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55 Cards in this Set
- Front
- Back
Inflammation of meningies and brain?
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meningoencephalitis
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Most common route of viral infection to brain? what others?
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Blood, then peripheral nerves, then olfactory nerve
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Target cells of viral encephalitis?
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neurons and oligodendroglia to cause demyelination
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Presentation of meningitis?
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stiff neck with headache
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Presentation of encephalitis?
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stick neck with headache AND altered state of consciousness
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What is unique about HSV encephalitis?
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It affects the temporal lobe and patient may present with hallucinations or bizzare behaviors
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What is the spectrum of conscienceness?
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pretains anywhere from lethargy to coma, depending on severity of encephalitis
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What is pleocytosis and how does it pertain to encephalopathy?
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it is elevated WBC in a body fluid. in this caes, pleocytosis in CSF with low/normal glucose indicates viral encephalitis
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Peripheral WBC counts with viral encephalitis?
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variable or normal
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mumps and measles peak during what season?
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winter and spring
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Arthropod borne encephalitis peaks when?
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summer, when ticks come out
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Rhabdovirus virion structure?
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bullet shaped, causes rabies; ss negative RNA
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Replication of rhabdovirus?
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like paramyxo (brings its own polymerase to synthesize mRNA in the cytoplasm)
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Rhabdovirus antigens?
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G(angster) spikes and nucleocapsid protein
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What does the nucleocapsid protein induce and what is this used for?
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complement fixation antibodies used for diagnosis, not protection
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inclusion bodies pathognomonic for rabies?
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Negri bodies
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What are negri bodies?
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aggregates of helical nucleocapsids
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Rhabdovirus: lysis or budding?
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budding bullets
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Mode of transmission for rhabdoviruses?
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bite of a dog
aerosol of a BAT |
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Why are rabies more common in males?
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because they are more likely to be exposed to it
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Vaccination rules for potential rabid bite?
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observe cat/dog for ten days. if no symptoms occur in the animal, then do not vaccinate
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What occurs during rhabdovirus incubation?
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viral replication at inoculation site, muscle, and connective tissue and migration into peripheral nerves
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How long is rhabdovirus incubation?
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18-60 days, up to a year or more even!
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Prodrome symptoms of rabies?
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nonspecific malaise/fever with pain/tingling at wound site
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What is the pain/tingling at wound site after rabies bite?
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arrival at the spinal ganglion
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When is rhabdovirus infection irreversible?
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when it finally reaches the spinal ganglion during prodrome
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What is hydrophobia?
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rabid, hyperactive patient has pharyngeal spasms when the patient swees water and has difficulty swallowing.
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What is dumb rabies?
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when rabid patient has no hyperactivity and only paralysis; coma and death occur
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Most common presentation of acute neurologic phase of rabies after prodrome?
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80% have periods of hyperactivity aka furious rabies where thrashing around with extreme agitation occur.
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Treatment of rabies?
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1) wound cleansing with 70% EtOH and debridement
2) HRIG (human rabies immunoglobulin) 5 doses over 4 weeks |
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The only vaccine that is effective post-exposure?
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HRIG
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Most common cause of sporadic encephalitis in US?
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HSV1 in adults
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Principal target of HSV1 encephalitis?
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temporal loves -- craziness + hallucinations!
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most common diagnostic tools for HSV encephalitis?
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CSF then EEG, then CT/MRI then biopsy
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Treatment of HSV?
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Acyclovir, but still has 40% mortality
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What disease commonly reaches the brain but doesn't always exhibit encephalopathy?
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Measles; 50% without CNS symptoms have abnormal EEGs
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How does measles cause CNS symptoms?
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direct damage during infection! think about it, CSF has not much immune response
Also post-infection encephalitis |
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What is the disease process of post-infection encephalitis?
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sensitization of the infected person to myelin; occurs with other infections too!
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What is subacute sclerosing panencephalitis?
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SSPE is caused by measles and super rare.
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Presentation of SSPE?
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insidious progressive behavrioral deterioration; potential myoclonic seizure
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Diagnosis of SSPE?
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EEG or Measles IgG in CSF
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How is SSPE caused?
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usually a child before 2 and it is caused by defective mutatns of measles virus arising in the brain; NOT transmitted.
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What causes transmissible spongiform encephalopathies?
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prions
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what is a prion?
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a normal host protein in an altered conformation that yields it resistant to proteases and has a tendency to form plaques
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Why is one prion so terrible?
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it is able to change normal copies of the same protein into the pathogenic conformation
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What gene is implicated in TSE?
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PrP gene
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Cannibals that eat brains get this
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Kuru - TSE and death within a year after a 30 year incubation period
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Kuru causes disease in what?
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brain and reticuloendothelial system
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Kuru-like disease with a more worldwide distribution?
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cruetzfeld-Jakob disease
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Kuru vs Creutzfeld-Jakob disease?
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CJD has a more worldwide distribution and only an incubation period of 18 months vs 30 years!
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What is an inherited form of Creuzfeld-Jakob?
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Gerstmann-Straussler-Scheinker Syndrome = the mutant form of prion protein is inherited
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What do you get from scraping wool off of fences?
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Scrapie! The disease of sheep that gives you CJ-like disease
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What is the medical term for mad cow disease?
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bovine spongiform encephalopathy
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What is Bovine Spongiform Encephalopathy?
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scrapie that transmitted to cattle
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Variant Creutz-Jakob Disease?
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linked to bovine spongiform encephalopathy but most people are under 45, which is younger than CJD
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