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2013-06-07 11:49:44
nervous system

chapter 19
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  1. bacterial diseases of the nervous system
    • meningococcal meningitis
    • haemophilus meningitis
    • botulism
    • tetanus
  2. meninges
    coverings of brain and spinal cord
  3. meningitis
    inflammation, fluid pressures brain and spinal cord
  4. What is the cause of meningococcal meningitis?
    • neisseria meningitidis
    • gram negative diplococci
    • pathogenic strain encapsulated
    • humans are natural carrier
  5. What is the pathology of meningococcal meningitis?
    • transmission- resp. droplets or close contact
    • lipid A of LPS in cell wall trigger fever, vasodilation, inflammation and shock, severe headache, light sensitivity, nauseau/vomiting, nuchal rigidity
  6. treatment for meningococcal meningitis?
    antibiotics; possibly IV
  7. vaccine for meningococcal meningitis?
    • acellular, LPS
    • recommended for age 11-18 and college students
  8. What is the cause of Haemophilus Meningitis?
    • haemophilus influenza type B, or HIB
    • gram negative bacillus
  9. vaccine for Haemophilus meningitis?
    • HiB vaccine
    • accellular
    • LPS
  10. Pathology for Haemophilus meningitis?
    • pneumonia, epiglottitis, otitis media
    • can cause meningitis
    • prior to 1980's was the most prevalent cause of meningitis in 3-18 month olds
  11. What is the cause of botulism?
    • intoxication (ingest toxins)
    • clostridium botulinum
    • gram + endospore forming bacillus
    • common in soil or water
    • anaerobic
    • botulism toxin (botox) - exotoxin, neurotoxin; blocks the release of ACH at the NMJ; results in flaccid paralysis
  12. source of botulism?
    foods that are improperly canned; must pressure can to kill spores
  13. pathology of botulism?
    • onset 1-2 days
    • starts in face and eventually diaphragm paralysis
  14. treatment for botulism?
    • antitoxin
    • antibody against botox
    • neutralizes toxin
  15. wound botulism
    colonizes wound and releases toxins
  16. infantile botulism
    spores in honey and corn syrup colonize GI tract
  17. prevention of botulism?
    • 20 min @ 80'C
    • 10 min @ 90'C
    • heat inactivates toxin
  18. cause of tetanus?
    • clostridium tetani
    • gram positive
    • anaerobic
    • spore forming bacillus
    • tetanospasmin - exotoxin - blocks release of inhibitory neurotransmitters, state of constant tetanus
  19. pathology of tetanus?
    • onset - hours to a week
    • lockjaw (trismus) one of first stages
    • opisthonus - fully contracted, back arched
  20. treatment for tetanus?
  21. vaccination for tetanus?
    • toxoid
    • inactivated toxin
    • DTaP
  22. viral causes of nervous system disease
    • rabies
    • polio
    • viral encephalitis
    • aseptic meningitis (non-bacterial)
  23. What is the cause of rabies?
    • rabies virus
    • rhabdoviridae
    • RNA virus
  24. transmission of rabies?
    • infected animal bite, scratches, and air
    • it's the saliva that is infected
  25. pathology of rabies
    • virus infects skeletal muscle
    • jumps NMJ to neuron and migrates up axon to CNS
  26. symptoms of rabies
    • first - pain, fever, malaise
    • then - seizures, disorientation, hallucinations, hydrophobia (very painful to swallow so resistant to drink), paralysis, and death
  27. treatment for rabies
    • post exposure - intramuscular IgG (anti rabies antibodies) and follow with rabies vaccine
    • pre exposure - vaccines
  28. cause of polio
    • polio virus
    • picornavirdae
    • 3 serotypes associated with disease
  29. transmission of polio
    ingest with fecal contaminated food and water (FCFW)
  30. symptoms of polio
    • asymptomatic (90%)
    • minor polio (5%) fever, sore throat, malaise
    • nonparalytic polio (2%) invade meninges & CNS; causes muscle spasms and back pain
    • paralytic polio (2%) invades spinal cord and motor cortex; paralysis is result; diaphragm may be paralyzed causing difficult respiration
  31. post polio syndrome
    • occurs 30-40 years after bout of polio
    • crippling degeneration of polio affected muscles
  32. vaccination for polio
    • trivalent - all 3 serotypes
    • salk vaccine (IPV) inactivated
    • Sabin vaccine (OPV) live attenuated, orally
  33. encephalitis
    • inflammation of brain
    • increased intracranial pressure
  34. viral encephalitis
    • cause:  multiple viruses including west nile virus (vector is mosquito and bird is the host)
    • symptoms:  most show no symptoms, some mild illness/symptoms w/ headache, body aches, skin rash, and swollen lymph nodes
    • a few people will develop encephalitis w/ sever headache, can be fatal
    • prevention:  clothing, drain all stagnant water, bug spray
  35. aseptic meningitis (non-bacterial)
    • cause:  many viruses
    • symptoms:  severe headache, low fever, nausea & vomiting, photosensitivity
    • few days to a week to recover
  36. fungal disease that affects CNS
  37. cryptococcosis
    • cause:  cryptococcus neoformans; grows in nitrogen rich bird droppings (pigeons)
    • transmission:  inhalation of spores
    • symptoms:  usually asymptomatic to a mild pneumonia; immunocompromised develop meningitis
    • treatment: antifungals 6-10 weeks
  38. protozoal disease nervous system
    • trypanosomiasis
    • primary amebic meningo encephalitis (PAM)
  39. trypanosomiasis
    • 2 forms- one of which is african sleeping sickness
    • cause:  trypanasoma brucei; T. rhodiense
    • vector:  tse tse fly
    • symptoms: headaches, fever, behaviroal changes, coma, meningoencephalitis
  40. primary amebic meningoencephalitis (PAM)
    • cause:  naegleria fowleria; live in warm waters, in the bottom (muck)
    • transmission: water up your nose, follws the olfactory tract to brain
    • symptoms: sudden onset of headache, fever, nausea, vomiting and stiff neck; rapidly progress to lethary, confusion, and coma