Neuro Infections
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Questions and Answers

Infection in which areas can eventually cause erosion of the skull bone? (Select all that apply)

  • Sinuses (correct)
  • Mastoid air spaces (correct)
  • Nasal cavity
  • Oral cavity

    • What do most CNS infections result from?

  • Passage of pathogens across the blood-brain barrier (correct)
  • Direct contact with contaminated surfaces
  • Airborne transmission of viruses
  • Injections from unsterilized needles

    • Which of the following pathogens are involved in meningitis in newborns and are acquired through the birthing process?

  • Group B streptococci (correct)
  • E. coli (correct)
  • Listeria monocytogenes
  • Staphylococcus aureus

    • What do H. influenzae, N. meningitidis, S. pneumoniae, L. monocytogenes, and Staphylococcus have in common?

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

    Which of the following are the most common viral causes of acute CNS infections? (Select all that apply)

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

    Which of the following are deep fungal mycoses?

    <p>Cryptococcus neoformans</p> Signup and view all the answers

    Which of the following common routes of infection corresponds to the description: infection of mononuclear phagocytic system cells?

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

    Which of the following routes of infection have the following description:

    -from complications of other infections such as: • Pneumonia • Pharyngitis • Skin abscesses • Infectious endocarditis?

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

    What are the least common routes to the CNS?

    <p>Intraneural pathways</p> Signup and view all the answers

    Which of the following viruses can infect the intraneural pathway?

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

    Antibiotic therapy is effective in tetanus and botulism infections once the exotoxin has been produced.

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

    Bacterial and fungal infections require prompt and aggressive treatment.

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

    What does treatment of a viral infection mostly consist of?

    <p>Supportive care</p> Signup and view all the answers

    Which bacteria causes infection that requires longer treatment?

    <p>M. tuberculosis</p> Signup and view all the answers

    Match each word to its definition

    <p>Meningitis = Infection of the meninges, membranes that surround brain and spinal cord Encephalitis = Infection of brain itself Myelitis = inflammation of spinal cord Encephalmyelitis = both brain and spinal cord are involved</p> Signup and view all the answers

    Match each hallmark sign to encephalitis or meningitis

    <p>Meningitis = Sudden fever; Severe headache; Nausea/vomiting ; Double vision Encephalitis = Fever ; Seizures ; Change in behavior Meningitis = Drowsiness ; Sensitivity to bright light ; Stiff neck Encephalitis = Confusion; Disorientation</p> Signup and view all the answers

    Which type of meningitis do the following symptoms belong to:

    -Brain damage • Hearing loss • Learning disability

    <p>Bacterial meningitis</p> Signup and view all the answers

    Which type of meningitis has more severe symptoms?

    <p>Bacterial meningitis</p> Signup and view all the answers

    What are 90% of viral meningitis cases caused by?

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

    Which type of meningitis do the following symptoms apply to? - Decreased appetite, Fever, Headaches, Lethargy, Light sensitivity, Nausea and vomiting, Seizures, Sleepiness, Stiff neck.

    <p>Viral Meningitis</p> Signup and view all the answers

    What is the most common form of arbovirus encephalitis?

    <p>St. Louis encephalitis</p> Signup and view all the answers

    What organisms can West Nile Virus affect? (Select all that apply)

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

    What are most human infections of West Nile Virus classified as?

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

    Which population can West Nile Virus lead to rapid death in?

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

    What is the most common cause of bacterial meningitis in the US?

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

    Streptococcus pneumoniae is capnophilic (CO2 loving).

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

    What is Strep pneumoniae treated with?

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

    What is the treatment for Strep pneumonia if the strain is Ceftriaxone resistant?

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

    What is group B strep?

    <p>Strep. agalactiae</p> Signup and view all the answers

    What does Strep. agalactiae (Group B Strep) form on blood agar?

    <p>Glistening gray colonies with a slim zone of beta hemolysis</p> Signup and view all the answers

    Strep. agalactiae is encapsulated.

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

    What is the treatment for Strep. agalactiae (group B strep)?

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

    Which of the following bacteria is described below:

    -Small, facultative anaerobe, pleomorphic, capnophilic, gram negative coccobacillus?

    <p>Haemophilus influenzae</p> Signup and view all the answers

    What is the treatment for Haemophilus influenzae?

    <p>Ceftriaxone + corticosteroids</p> Signup and view all the answers

    Haemophilus influenzae can be encapsulated (typable) or unencapsulated (non-typable)

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

    What influenza serotype does the vaccine target?

    <p>Serotype B</p> Signup and view all the answers

    How many serotypes does influenza have?

    <p>6</p> Signup and view all the answers

    What is the purified polyribosylribitol phosphate (PRP) conjugated to?

    <p>non-toxic diphtheria toxin CRM197, tetanus toxoid, or meningococcal outer membrane protein</p> Signup and view all the answers

    Which of the following is described below:

    • Small gram-negative diplococci
    • Latex agglutination (latex particles are coated with specific antigen) and coagglutination are rapid serologic tests?

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

    What causes the meningitis rash associated with Neisseria?

