| How dose a normal CSF and a CSF in meningitis look like | normal - clear, colourless
meningitis - milky, containing bacteria and neutrophils |
| How dose a normal CSF and a CSF in meningitis look like | normal - clear, colourless
meningitis - milky, containing bacteria and neutrophils |
| How dose a normal CSF and a CSF in meningitis look like | normal - clear, colourless
meningitis - milky, containing bacteria and neutrophils |
| How dose a normal CSF and a CSF in meningitis look like | normal - clear, colourless
meningitis - milky, containing bacteria and neutrophils |
| List bacteria that can cross blood-brain barrier transcellularily | staphylococcus pneumoniae
haemophilus influenzae
neisseria meningitidis
escherichia coli K1 |
| Which bacteria can cross blodd-brain barrier paracelullarily | spiral bacteria
some viruses |
| Which bacteria use the trojan horse mechanism within white blood cells.... | Mycobacterium tubuerculosis
Listeria monocytogenes
Epstein Barr virus
Cytomegalovirus |
| List spieces that cause bacterial meningitis in neonates | Escherichia coli
Group B streptococcus (Staphylococcus agalactiae)
Listeria monocytogenes |
| List spiecies that cause bacterial meningitis in children older than 5yr | Neisseria meningitidis
Haemophilus influenzae |
| List spieces that cause bacterial meningitis in young adults 15-35 years | Viruses
Neisseria meningitidis
Streptococcus pneumoniae |
| List the spiecies that cause bacterial meningitis in older people | Streptococcus pneumoniae
Listeria monocytogenes
gram negative bacteria
Neisseria meningitidis
Haemophilus influenzae |
| List spieces that cause bacterial meningitis in immunosuppressed people | Mycobacterium tuberculosis
Cryptococcus (fungi) |
| What is a prion and why is it important in brain infections | prion - misfolded proteins with the ability to transmit their misfolded shape onto normal variants of the same protein.
They characterize several fatal and transmissible neurodegenerative diseases. |
| What encephalopathys are caused by prions | Creutzfeldt-Jakob disease
variant Creutzfeldt-Jakob disease
Kuru |
| What is the cause of Poliomyelitis | poliovirus |
| What are the CSF findings in bacterial meningitis | low glucose
raised protein
polymorphs raised |
| What is septicaemia | Septicaemia is when bacteria enter the bloodstream, and cause blood poisoning which triggers sepsis. |
| Which spiecies can cause viral meningitis | enterovirus
mumps
herpes simplex
arboviruses |
| What are the CSF findings in viral meningitis | glucose normal
protein raised
lyphocytosis raised |
| Which spiecies cause viral encephalitis | herpes simplex
arboviruses
mumps
measles |
| Which spieces cause brain abscesses | anaerobic streptococcus
bacteroides
staphylococci
gram negatives |
| How to store CSF collected from lumbar puncture | - delivery to th elab ASAP
- temp. not lower than 30C
- never refrigerate
- if inoculated in media, then 37C
- if incubation then 37C 5-10 porcent of CO2 24h |
| What can we do with the pellet and the supernatant after centrifugation of CSF | pellet
-gram staining
-methylene blue staining
-Ziehl Neelsen staining
supernatant
-latex test
-PCR |
| List constitiuents of CSF, group them in those that are lower and higher than in blood plasma | LOWER
-proteins
-glucose
-phosphorous
-bicarbonate
-potassium
-sulfate
-cholesterol
-enzymes
HIGHER
-sodium
-cholride |
| Which white blood cells can we find in CSF | lymphocytes
monocytes |
| Major protein in CSF is... | albumin |
| Major Ig in CSF is... | IgG |
| Helathy CSF do not contain.... | erythrocytes |
| What is meningism | group of symptoms and signs that accompany meningitis |
| How dose a normal CSF and a CSF in meningitis look like | normal - clear, colourless
meningitis - milky, containing bacteria and neutrophils |
| List spiecies that cause meningitis in infants and children up to 2 years | group B streptococcus (streptococcus agalactiae)
neisseria meningitidis
haemophilus influenzae |
| List spieces that cause meningitis in children from 2-15 years | viruses - coxackie A, coxackie B, Echo, Herpes, mumps virus
haemophilus influenzae
neisseria meningitidis
streptococcus pneumoniae |
| List spiecies that cause meningitidis in adults older than 35 years | Streptococcus pneumoniae
Neisseria meningitidis |
| What kind of diagnostics can you performe to diagnose meningitis | - CSF compositioin and colour
- micrsocopy
- culture
- blood culture
- nasopharyngeal swab
- aspirate of purpuric spot from the skin
- serology
- PCR (blood and CSF) |
| What is meningococcal rash a sign of... | meningitis |
| How may you accuire meningitis... | adult (neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae) - inhalation of respiratory droplets
babies (Streptococcus agalactiae) - during passage through infected birth canal |
| In most cases bacteria spread to the meninges from... | lungs
sinusitis
otitis media
bacteremia |
| What is bacteria protected with capsule doing in CSF? | metabolize glucose |
| What is the leading cause of bacterial meningitis in newborns? | Streptococcus agalagtiae |
| What is the leading cause of bacterial meningitis? | Streptococcus pneumoniae
