Viral Pathogens of the CNS/ Encephalitis
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Questions and Answers

Which of the following is the hallmark triad of meningitis?

  • Fever, headache, and altered mental status
  • Headache, neck stiffness, and photophobia (correct)
  • Seizures, weakness, and vomiting
  • Motor deficits, sensory deficits, and personality changes
  • Which condition primarily affects the protective membranes around the brain and spinal cord?

  • Meningitis (correct)
  • Encephalitis
  • Stroke
  • Epilepsy
  • Which of the following is NOT a common symptom of meningitis?

    A) Vomiting B) Irritability in children C) Altered mental status D) Neck stiffness

  • Vomiting
  • Irritability in children
  • Altered mental status (correct)
  • Neck stiffness
  • Encephalitis typically causes which of the following symptoms? (Select all that apply)

    <p>Seizures and confusion</p> Signup and view all the answers

    Which of the following is a shared symptom between meningitis and encephalitis?

    A) Altered mental status B) Seizures C) Neck stiffness D) Photophobia

    <p>Seizures</p> Signup and view all the answers

    Which of the following viruses can cause post-infectious encephalitis, such as subacute sclerosing panencephalitis (SSPE)?

    <p>Measles virus</p> Signup and view all the answers

    Which virus is commonly associated with causing flaccid paralysis as part of a lower motor neuron involvement?

    <p>Polio virus</p> Signup and view all the answers

    Which of the following viruses is most commonly linked with enteroviral meningitis?

    <p>Enteroviruses</p> Signup and view all the answers

    Which of the following mosquito-borne viruses is associated with encephalitis?

    <p>West Nile virus (WNV)</p> Signup and view all the answers

    What type of CNS infection is typically caused by Herpes simplex virus (HSV)?

    <p>Encephalitis</p> Signup and view all the answers

    Which of the following viruses can cause vasculitis, arteritis, and stroke as a complication in the CNS?

    <p>Varicella-zoster virus (VZV)</p> Signup and view all the answers

    Which viral infection typically presents with meningitis symptoms such as headache, fever, and photophobia?

    <p>Mumps virus</p> Signup and view all the answers

    Which of the following viruses is associated with tick-borne encephalitis?

    <p>Flaviviruses</p> Signup and view all the answers

    Which of the following viruses is the most common cause of viral meningitis?

    <p>Enteroviruses</p> Signup and view all the answers

    Which of the following is NOT a common cause of viral meningitis?

    <p>Streptococcus pneumoniae</p> Signup and view all the answers

    What is the most common route of infection for enteroviruses to reach the CNS in viral meningitis?

    <p>Via the bloodstream</p> Signup and view all the answers

    Which of the following viruses can reach the CNS along nerve pathways, causing viral meningitis?

    <p>Rabies virus</p> Signup and view all the answers

    Which of the following is the typical primary site of multiplication for enteroviruses, which can then lead to viral meningitis?

    <p>Gastrointestinal tract</p> Signup and view all the answers

    Which of the following viruses is associated with viral meningitis and can also cause encephalitis?

    <p>Herpes simplex virus (HSV)</p> Signup and view all the answers

    Which of the following viruses can cause viral meningitis through the olfactory mucosa?

    <p>Rabies virus</p> Signup and view all the answers

    What is the primary cause of cellular damage in the CNS during a viral infection?

    <p>Virus multiplication and resultant cellular damage</p> Signup and view all the answers

    Which aspect of the body's immune response plays a significant role in the pathology of viral CNS infections?

    <p>Cellular immune response (T-cells) and cytokines</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly seen in viral meningitis?

    <p>Severe sepsis</p> Signup and view all the answers

    How does the clinical presentation of viral meningitis typically compare to bacterial meningitis?

    <p>Symptoms evolve more slowly in viral meningitis</p> Signup and view all the answers

    Which of the following is the most common route through which viruses cause CNS damage?

    <p>Host immune response causing inflammation</p> Signup and view all the answers

    In viral meningitis, which of the following is true about the patient's condition compared to those with bacterial meningitis?

