Questions and Answers
Which of the following is NOT considered a common infection of the central nervous system?
What is the most common route of infection to the central nervous system?
Which factor is associated with neuronal damage during meningitis?
What condition involves inflammation of both the meninges and the brain?
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Which of the following is a potential consequence of meningitis?
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Infections can spread to the CNS through which of the following mechanisms?
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Which of the following statements about the pathophysiology of meningitis is accurate?
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Which pathogen is commonly associated with the condition of myelitis?
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Which condition is typically associated with a stiff neck?
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What is one of the late complications of acute pyogenic meningitis?
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Which of the following is a common pathogen for neonatal meningitis?
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Which clinical manifestation indicates increased intracranial pressure?
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What form of paralysis might present as a complication in patients with acute pyogenic meningitis?
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Which pathogen is commonly associated with adult meningitis?
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Which of the following is a symptom associated with the nervous system disorder?
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Which of the following complications can lead to seizures in patients with pyogenic meningitis?
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Which organism is commonly associated with chronic bacterial meningitis?
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What is a characteristic finding in the CSF during an aseptic meningitis diagnosis?
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Which of the following conditions is typically absent in viral aseptic meningitis?
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What is the expected appearance of the CSF in a patient with bacterial meningitis?
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Which viral infection is NOT typically associated with signs of aseptic meningitis?
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In terms of pressure measurements, which position typically shows elevated values in bacterial meningitis?
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What is the typical WBC count found in the CSF of a healthy individual?
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Which organism is a fungal pathogen that can cause meningitis?
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Study Notes
Learning Outcomes
- Ability to identify common infections affecting the central and peripheral nervous systems.
- Knowledge of key pathogens responsible for these infections and their associated disorders.
- Understanding of host characteristics and microbial virulence factors in nervous system disorders.
CNS Infections
- Common CNS infections include encephalitis, meningitis, myelitis, meningoencephalitis, and meningoencephalomyelitis.
- CNS infections can lead to abscess formation in the brain, epidural, and subdural spaces due to infection or necrosis of brain tissue.
PNS Disorders
- Peripheral nervous system can be affected by conditions such as neuritis, polyneuropathy, and Guillain-Barre syndrome.
- Involves damage to cervical, thoracic, lumbar, and sacral nerves including the cauda equina.
Routes of Infection
- Haematogenous spread is the most common route of infection to the CNS.
- Local extension from nearby infected sites such as sinusitis or otitis media can lead to CNS infections.
- Direct implantation may occur through skull or spinal fractures, surgical procedures, or neural tube defects.
- Certain viruses can spread along peripheral nerves to the CNS, e.g., herpes zoster and rabies.
Pathophysiology
- Meningitis inflammation results in blood-CSF barrier disruption and increased volume in the subarachnoid space.
- This can lead to ventricle distortion and compression of brain structures.
- Neuronal damage is driven by bacterial components, toxins, and immune cell cytotoxic products.
Clinical Manifestations
- Symptoms may include fever, headache (indicative of increased intracranial pressure), and stiff neck.
- Potential complications include confusion, rash, sleepiness, seizures, and varying degrees of paralysis (flaccid or spastic).
Late Complications
- Possible long-term effects include cranial nerve palsies, hydrocephalus, learning difficulties, and neuropsychological deficits.
- Additional complications include seizures, deafness, and blindness, as well as paraspinal abscesses and calcification.
Etiology of Acute Pyogenic Meningitis
- Most common pathogens:
- Group B Streptococcus, Listeria monocytogenes, Gram-negative bacilli (E. coli, Klebsiella).
- Neisseria meningitidis and Streptococcus pneumoniae are common in childhood and adult meningitis.
Chronic Bacterial Meningitis
- Chronic forms include infections caused by Mycobacterium tuberculosis and Treponema pallidum.
Aseptic Meningitis
- Characterized by pleocytosis and primarily lymphocytic response in CSF.
- Typically acute and self-limiting, with viral origins (Coxsackie, HSV, VZ, etc.) and may also include fungal and parasitic infections.
- Associated signs of enteroviral infection may include exanthemas and myocarditis.
Typical CSF Findings
- CSF appearance varies based on infection type:
- Normal: Clear; Bacterial: Cloudy; Viral: Clear; Fungal/TB: Clear/Cloudy.
- Elevated opening pressure seen in bacterial and viral infections.
- WBC counts differ significantly, with bacterial meningitis showing counts >100/µl, while normal levels are 0-5/µl.
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Description
This quiz focuses on the various infections that affect the central and peripheral nervous systems. Students will be assessed on their ability to list and describe common infections as well as the pathogens responsible for these conditions. Prepare to enhance your understanding of neurological infections.