Meningitis and Encephalitis Quiz
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Questions and Answers

Which type of meningitis is primarily caused by viruses and is usually mild with complete recovery?

  • Fungal meningitis
  • Tuberculous meningitis
  • Bacterial meningitis
  • Aseptic (viral) meningitis (correct)

What is a common route of infection that involves local extension, such as from otitis media?

  • By blood
  • By nerves
  • Local extension (correct)
  • Direct (trauma)

Which organism is NOT typically associated with bacterial meningitis in adults and the elderly?

  • H influenzae
  • Streptococcus pneumoniae
  • Group B streptococci (correct)
  • E.coli

Which clinical feature is NOT considered a hallmark symptom of meningitis?

<p>Skin rash (D)</p> Signup and view all the answers

What complication may arise from meningitis due to cerebral edema?

<p>Death from herniation (D)</p> Signup and view all the answers

Which of the following is a characteristic finding in the CSF of a patient with aseptic (viral) meningitis?

<p>Clear CSF with lymphocytosis (A)</p> Signup and view all the answers

What pathological finding is associated with tuberculous meningitis?

<p>Granuloma and fibrocaseous exudates (D)</p> Signup and view all the answers

Which diagnostic procedure is least commonly used for diagnosing meningitis?

<p>Biopsy of the brain or meninges (D)</p> Signup and view all the answers

What is the primary cause of acute encephalitis?

<p>Viral infection (A)</p> Signup and view all the answers

Which virus is associated with temporal lobe necrosis in acute encephalitis?

<p>Herpes Simplex Virus (HSV) (A)</p> Signup and view all the answers

Negri bodies are characteristic of which condition?

<p>Rabies (B)</p> Signup and view all the answers

Which of the following is NOT a part of the TORCH complex?

<p>HIV (D)</p> Signup and view all the answers

What is the main source of Toxoplasmosis infection in neonates?

<p>Transplacental transmission from the mother (C)</p> Signup and view all the answers

Which type of encephalitis is characterized by infectious proteins?

<p>Slow Encephalitis (A)</p> Signup and view all the answers

What are the clinical manifestations commonly associated with TORCH infections?

<p>CNS calcifications and microcephaly (C)</p> Signup and view all the answers

In the context of brain abscess, what can result from rupture of the abscess?

<p>Spread of infection (A)</p> Signup and view all the answers

What is one common effect of increased intracranial pressure (ICP)?

<p>Headache (D)</p> Signup and view all the answers

Which of the following is NOT an example of a space occupying lesion (SOL)?

<p>Cerebral edema (D)</p> Signup and view all the answers

Which site of brain herniation is associated with rapid coma and compression of the cranial nerves controlling eye movement?

<p>Tentorial (C)</p> Signup and view all the answers

What is a primary management strategy used for cerebral edema?

<p>Osmotic agents such as mannitol (C)</p> Signup and view all the answers

What combination of effects is typically observed in adults with hydrocephalus?

<p>Dilated ventricles, brain atrophy, and increased ICP (A)</p> Signup and view all the answers

Cerebral infarction is primarily caused by which of the following?

<p>Arterial narrowing due to atherosclerosis (A)</p> Signup and view all the answers

Which symptom is characteristic of a cerebral vascular accident (CVA)?

<p>Sudden confusion and trouble speaking (A)</p> Signup and view all the answers

What type of fluid is associated with vasogenic edema in the brain?

<p>High in protein (D)</p> Signup and view all the answers

What is the main difference between a transient ischemic attack (TIA) and an ischemic stroke?

<p>The blockage in a TIA is temporary and resolves on its own. (D)</p> Signup and view all the answers

Which of the following conditions is NOT a cause of cerebral hemorrhage?

<p>Transient ischemic attacks (B)</p> Signup and view all the answers

Which type of hematoma is caused by the rupture of small bridging veins?

