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Micro. Semi. CNS - Marcador
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| 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 |
| 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) |
| 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) |
| 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 |
| 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 |
| Meningitis in newborns | Escherichia coli K1 Group B streptococci (Streptococcus agalctiae) Listeria monocytogenes Klebsiella pneumoniae |
| Meningitis in infants and little children | Group B streptococci (Streptococcus agalactiae) Neisseria meningitidis Haemophilus influenzae Streptococcus pneumoniae |
| Meningitis in children, teenagers and young adults | Viruses (Coxackie A & B, Echoviruses, Herpes viruses, mumps virus) Neisseria meningitidis Streptococcus pneumoniae |
| Meningitis in elderly people | Streptococcus pneumoniae Listeria monocytogenes Enterobacteriaceae Pseudomonas aeruginosa Acinetobacter baumannii |
| "Culture negative" meningitis (without paracites) | Mycobacterium tuberculosis Candida albicans Cryptococcus neoformans Aspergillus Mucor Treponema pallidum Borrelia burgdorferi Leptospira interrogans Rickettsia rickettsiae Rickettsia prowazeki Coxiella burnetii Chlamydia psittaci Mycoplasma pneumoniae |
| "Culture negative" meningitis (only paracites) | Toxoplasma gondii Plasmodium falciparum Naegleria fowlerii |
| Nosocomial meningitis | Staphylococcus aureus Staphylococcus epidermidis Gram-negative rods (Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter baumannii) Enterococcus spp. Candida spp |
| What are the basic specimens for bacteriological diagnostics in CNS infection? | Cerebrospinal fluid Blood (in 50-70% meningitis cases pathogen can be isolated from blood) |
| What are the additional specimens (depending on the case) for CNS infection | Skin rash scrapings (for Neisseria meningitidis ) Materials from a primal focus of infection (ear swab, sputum, urine, wound swab) Nasopharyngeal swab (for carriage detection) Swab of vagina (for colonization detection) |
| How do we collect CSF? | Cerebrospinal fluid is collected aseptically from lumbar puncture. After proper antiseptic treatment of skin in lumbar area, the CSF sample is collected to sterile tubes preheated to 37°C. One part of CSF should be sent for direct microscopy. CSF should be sent immediately to the lab (in time no longer than 15 min in 37°C). In case of prolongation of transport (in 2h) temperature 37°C should be kept and never lowered under 30°C. For bacteriological culture, CSF should be also additionally added to a transport medium (preheated to 37°C) and sent in 37°C. |