    <p>Bleeding under the skin</p> Signup and view all the answers

    What can develop after Neisserial disease has progressed to the blood?

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

    How is Neisseria transmitted?

    <p>person to person droplet</p> Signup and view all the answers

    What can appear in the late stages of a Neisseria infection?

    <p>Dark purple rash</p> Signup and view all the answers

    What are the treatments for nasal carriage of Neisseria? (Select all that apply)

    <p>Rifampin, ciprofloxacin, ceftriaxone</p> Signup and view all the answers

    What is the treatment for meningitis caused by Neisseria?

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

    What is the 3rd most common cause of bacterial meningitis in adults?

    <p>Listeria monocytogenes</p> Signup and view all the answers

    Which of the following is described below:

    • gram positive bacillus
    • beta hemolytic
    • resistant to cephalosporins?

    <p>Listeria monocytogenes</p> Signup and view all the answers

    What is used to treat Listeria monocytogenes?

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

    Which bacteria can invade microvascular endothelial cells?

    <p>E. coli</p> Signup and view all the answers

    What is used to treat meningitis in newborns caused by E. coli?

    <p>3rd generation cephalosporin plus aminoglycoside</p> Signup and view all the answers

    Which population is bacterial meningitis due to TB (Mycobacterium tuberculosis) associated with?

    <p>AIDS patients</p> Signup and view all the answers

    What does TB infection of the brain cause?

    <p>Rich foci</p> Signup and view all the answers

    What causes tetanus?

    <p>Clostridium tetani</p> Signup and view all the answers

    Which of the following bacteria is described below:

    • Gram-positive
    • Anaerobic
    • Rod shaped
    • Produces a terminal spore
    • Neurogenic toxin?

    <p>Clostridium tetani</p> Signup and view all the answers

    Where are clostridium spores usually found?

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

    How are tetanus neurotoxins transported to the spinal cord?

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

    What does Tetanus Neurotoxin block the release of?

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

    What does Tetanus produce?

    <p>spastic paralysis.</p> Signup and view all the answers

    The shorter the incubation for tetanus, the less severe the symptoms.

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

    What is the first muscle usually affected by tetanus?

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

    What is another differential symptom of tetanus?

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

    What is used in tetanus treatment?

    <p>Tetanus immunoglobulins</p> Signup and view all the answers

    What are other supportive measures taken in tetanus infection?

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

    What state do C. botulism spores convert to prior to producing toxin?

    <p>Vegetative state</p> Signup and view all the answers

    Where is botulism usually seen?

    <p>Home canning</p> Signup and view all the answers

    What does botulism pathogenesis begin with?

    <p>Cranial nerve palsy</p> Signup and view all the answers

    Botulism has obvious signs of infection such as fever and inflammation.

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

    Where is botulism toxin directly absorbed?

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

    Which neurotransmitter does botulism block?

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

    Botulism leads to symmetrical paralysis that begins with the ocular, laryngeal, and respiratory muscles.

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

    What is the most serious complication of botulism?

    <p>Complete respiratory paralysis</p> Signup and view all the answers

    What age group is most at risk for botulism infection?

    <p>Infants between 3 weeks and 8 months old</p> Signup and view all the answers

    The risk of paralysis with polio decreases with age.

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

    What kind of virus is the polio virus?

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

    Match each polio pathogenesis to its description

    <h1>Abortive poliomyelitis: = Nonspecific febrile illness; Lasts two to three days; No signs or symptoms Nonparalytic poliomyelitis (aseptic meningitis): = Characterized by meningeal irritation, stiff neck, back pain, and back stiffness; Rapid and complete recovery Paralytic poliomyelitis: = Occurs in 2% of persons infected; Characterized by asymmetric flaccid paralysis •Extent varies from case to case; Temporarily damaged neurons can regain function; Recovery can take six months; Paralysis persisting after this period is permanent</h1> Signup and view all the answers

    Which viral infection has a 90% mortality rate?

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

    Which of the following causes these symptoms:

    • Relentless progression of excess motor activity
    • Agitation
    • Hallucinations
    • Overproduction of saliva
    • Inability to swallow?

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

    What two forms does rabies exist in?

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

    Which rabies form is associated with unimmunized dogs and cats?

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

    Which rabies form is seen in wild animals?

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

    Rabies infections in humans are incidental.

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

    Which virus family are the following associated with: West Nile Virus, Japanese encephalitis virus, St. Louis encephalitis virus, Zika virus, Yellow fever virus?

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

    Which viral family are the following associated with: Eastern equine encephalitis (EEE) virus, Venezuelan equine encephalitis (VEE), Chikungunya virus?