<p>Subdural hematoma (A)</p> Signup and view all the answers

What is a common result of severe trauma related to intracerebral hemorrhage?

<p>Can be fatal (D)</p> Signup and view all the answers

Which degenerative disease is characterized by loss of functional neurons resulting in dementia and abnormal movement?

<p>Alzheimer's Disease (B), Prion Disease (C), Parkinsonism (D)</p> Signup and view all the answers

Which of the following symptoms is associated with subarachnoid hemorrhage?

<p>Meningismus (B)</p> Signup and view all the answers

What is the effect of an extradural hematoma after the rupture of the middle meningeal artery?

<p>A prolonged lucid period (C)</p> Signup and view all the answers

Which condition can lead to scarring and epilepsy as a result of delayed effects from head injury?

<p>Subdural hematoma (D)</p> Signup and view all the answers

Which of the following is NOT a known cause of dementia?

<p>Routine exercise (B)</p> Signup and view all the answers

What is a common clinical symptom of Alzheimer's Disease?

<p>Progressive dementia (C)</p> Signup and view all the answers

What pathology is associated with Alzheimer's Disease?

<p>Senile plaques and neurofibrillary tangles (D)</p> Signup and view all the answers

Which of the following symptoms is characteristic of Parkinsonism?

<p>Resting tremors (D)</p> Signup and view all the answers

What is a known secondary cause of Parkinson's Disease?

<p>Trauma (C)</p> Signup and view all the answers

Which vitamin deficiency is linked to subacute combined degeneration of the brain?

<p>Vitamin B12 (A)</p> Signup and view all the answers

Which disorder is characterized by episodes of neurological defects due to selective demyelination?

<p>Multiple sclerosis (A)</p> Signup and view all the answers

What type of gait is commonly associated with Parkinson's Disease?

<p>Festinating gait (B)</p> Signup and view all the answers

Which symptom is most commonly associated with Guillain-Barré syndrome (GBS)?

<p>Muscle weakness (B)</p> Signup and view all the answers

What is the most commonly used treatment for Guillain-Barré syndrome?

<p>Intravenous immunoglobulin (IVIG) (C)</p> Signup and view all the answers

Which type of nerve injury is characterized by the loss of myelin sheath?

<p>Demyelinating neuropathy (C)</p> Signup and view all the answers

Which of the following is classified under primary brain tumors?

<p>Meningiomas (B), Neurofibromas (C)</p> Signup and view all the answers

Which of the following statements about gliomas is correct?

<p>They have many histological grades. (D)</p> Signup and view all the answers

What is the primary concern regarding benign brain tumors?

<p>They can cause significant pressure effects. (B)</p> Signup and view all the answers

Which type of tumor is classified as a lymphoid neoplasm?

<p>Hematopoietic neoplasm (B)</p> Signup and view all the answers

Which factor contributes to the classification of tumors in the WHO classification system?

<p>Histological origin of tumor (C)</p> Signup and view all the answers

Flashcards

Bacterial Meningitis

Meningitis caused by bacteria, typically affecting newborns, children, and adults. It can be severe and life-threatening.

Meningitis

An acute inflammation of the meninges, the membranes that surround the brain and spinal cord.

Pachymeningitis

A type of meningitis that affects the outer layer of the meninges (dura mater).

Viral Meningitis

Meningitis primarily caused by viruses, usually milder than bacterial meningitis, and often resolves on its own.

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Brain Abscess

A collection of pus within the brain tissue, commonly caused by bacteria, fungi, or parasites.

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Tuberculous Meningitis

Meningitis caused by Mycobacterium tuberculosis, typically presenting with granulomas and fibrosis.

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Encephalitis

Inflammation of the brain tissue itself, often caused by viruses, bacteria, fungi, or parasites.

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Neck Stiffness (Nuchal Rigidity)

A common symptom associated with meningitis, caused by inflammation and irritation of the meninges.