    A) Viral meningitis patients are usually sicker than bacterial meningitis patients B) Patients with viral meningitis typically show more severe neurological impairment C) Viral meningitis is usually less severe, and patients are not as sick as those with bacterial meningitis D) Viral meningitis patients always have a higher fever than bacterial meningitis patients

    <p>Viral meningitis is usually less severe, and patients are not as sick as those with bacterial meningitis</p> Signup and view all the answers

    Which of the following is the most common cause of viral meningitis, especially in infants and young children?

    <p>Non-polio enteroviruses</p> Signup and view all the answers

    Which of the following subtypes of non-polio enteroviruses is most commonly associated with viral meningitis?

    <p>Echoviruses</p> Signup and view all the answers

    What is the primary route of transmission for non-polio enteroviruses?

    <p>Faecal-oral route</p> Signup and view all the answers

    In non-polio enterovirus infections, which of the following is NOT a typical symptom?

    <p>Severe respiratory distress</p> Signup and view all the answers

    What is the peak activity period for non-polio enterovirus infections?

    <p>Late spring to autumn</p> Signup and view all the answers

    Which of the following groups is most at risk for severe illness from non-polio enterovirus infections?

    A) Elderly adults B) Neonates and young infants C) Healthy adults D) Adolescents

    <p>Neonates and young infants</p> Signup and view all the answers

    What is the human reservoir for non-polio enteroviruses?

    <p>Infected humans only</p> Signup and view all the answers

    Which of the following non-polio enteroviruses is strongly associated with encephalitis, especially in East and Southeast Asia?

    <p>Enterovirus 71</p> Signup and view all the answers

    What is the possible neurological complication associated with Enterovirus D68?

    <p>Acute flaccid paralysis following respiratory illness</p> Signup and view all the answers

    Which of the following is a common systemic manifestation of non-polio enteroviral infections, not involving the CNS?

    <p>Myocarditis and pericarditis</p> Signup and view all the answers

    Hand, foot, and mouth disease is most commonly caused by which of the following viruses?

    A) Coxsackie viruses and Enterovirus 71 B) Epstein-Barr virus C) Herpes simplex virus D) Varicella-zoster virus

    <p>Coxsackie viruses and Enterovirus 71</p> Signup and view all the answers

    On-polio enteroviruses often cause mild illnesses, but in rare cases, they can lead to serious conditions. Which of the following can be a manifestation in addition to CNS involvement?

    <p>Myocarditis and pericarditis</p> Signup and view all the answers

    In addition to causing encephalitis, Enterovirus 71 is also commonly associated with which of the following conditions?

    <p>Hand, foot, and mouth disease</p> Signup and view all the answers

    Which of the following infections can cause a lymphocytic response in the CSF, making it important to differentiate from viral meningitis?

    A) Leptospirosis B) Cryptococcosis C) Syphilis D) All of the above

    <p>All of the above</p> Signup and view all the answers

    Which of the following conditions is NOT typically associated with a lymphocytic CSF response?

    <p>Acute bacterial meningitis</p> Signup and view all the answers

    Treatment of viral meningitis (except in the neonatal period) typically involves which of the following?

    A) Antiviral therapy with aciclovir B) Supportive care, including rest and hydration C) Intravenous antibiotics D) Steroid therapy for inflammation

    <p>Supportive care, including rest and hydration</p> Signup and view all the answers

    HSV encephalitis should be treated with which of the following medications?

    <p>Aciclovir</p> Signup and view all the answers

    Mumps meningitis is preventable by vaccination. Which vaccine provides protection against mumps?

    <p>MMR (Measles, Mumps, Rubella)</p> Signup and view all the answers

    In cases of viral meningitis, why might acyclovir be considered in some instances despite being used primarily for HSV encephalitis?

    <p>It may provide some benefit in reducing viral replication</p> Signup and view all the answers

    Seizure management in viral meningitis involves which of the following?

    <p>Managing the seizures with antiepileptic drugs (if necessary)</p> Signup and view all the answers

    What is the most common causative agent of herpes simplex encephalitis (HSE) in Northern European countries?

    <p>HSV-1</p> Signup and view all the answers

    Which of the following best explains the route of infection in Herpes Simplex Encephalitis?

    <p>Spread from latent infection in cranial nerve ganglia to the brain via the trigeminal or olfactory nerve</p> Signup and view all the answers

    In neonatal HSV encephalitis, the infection is primarily caused by which virus?