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

    Match each arbovirus to its description, clinical manifestations and neurological complications

    <p>Chikungunya = Aedes aegypti and Aedes albopictus mosquitos Humans are primary reservoir – some primates in Africa Asia, Africa, Europe and Americas Zika = Aedes aegypti and Aedes albopictus mosquitos Non-human primates are reservoir Mainly in South America Chikungunya = Clinical:Chronic inflammatory rheumatism; complications:Guillain-Barre syndrome Encephalitis Myelopathy Myopathy Polyneuropathy Optic neuritis Retinitis Zika = Clinical:Non-purulent conjunctivitis Congenital microecephaly; complications:Guillain-Barre syndrome Transverse myelitis Meningoencephalitis Sensory neuropathy Cerebrovascular complications Retinitis Optic neuritis</p> Signup and view all the answers

    Match each arbovirus to its description

    <p>Dengue = Aedes aegypti and Aedes albopictus mosquitos Humans and mosquitos are reservoirs Americas, Africa, Middle East, Pacific Islands West Nile Virus = Culex mosquitoes C. tarsalis is vector in USA Birds are the reservoir Dengue = Clinical:Severe myalgias, arthralgias (breakbone fever) Hemorrhagic fever Shock syndrome; complications:Meningoencephalitis Stroke Transverse myelitis Myositis Retinal vasculopathy Optic neuropathy Hypokalemic paralysis West Nile Virus = Clinical:Acute flaccid paralysis Autonomic instability Movement disorders; complications:Encephalitis Meningitis Poliomyelitis Seizures Parkinsonism Optic neuritis Retinal vasculitis</p> Signup and view all the answers

    What do HIV-AIDS dementia complexes (which occur in asymptomatic AIDS patients) lead to?

    <p>Mild to severe progressive dementia</p> Signup and view all the answers

    Which ganglia can reactivate HSV-1?

    <p>Trigeminal ganglia</p> Signup and view all the answers

    What is the most frequent prenatal infection?

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

    Which respiratory tract virus is associated with serious sequela and death in extra respiratory complications?

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

    Which virus is associated with Reye syndrome?

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

    Which of the following are paramyxoviruses? (Select all that apply)

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

    Which viral infection is associated with asymptomatic pleocytosis of CSF?

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

    Which viral infection is associated with Subacute sclerosing panencephalitis?

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

    Which of the following endemic mycoses has the listed symptoms: headache, altered mental status, nausea, and vomiting?

    <p>Coccidioides immitis</p> Signup and view all the answers

    Which endemic mycosis has the following symptoms: fever, headaches, lethargy, altered mental status, weakness, hydrocephalus, and focal neurological deficits that resemble cerebrovascular accidents (stroke)?

    <p>Histoplasma capsulatum</p> Signup and view all the answers

    What is the most important fungal central nervous system (CNS) infection?

    <p>Cryptococcus neoformans</p> Signup and view all the answers

    Which fungus is found throughout the world in soil contaminated with bird droppings?

    <p>Cryptococcus neoformans</p> Signup and view all the answers

    Which fungal infection has the following characteristics:

    • Capsule is anti-phagocytic
    • Can bind to complement components
    • Reduces opsonization
    • Can interfere with the presentation of antigens to T cells
    • Inhibits the adaptive immune response?

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

    Which fungal infection has the following symptoms in later stages: Seizures, cranial nerve damage, and papilledema (edema of the optic nerve), dementia, and decreased levels of consciousness?

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

    Where do most Acanthamoeba infections occur?

    <p>Southeastern US</p> Signup and view all the answers

    Which of the following is found in the oropharynx of asymptomatic humans?

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

    How does Naegleria enter the CNS?

    <p>Traversing the nasal mucosa and cribriform plate</p> Signup and view all the answers

    What does Naegleria produce in the CNS?

    <p>Purulent, hemorrhagic inflammatory reaction</p> Signup and view all the answers

    Which infectious species causes severe bifrontal headache and seizures?

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

    What does an Amebic Meningoencephalitis infection produce?

    <p>necrotizing granulomatous encephalitis</p> Signup and view all the answers

    Which Plasmodium species is associated with seizures in children and neurological complications like Guillain-Barre Syndrome (GBS) and cerebellar ataxia?

    <p>P. vivax</p> Signup and view all the answers

    Which tapeworm is the cause of epileptic seizures?

    <p>Taenia solium</p> Signup and view all the answers

    Match each stage of neurocysticercosis with its definition:

    <p>noncystic = invasion of tissue of the larva, asymptomatic vesicular = cyst develops, usually asymptomatic colloidal vesicular = cyst filled with clear liquid and has thin wall, opaque – usually asymptomatic granular nodular = cyst transforms into granulomatous nodular lesion</p> Signup and view all the answers

    Which stage of neurocysticercosis is usually asymptomatic but can cause epilepsy in many patients?

    <p>Calcified nodular</p> Signup and view all the answers

    What is the most common cause of brain mass lesions in HIV patients?

    <p>Toxoplasma encephalitis</p> Signup and view all the answers

    What causes African sleeping sickness?

    <p>Trypanosoma spp.</p> Signup and view all the answers

    What organism transmits Trypanosoma spp.?

    <p>Tsetse flies</p> Signup and view all the answers

    Who is at risk for Trypanosoma spp. infection? (Select all that apply)

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

    What can be used to treat Trypanosoma infection?

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

    Which parasites cause Trypanosoma?

    <p>T. brucei rhodesiense</p> Signup and view all the answers

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