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Increased Intracranial Pressure (ICP)

Increased pressure within the skull, often caused by a buildup of cerebrospinal fluid (CSF) due to an obstruction in its flow.

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Brain Herniation

A condition that involves the brain being pushed out of its normal position due to increased pressure.

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Brain Edema

An excess amount of water within the brain tissue, which can be caused by a variety of factors.

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Hydrocephalus

A condition characterized by an abnormal accumulation of cerebrospinal fluid within the brain.

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Cerebral Infarction

A blockage of blood flow to the brain, leading to tissue damage and death.

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Cerebral Hemorrhage

An accumulation of blood within the brain, caused by a ruptured blood vessel.

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Space Occupying Lesion

A space-occupying lesion is a growth or abnormality inside the brain that takes up space and puts pressure on surrounding tissue.

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Osmotic Agents (Mannitol & Hypertonic Saline)

These agents are used to reduce brain swelling by drawing fluid from the brain into the bloodstream.

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What is a brain abscess?

A localized collection of pus in the brain, often caused by bacteria, fungi, or parasites. It can be caused by direct infection or spread from other parts of the body. It can cause increased intracranial pressure, scar formation, and brain damage.

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What is encephalitis?

Inflammation of the brain tissue, often caused by viruses, bacteria, fungi or parasites. It can cause a range of symptoms from mild flu-like illness to severe neurological damage and even death. There are three main types: acute, persistent and slow.

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What is a prion disease?

A severe form of encephalitis characterized by the presence of abnormal infectious proteins called prions. It can be caused by mutations in PrPc genes or by consuming contaminated meat from infected animals.

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What is Toxoplasmosis?

A parasitic infection caused by Toxoplasma gondii, often transmitted through contaminated food or contact with cat feces. It can potentially cause serious complications, especially in pregnant women and people with compromised immune systems.

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What is TORCH complex?

A group of infections that can be transmitted from a mother to her baby during pregnancy, potentially causing birth defects and neurological complications. The acronym TORCH stands for Toxoplasma, Rubella, Cytomegalovirus, and Herpes simplex virus.

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What is HSV encephalitis?

A viral form of encephalitis caused by the Herpes simplex virus. It can cause severe nerve damage and brain injury, particularly in the temporal lobes.

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What is CMV encephalitis?

A viral form of encephalitis caused by the Cytomegalovirus (CMV). It can cause widespread brain damage and neurological complications.

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What is rabies encephalitis?

A viral form of encephalitis caused by the rabies virus. It can cause neurological problems, behavioral changes, and ultimately death.

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Transient Ischemic Attack (TIA)

Brief episodes of neurological dysfunction caused by a temporary disruption of blood flow to the brain. They do not cause permanent damage, but are considered warning signs of a potential stroke.

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Ischemic Stroke

A type of stroke resulting from a blockage in an artery in the brain, causing tissue damage due to reduced blood flow.

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Concussion

A traumatic brain injury that involves a disruption to the brain's normal functioning. It can range from mild to severe and may result in a variety of symptoms, including confusion, dizziness, and memory problems.

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Extradural Hematoma

A collection of blood that forms between the dura mater (outer layer of the meninges) and the skull following a head injury.

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Subdural Hematoma

A collection of blood that forms beneath the dura mater (outer layer of the meninges) following a head injury.

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Intracerebral Hemorrhage

A type of brain injury characterized by bleeding within the brain tissue itself. Often associated with severe head trauma.

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Degenerative Brain Diseases

Progressive neurological disorders that involve the loss of brain cells and a decline in cognitive function, leading to various symptoms like memory loss, personality changes, and movement difficulties.

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Alzheimer's Disease

A progressive neurodegenerative disease characterized by memory loss, impaired cognitive function, and personality changes.

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Senile or Neuritic Plaques

These are abnormal clumps of protein fragments that build up in the brain and are associated with Alzheimer's Disease.

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Neurofibrillary Tangles

These are twisted fibers that build up inside brain cells and are associated with Alzheimer's Disease.