    A) HSV-1 B) HSV-2 C) Varicella-Zoster Virus (VZV) D) Epstein-Barr Virus (EBV)

    <p>HSV-2</p> Signup and view all the answers

    Which part of the brain is most commonly affected in adults and children over the age of 3 months with HSV-1 encephalitis?

    <p>Temporal lobe</p> Signup and view all the answers

    What is the mortality rate for HSV-1 encephalitis in adults and children without treatment?

    <p>70%</p> Signup and view all the answers

    The clinical features of Herpes Simplex Encephalitis typically include all of the following except:

    <p>Generalized weakness</p> Signup and view all the answers

    What is the key diagnostic method for HSV encephalitis?

    <p>MRI showing temporal lobe changes</p> Signup and view all the answers

    What is the treatment of choice for Herpes Simplex Encephalitis?

    <p>Intravenous aciclovir</p> Signup and view all the answers

    In neonatal HSV encephalitis, what is the primary route of infection?

    <p>Acquisition from the mother’s infected genital secretions during delivery</p> Signup and view all the answers

    What is the most important preventive measure for neonatal HSV encephalitis?

    A) Antiviral treatment during pregnancy B) Vaccination of neonates against HSV C) Guidelines on genital herpes in pregnancy to avoid primary infection D) Caesarean section for all pregnant women

    <p>Guidelines on genital herpes in pregnancy to avoid primary infection</p> Signup and view all the answers

    Varicella Zoster Virus (VZV) encephalitis can occur as a complication of which of the following?

    A) Primary infection (varicella/chickenpox) B) Reactivation of latent virus (shingles) C) Both A and B D) Only bacterial infection

    <p>Both A and B</p> Signup and view all the answers

    Which of the following is the most common clinical presentation of VZV encephalitis?

    <p>Similar symptoms and signs to HSV encephalitis</p> Signup and view all the answers

    What is the diagnostic test of choice for detecting VZV encephalitis?

    <p>PCR detection of VZV DNA in CSF</p> Signup and view all the answers

    What is the treatment of choice for VZV encephalitis?

    <p>High-dose intravenous aciclovir</p> Signup and view all the answers

    Which of the following is a preventive measure for VZV encephalitis? (Select one)

    <p>Childhood chickenpox vaccine and adult shingles vaccine</p> Signup and view all the answers

    Which of the following is the main reservoir for the rabies virus?

    <p>Wild and domestic dogs, wolves, bats</p> Signup and view all the answers

    What is the typical incubation period for rabies after exposure?

    <p>3-12 weeks</p> Signup and view all the answers

    How does the rabies virus travel to the brain?

    <p>By following peripheral nerves (retroaxonal)</p> Signup and view all the answers

    What is the clinical presentation during the prodrome phase of rabies infection?

    <p>Fever, pain at the bite site, and salivation</p> Signup and view all the answers

    The definitive diagnosis of rabies can be confirmed by which of the following methods?

    <p>Direct immunofluorescent test for human rabies in skin biopsy</p> Signup and view all the answers

    What is the treatment for rabies exposure?

    <p>Immediate vaccination and rabies immunoglobulin (RIG)</p> Signup and view all the answers

    Which of the following is a preventive measure for rabies? (Select all that apply)

    <p>All of the above</p> Signup and view all the answers

    Which of the following are common CNS symptoms in the later stages of rabies infection?

    <p>Restlessness, irritability, and aggression</p> Signup and view all the answers

    What is the characteristic progression of rabies after the prodrome phase?

    <p>Encephalitis and paralysis</p> Signup and view all the answers

    Which laboratory test is most commonly used to diagnose rabies?

    <p>PCR from CSF or saliva</p> Signup and view all the answers

    A skin biopsy from the nape of the neck (above the hairline) is used in rabies diagnosis for which purpose?

    <p>To detect the rabies virus using direct immunofluorescent staining</p> Signup and view all the answers

    If a patient has no prior rabies vaccination or post-exposure prophylaxis (PEP), which of the following is useful for diagnosis?

