw
autonomic dysfunction |
|
|
Term
| how is C. tetani prevented and treated |
|
Definition
active and passibe immunity
no tx |
|
|
Term
| how does C. botulinium cause damage |
|
Definition
|
|
Term
| how is C. botulinium transmitted |
|
Definition
| food, heroin, injections, soil, inhalation (terrorism) |
|
|
Term
| what are 4 signs of botulism toxin |
|
Definition
vision issues
speech issues
restlessness
paralsis
difficulty swallowing |
|
|
Term
|
Definition
|
|
Term
| how do dinoflagellates cause damage |
|
Definition
|
|
Term
| dinoflagellate transmission (4) |
|
Definition
| snaller, groupr, sea bass, and barracuda hich eat dinoflagellates |
|
|
Term
|
Definition
| interfers with Na movement |
|
|
Term
| 7 signs of ciguatera toxicity |
|
Definition
numbness around mouth, lips, arms, legs
nausea
vomiting
muscle pain
muscle weakness
headache
dizzy
tachycardia |
|
|
Term
| what does PANDAS stand for |
|
Definition
| pediatric atoimmune neurophsychiatric disease associated with streptococci |
|
|
Term
| what is the cause of PANDAS |
|
Definition
| post strep caused cross reactivity to brain tissue (rheumatic hypersensitivity) |
|
|
Term
| what are 7 signs of PANDAS |
|
Definition
emotional
OCD
depression
agression
disruptive behavior
attention defcit
tourettes |
|
|
Term
| what are 6 mushrooms that cause CNS symptoms |
|
Definition
aminita
fly agatic
brain mushroom
false moreles
death cap
destorying angel |
|
|
Term
| what are 6 wild berries that cause CNS symproms, describe some |
|
Definition
poke weed /black night shade: leafted green shrub with purple berries on pink stems
bittersweet: clusters of red orange betties
lilley of the valley
daphine
belladonna |
|
|
Term
| what are 9 house plants that cause CNS symptoms |
|
Definition
milstone
philodendron
pothos
bulbs: tulips, narcissus, iris
diffenbachia
poinsettia
easter lilly |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| neurocysteriosis T. solium |
|
|
Term
|
Definition
|
|
Term
|
Definition
| pokeweed blacknight shade |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
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