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Parkinsonism

A progressive neurodegenerative disorder that affects movement due to the loss of dopamine-producing cells in the brain.

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Lewy Inclusion Bodies

These are abnormal protein deposits found in the brain cells of individuals with Parkinson's Disease.

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Subacute Combined Degeneration

A condition caused by a deficiency of vitamin B12, leading to damage to the myelin sheath that surrounds nerve fibers.

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Wilson's Disease

A rare inherited disorder that causes copper to accumulate in the liver, brain, and other organs, leading to neurological dysfunction.

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Multiple Sclerosis (MS)

A neurological disorder characterized by episodes of demyelination (destruction of the myelin sheath) in the white matter of the brain and spinal cord.

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Guillain-Barré Syndrome (GBS)

A rare autoimmune disorder where the immune system attacks the myelin sheath of peripheral nerves, causing muscle weakness and sometimes paralysis.

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Demyelinating Neuropathy

A type of neuropathy characterized by the loss of myelin sheath around nerves, leading to impaired nerve function. Examples include Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyneuropathy.

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Axonal Neuropathy

A type of neuropathy where nerve fibers are damaged directly. Examples include diabetic neuropathies, alcoholic neuropathies, and neuropathies caused by herpes zoster and HIV.

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Primary Brain Tumors

Brain tumors that originate from cells within the brain itself.

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Secondary Brain Tumors

Brain tumors that are caused by the spread of cancer from other parts of the body.

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WHO Classification of CNS Tumors

A classification system for brain tumors, categorizing them based on the type of cells they originate from.

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Astrocytoma

The most common type of primary brain tumor, arising from astrocytes, star-shaped cells that support neurons.

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Glioblastoma Multiforme

A type of astrocytoma that is highly aggressive and fast-growing.

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Study Notes

CNS Pathology

  • This presentation covers various pathologies affecting the central nervous system (CNS).
  • Topics covered include infections, space-occupying lesions, brain herniation, brain edema, hydrocephalus, cerebrovascular accidents (CVAs), and degenerative diseases.
  • Different types of CNS infections, such as meningitis, encephalitis, and brain abscesses, are discussed.

CNS Infections

  • Meningitis: An acute inflammation of the meninges.
    • Anatomical types: Leptomeningitis (pia + arachnoid matter), pachymeningitis (dura).
    • Causes: Group B streptococci, E. coli, Listeria monocytogenes (neonates); Streptococcus pneumoniae (adults and elderly), H. influenza (non-vaccinated infants); Coxsackie virus (children, fecal-oral transmission); fungi (immunocompromised individuals).
    • Symptoms: Fever, severe headache, neck stiffness, nausea, vomiting, confusion, disorientation, photophobia, altered mental status.
    • Complications: Death (herniation secondary to cerebral edema); hydrocephalus, hearing loss, seizures.
    • Pathology: Subarachnoid pus, organization of pus, turbid cerebrospinal fluid (CSF), hydrocephalus, normal cortex.
  • Viral Meningitis: Typically mild, complete recovery.
    • Causes: HSV, CMV, enteroviruses, mumps
    • Pathology: Clear CSF, lymphocytosis, normal sugar, slightly increased protein.
  • Tuberculosis Meningitis: Pathology on the surface of pia/arachnoid.
    • Early exudates with lymphocytes & neutrophils
    • Next: Granuloma + fibrocaseous exudates
    • Later: fibrosis + adhesion, spread
    • Finally: Tuberculoma in cerebrum (adults) - encapsulated mass
  • Brain Abscess: Localized collection of capsulated pus.
    • Causes: Bacterial, fungal, parasitic, tumor
    • Source: Direct, metastatic
    • Clinical effects: As space-occupying lesion (SOL), increased intracranial pressure (ICP), scar formation (epilepsy), rupture, spread.
  • Encephalitis: Inflammation of the brain tissue (usually viral).
    • Forms: Acute (HSV, HZV, rabies, ...), Persistent (PMLE, CJ virus, SSPE, rubella & measles), Slow (prion diseases).
    • Pathology (Acute): Perivascular inflammation, glial hyperplasia, inclusion bodies, neuronal damage, temporal lobe necrosis (HSV), disseminated necrosis (CMV), Negri bodies (rabies).
  • Toxoplasmosis: Parasitic infection of the brain caused by Toxoplasma gondii.
    • Neonatal transmission: Transplacental from infected mother
    • Other transmission: Ingestion of contaminated foods (especially cat feces)