    <p>CSF analysis for rabies antibodies</p> Signup and view all the answers

    Which of the following is the most common host for the West Nile virus? A) Humans B) Birds C) Ticks D) Bats

    <p>Birds</p> Signup and view all the answers

    What is the most common clinical presentation of West Nile virus infection?

    <p>Mild flu-like symptoms</p> Signup and view all the answers

    Which of the following groups are at higher risk for severe symptoms from West Nile virus infection?

    <p>Older adults and those with immunosuppression</p> Signup and view all the answers

    What is the recommended diagnostic method for West Nile virus infection?

    <p>West Nile Virus IgM in blood or CSF</p> Signup and view all the answers

    What is the typical management approach for West Nile virus infection?

    <p>Supportive care, including hydration and management of complications</p> Signup and view all the answers

    What is the primary vector for Japanese Encephalitis (JE) transmission?

    <p>Culex mosquitoes</p> Signup and view all the answers

    In which type of environment is Japanese Encephalitis (JE) most commonly found?

    <p>Rural agricultural areas, particularly rice paddy fields</p> Signup and view all the answers

    Which age group is most affected by Japanese Encephalitis (JE) infection?

    <p>Children</p> Signup and view all the answers

    What is the case fatality rate for Japanese Encephalitis in infected individuals?

    <p>20-30%</p> Signup and view all the answers

    Which of the following is the most important preventive measure for Japanese Encephalitis?

    <p>Immunization with the JE vaccine</p> Signup and view all the answers

    Which of the following is the most accurate method for diagnosing West Nile virus infection in the early stages?

    <p>West Nile Virus IgM detection in blood or CSF</p> Signup and view all the answers

    Which of the following is true regarding the epidemiology of West Nile virus? (Select all that apply)

    <p>It is transmitted year-round in tropical climates</p> Signup and view all the answers

    What is the most significant risk factor for severe West Nile virus disease?

    <p>Advanced age</p> Signup and view all the answers

    What is the recommended diagnostic test for suspected Japanese Encephalitis infection?

    <p>Serological testing for JE virus IgM in blood or CSF</p> Signup and view all the answers

    Which of the following is the primary mode of transmission for Tick-borne Encephalitis (TBE)?

    <p>Bite from an infected Ixodes tick</p> Signup and view all the answers

    Which of the following best describes the geographic distribution of Tick-borne Encephalitis (TBE)?

    <p>Central, Eastern Europe, Russia, Mongolia, and China</p> Signup and view all the answers

    What is the incubation period for Tick-borne Encephalitis (TBE)?

    <p>6-28 days</p> Signup and view all the answers

    Which phase of Tick-borne Encephalitis (TBE) involves the central nervous system (CNS)?

    <p>The second phase following CNS involvement</p> Signup and view all the answers

    What is the most effective preventive measure against Tick-borne Encephalitis (TBE)?

    A) Antiviral medications B) Immunization with TBE vaccine C) Avoidance of mosquito bites D) Use of antibiotics

    <p>Immunization with TBE vaccine</p> Signup and view all the answers

    What is the most common cause of paralytic poliomyelitis?

    <p>Infection with wild poliovirus</p> Signup and view all the answers

    What is the main method of transmission for poliovirus?

    A) Airborne transmission B) Contact with contaminated water C) Fecal-oral route D) Inhalation of respiratory droplets

    <p>Fecal-oral route</p> Signup and view all the answers

    Which of the following countries still reported wild poliovirus cases in 2020?

    A) India and Bangladesh B) Pakistan and Afghanistan C) Egypt and Sudan D) Russia and Mongolia

    <p>Pakistan and Afghanistan</p> Signup and view all the answers

    Which type of polio is characterized by asymmetric paralysis, usually affecting the legs and due to destruction of lower motor neurons?

    <p>Spinal polio</p> Signup and view all the answers

    Bulbar polio primarily affects which of the following?

    A) Lower extremities B) Tongue and pharyngeal muscles C) Respiratory muscles D) Sensory neurons

    <p>Tongue and pharyngeal muscles</p> Signup and view all the answers

    What condition occurs 30-40 years after paralytic polio and is characterized by increased muscle weakness and pain?