Neisseria meningitidis |
| Which type of meningitis is epidemic? | Meningococcal meningitis |
| Diagnosis of bacterial meningitis is based on... | symptoms
culture from CSF |
| What is most vital in treating bacterial meningitis? | quick diagnosis |
| List the preventive mesures for bacterial meningitis | -vaccination of children agains Streptococcus pneumoniae, Haemophilus influenzae type B, Neisseria meningitidis
-penicillin to child whose mother is colonized with Streptococcus agalactiae
-treatment of infected pregnant mothers with penicilin (ampicillin or vancomycin) to prevent spread of Streptococcus agalactiae
-meningococcal vaccine for college freshmen and military recruits
-people in contact with infected people should take rifampin, tetracyclines or sulfonamides
- people at risk of listeriosis should avoid soft cheeses, unpasteurized milk etc |
| What can listeria monocytogenes cause? | listeriosis, human-human transmission like mother-child can cause meningitis |
| Aseptic meningitis | - caused by viruses
- no bacteria in CNS
- milder than bacterial meningitis
- similar symptoms as bacterial meningitis |
| 90% of viral meningitis is caused by... | enteroviruses
HSV
mumps virus
coxackie A virus
coxackie B virus
echoviruses
poliovirus |
| How dose enterovirus spread? | person-person
fecal-oral
respiratory secretions (only coxackie or enteroviruses) |
| What is the incubation time for enteroviruses? | 3-7 days |
| "Enteroviruses can survive in chlorinated pools" | TRUE |
| How to diagnose viral meningitis? | symptoms
no bacteria in CSF |
| What is the treatment of viral meningitis? | acyclovir
gancyclovir (for HSV) |
| Encephalitis is caused by... | VIRUSES
HSV (mostly)
arboviruses (st.Louis virus, western equine virus, eastern equine virus, west nile virus)
rabies virus |
| What is the pathogenesis of viruses causing encephalitis? | HSV - acute diffuse encephalitis
Arboviruses - neuronal infection
Rabies virus - peripheral nerves invasion |
| Mosquitos are the vectors of what virus? | arboviruses |
| Brain abscesses can be caused by... | parameningal suppuration
foreign bodies
haematogenous from distant sepsis |
| What aerobes and anaerobes can be found in brain abscesses? | aerobes: staphylococcus aureus, staphylococci, streptococci, gram negative rods (enterobacteriacae)
anaerobes: bacteroides, fusobacterium |
| What are the clinical features of brain abscesses? | headache
fever
reduced consciousness
neurological signs
increased intracranlial pressure |
| How to diagnose brain abscesse? | CT scan
culture from pus
normal or low glucose in CSF
high WBC in CSF |
| Poliomyelitis | affects children
fecal-oral route
person-person
can cause paralysis
NO CURE (only vaccine) |
| Symptoms of poliomyelitis | fever
fatigue
neck stifness
pain in limbs
vomiting
headche |
| How to diagnose polio? | virus present in throat or feces
Chronic fatigue syndrome
cell culture techniques |
| Treatment of polio | pleconaril
popocavir |
| List 2 vaccines against polio | salk
sabine |
| Is rabies endemic? | yes (not antarctica and hawaii) |
| In which phase of rabies can we detect antibody in serum and CNS? | neurologic phase |
| Rabies treatment | wash wound with soap and water as fast as possible
begin post exposure prophylaxis (one dose of human rabies immune globulin, four doses of rabies vaccine over 1 month ) |
| Rabies diagnosis | cell culture and virus isolation
immunodiagnostic procedures
observation of negri bodies in animal brain |
| Tetanus is cause by... | ingestion of exotoxin from clostridium tetani (spores get into tussue and tetanospasmin is produced) |
| Diagnosis of tetanus | muscle spasms in guinea pigs that where injected with scrapings from the wound |
| Prophylaxis of tetanus | vaccine |
| Fungal CNSI, give examples of diseases with the spiecies | chronic meningitis
vasculitis (mucor, aspergillus)
brain parenchyma invasion (cryptococcus, candida) |
| What is mycosis? | infection cause by a fungus |
| Which type of mycosis is the leading one (most common?) | cryptococcosis |
| What is the treatment for fungal CNSI? | fluconazole and voriconazole against aspergillus
amphoericin B against candida and cryptococcus |
| List some of the degenerative CNS diseases and their etiological factors | SSPE (subacute sclerosing panencephalitis) - measles virus
PML (progressive multifocal leukoencephalopathy) - human plyoma virus 2
Kuru disease - prions
Crteutzfeldt Jacob disease - prions |
| Variant creutzfeldt jakob disease | - encephalopathy
- brain tissue destroyed
- death in 12 months
- caused by prions |
| Treatment Variant creutzfeldt jakob disease | NONE |
| Diagnosis Variant creutzfeldt jakob disease | lab tests on samples from CNS to confirm presence of prions |
| What sample is need in diagnosis of meningococcal CNSI? | pharyngeal swab from the person and all its relatives |
| Rapid test for bacterialpolsaccharide capsular antigens is used in in diagnosis of which spiecies? | neisseria meningitidis
haemophilus influenzae
E.coli K1 |
| Rapid test for endotoxin is used in diagnosis of which spiecies? | LPS-gram negative bacteria |