Routes of Infections

  • By blood (direct trauma)
  • Local extension (e.g., from otitis media)
  • By nerves (e.g., rabies, herpes)

Other CNS Topics

  • Space-Occupying Lesions (SOLs): Examples include abscesses, hematomas, tumors, recent infarcts, brain edema.
    • Effects: Increased ICP (headache, vomiting, papilledema, coma), brain herniation, neuronal damage.
  • Brain Herniation: Pushing of part of the brain due to force.
    • Types: Supracallosum, tentorial, tonsillar, extracranial
  • Brain Edema: Intracellular and extracellular water increases.
    • Causes: Local/general, vasogenic (protein), cytotoxic (watery).
    • Effects: Vascular damage, CSF flow obstruction, neuronal damage.
    • Management: Mannitol and hypertonic saline (osmotic agents)
  • Hydrocephalus: Increased CSF volume within the cranium.
    • Mechanism: Production, obstruction, reabsorption
    • Clinical presentation in infants: Increased head size, dilated ventricles, mental retardation
    • Clinical presentation in adults: Dilated ventricles, brain atrophy, increased ICP
  • Cerebrovascular Accidents (CVAs): Cerebral infarction, cerebral hemorrhage
    • Infarction: Ischemia due to arterial narrowing (thrombosis/atheroma), shock, increased ICP, site is according to affected artery.
    • Hemorrhage: Due to hypertension, tumors, bleeding disorders, arteriovenous malformations (AVMs).
  • Transient Ischemic Attacks (TIAs): Brief episodes of impaired neurological function due to temporary disruption of cerebral circulation, not associated with permanent damage — precursors to more serious occlusive events.
  • Head Injuries: Any trauma to the scalp, skull, or brain.
    • Effects: Concussion, skull fracture, contusion, delayed edema, CSF leak, extradural (epidural), subdural, intracerebral hematoma, scarring, shrinking, epilepsy.
  • Degenerative Diseases: Alzheimer's disease, Parkinsonism, prion diseases, others.
  • Classification, causes and clinical manifestations of major types of brain tumours and a brief description of WHO classifications.
    • Glioma (Astrocytoma, Oligodendroglioma, Ependymoma, Mixed)
    • Meningioma
    • Medulloblastoma
    • Peripheral Nerve Sheath Tumors (Schwannoma)
  • Neurofibromatosis - A genetic disorder affecting the nervous system resulting in the growth of tumors on nerves.
  • Neurological conditions are also investigated.
  • Neural Tube Defects: Characterized by failure of neural tube closure, resulting in defects that can involve the vertebrae, skull, meninges, spinal cord, or brain; linked with maternal folic acid deficiency.
  • Spina bifida occulta: No clinically apparent abnormalities; often limited to one or two vertebrae.

Diagnosis and Management

  • Biopsy (rare)
  • Blood culture
  • Chest X-ray
  • CSF examination (cell count, glucose, protein)
  • CT scan of the head
  • Gram stain, other special stains, and culture of CSF
  • Polymerase chain reaction (PCR) of CSF

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Description

Test your knowledge on the types of meningitis and encephalitis, their causes, symptoms, and complications. This quiz covers viral and bacterial forms, diagnostic procedures, and key pathological findings. Perfect for students studying neurology or infectious diseases.

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