    A) Post-polio syndrome B) Guillain-Barré syndrome C) Progressive multifocal leukoencephalopathy D) Spinal cord atrophy

    <p>Post-polio syndrome</p> Signup and view all the answers

    Which of the following has contributed to the re-emergence of polio in areas previously considered eradicated?

    <p>Disruption in vaccine programs and waning vaccine uptake</p> Signup and view all the answers

    What is the primary mode of transmission for Zika virus?

    <p>Mosquito bites, primarily Aedes spp.</p> Signup and view all the answers

    Which of the following is a major feature of congenital Zika syndrome?

    <p>Severe brain damage leading to microcephaly</p> Signup and view all the answers

    Zika virus infection is associated with which neurological condition?

    A) Guillain-Barré syndrome B) Multiple sclerosis C) Parkinson’s disease D) Amyotrophic lateral sclerosis

    <p>Guillain-Barré syndrome</p> Signup and view all the answers

    Which of the following is a feature of Subacute Sclerosing Panencephalitis (SSPE)?

    <p>Seizures, dementia, and motor disorders</p> Signup and view all the answers

    Which of the following is the treatment approach for Progressive Multifocal Leukoencephalopathy (PML)?

    <p>Reducing immunosuppression</p> Signup and view all the answers

    Progressive Multifocal Leukoencephalopathy (PML) is caused by the reactivation of which virus?

    <p>JC virus</p> Signup and view all the answers

    Subacute sclerosing panencephalitis (SSPE) is a rare, progressive complication of which viral infection?

    <p>Measles</p> Signup and view all the answers

    Which of the following is true about Transmissible Spongiform Encephalopathies (TSEs)?

    A) TSEs are caused by viruses that are inactivated by standard chemical and thermal methods. B) TSEs evoke a strong immune response. C) TSEs have a long incubation period and are fatal degenerative diseases. D) The causative agent of TSEs is a bacterium.

    <p>TSEs have a long incubation period and are fatal degenerative diseases.</p> Signup and view all the answers

    Creutzfeldt-Jakob Disease (CJD) is most commonly caused by which of the following?

    <p>Mutations of prion proteins</p> Signup and view all the answers

    Variant Creutzfeldt-Jakob Disease (vCJD) is primarily associated with which of the following?

    <p>Ingestion of BSE-contaminated animal products</p> Signup and view all the answers

    How can Variant Creutzfeldt-Jakob Disease (vCJD) be prevented?

    <p>Avoidance of consuming BSE-contaminated beef products</p> Signup and view all the answers

    Which diagnostic test is commonly used for detecting Creutzfeldt-Jakob Disease (CJD)?

    <p>CSF 14-3-3 protein test</p> Signup and view all the answers

    What is the most effective method for sterilizing surgical instruments exposed to Creutzfeldt-Jakob Disease (CJD)?

    <p>Destroying instruments by incineration</p> Signup and view all the answers

    Which of the following symptoms is NOT characteristic of sporadic Creutzfeldt-Jakob Disease (CJD)?

    <p>Hypertension with muscle spasms</p> Signup and view all the answers

    What distinguishes Variant Creutzfeldt-Jakob Disease (vCJD) from classic CJD?

    <p>It primarily affects younger individuals, often in their 20s.</p> Signup and view all the answers

    What is considered the most definitive method for diagnosing Creutzfeldt-Jakob Disease (CJD)?

    <p>Post-mortem histological examination</p> Signup and view all the answers

    Which strategy effectively helps prevent the spread of Creutzfeldt-Jakob Disease in the community?

    <p>Excluding individuals at risk from blood donation</p> Signup and view all the answers

    Why is it important to avoid reusing surgical instruments that were used in patients with Creutzfeldt-Jakob Disease (CJD)?

    <p>Prion proteins are resistant to normal sterilization methods.</p> Signup and view all the answers

    Which of the following methods is considered least effective at eliminating prion proteins from surgical instruments?

    <p>Disinfection with formaldehyde</p> Signup and view all the answers

    What is a primary concern regarding prion protein transmission in the context of surgical instruments?

    <p>They can persist on instruments even after cleaning.</p> Signup and view all the answers

    What is the primary route of transmission for Variant Creutzfeldt-Jakob Disease?

    <p>Ingestion of contaminated animal products</p> Signup and view all the answers

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