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Micro CNS Infection
KYCOM Block 11
236
Microbiology
Graduate
10/20/2013

Additional Microbiology Flashcards

 


 

Cards

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
HSV, rabies
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
anaerobes or aerobes
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
s. pneumo, neisseria
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
E. coli, listeria, GBS
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
GBS
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
how is a LP done
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
neisseria, listeria
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
1-3d
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
capsule
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
how is influenza treated
Definition
it isnt, get the vaccine
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
bacteremia
high mortality
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
[image]
Definition
gram negatie rod
E. coli
MacConkey agar
lactose fermentation
Term
[image]
Definition
gram negative diplococci
neisseria meningitidis
Term
[image]
Definition
gram negative rod
H. influenza
Term
[image]
Definition
listeria monocytogens
Term
[image]
Definition
peticheal maculopapular rash
caused by neisseria meningitidis
Term
[image]
Definition
strep pneumo
alpha hemolysis mucoid colonies
Term
[image]
Definition
strep pneumo
diplococci
anti phagocytic capsule
Term
[image]
Definition
subarachnoid with inflammatory cells
Term
[image]
Definition
neisseria meningitidis
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
N. meningitidis
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
define encephalitis
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
HSV-1
travels along CN5
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
zygomycetes: rhizopus
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
greek for lud violent
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
what does the fox say
Definition
rabies rabies rabies....
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
2-7d
encephalitis like
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
how is rabies treated
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
how is polio transmitted
Definition
fecal oral
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
what is guillan barre
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
CT
MRI
Term
how is a brain abscess treated
Definition
antimicrobials
drainage
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
anti-parisitic
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
tsetse fly
Term
what does T. bruci do after the tsetse fly bites you
Definition
enters blood then CNS
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
JC virus in compormised
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
what do prions do
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
PrP gene mutation
Term
what is the cause of fatal insonmia
Definition
PrP gene mutation
Term
how does c. tetani cause damage
Definition
tetanospasmin toxin
Term
how is C. tetani transmitted
Definition
spores in soil get into open wounds
Term
MOA tetaospasmin toxin
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
botulism toxin
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
C. botulinium tx
Definition
antitoxin
Term
how do dinoflagellates cause damage
Definition
ciguatera toxin
Term
dinoflagellate transmission (4)
Definition
snaller, groupr, sea bass, and barracuda hich eat dinoflagellates
Term
ciguatera toxin MOA
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
image:890158|center}
Definition
aseptate
Term
[image]
Definition
B. burdgorferi
Term
[image]
Definition
belladona
Term
[image]
Definition
lilly of the valley
Term
[image]
Definition
negri body
Term
[image]
Definition
negri body
Term
[image]
Definition
neurocysteriosis T. solium
Term
[image]
Definition
septate
Term
[image]
Definition
pokeweed blacknight shade
Term
[image]
Definition
T. brucei
Term
[image]
Definition
T. solium cysts
Term
[image]
Definition
T. solium
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