Case Study 1 (NO HISTO)

What does SOAP stand for?

Subjective, objective, assessment, plan

What is the subjective of SOAP?

History, presenting complaint, signalment of patient

What is the objective of SOAP?

Clinical signs from physical exam

What is nystagmus?

Involuntary lateral eye movements

What is ipsilateral ataxia?

Wobbliness on one side

What is pytalism?

Excessive salivation

What is lateral recumbency?

Lying on side

What is dysphagia?

Difficulty swallowing

What is tachycardia?

Increased heart rate

Where are the two locations you can perform a CSF tap?

Cerebellomedullary cistern and lumbar cistern

Where is CSF located?

Subarachnoid space

Where is CSF produced?

Choroid plexus in lateral ventricle

What is the flow of CSF, starting where it is produced?

Choroid plexus → lateral ventricle → interventricular foramen → third ventricle → cerebral aqueduct → fourth venticle → lateral aperture → subarachnoid space → venous return

What type of fluid is CSF?

Acellular

What happens to the blood-brain barrier during inflammation/infection?

Break in tight junctions btw. ependymal cells

What is the tighest endothelium in the body?

Blood-brain barrier

What types of molecules can cross the blood-brain barrier?

Lipophilic, small, positively-charged molecules

What is the accumulation of inflammatory cells around a blood vessel?

Perivascular cuffing

How does Listeria monocytogenes get into the brain after ingestion?

Ascends trigeminal nerve

Does Listeria monocytogenes have zoonotic potential?

Yes

What is the Gram and shape of Listeria monocytogenes?

Gram-positive, coccobacillus

Where is Listeria monocytogenes often found?

Soil

What is a concern with pregnant women eating deli meat?

Listeria monocytogenes thrives in refrigerators

What are the round inclusions within the cytoplasm of nerve cells in animals with rabies?

Negri bodies

What are some confirmatory tests you can run for rabies?

• Direct fluorescent antibody (DFA) of brain stem/cerebellum

• IHC

• Saliva, spinal fluid, skin biopsies

What is polioencephalomalacia?

Necrosis of gray matter

What are two causes of polioencephalomalacia?

Thiamine deficiency and excess sulfur intake

How does excess sulfur intake cause a thiamine deficiency?

Binds to thiamine

What is another name for polioencephalomalacia?

Cerebrocortical necrosis

What is a common parasite of cervids?

Parelaphostrongylus tenuis

How does P. tenuis travel?

Spinal nerves

Where does P. tenuis reside?

Subdural space

What is the giant parasite that is found in the placentas of sperm whales?

Placentonema gigantissima

What is the roundworm commonly found in raccoons?

Baylisascaris procyonis

What is a paratenic host?

Carries a parasite to a new host but doesn't allow the parasite to develop or multiply within itself

What is the infection caused by roundworms of Baylisascaris procyonis?

Visceral larval migrans

What is the term for brain inflammation caused by larval migrans?

Eosinophilic meningoencephalitis

How can you identify ocular migrans?

Fundic exam

How can you identify neural or renal migrans?

Histopathology