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3 Neurology > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

untreated CNS infection can cause

A

brain herniation
cord compression and necrosis
paralysis

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2
Q

when the brain parenchyma is inflamed it is called…

A

encephalitis

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3
Q

viral meningitis is an example of __ meningitis

A

aseptic

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4
Q

a brain abscess means there is…

A

acute, focal pus-forming area of the brain that is infected

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5
Q

a brain abscess will present with what kinds of symptoms

A

focal, stroke-like symptoms

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6
Q

meningitis from pus forming cells is called…

A

pyogenic meningitis

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7
Q

what does pyogenic meningitis look like microscopically?

A

neutrophils in SA space

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8
Q

where is the pus in pyogenic meningitis?

A

layer over the leptomeninges on the surface of the brain

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9
Q

main bacterial causes of meningitis

A

pneumococcus
meningococcus
listeria rarely

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10
Q

who could get listeria meningitis?

A

> 60s

immunosuppressed people

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11
Q

Tx of CABM (community acquired)

A

ceftriaxone iV + dexamethasone IV

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12
Q

gram +ve diplococci in a suspected meningitis patient…

A

strep pneumoniae

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13
Q

gram +ve bacillus in an old person with suspected meningitis…

A

listeria monocytogenes

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14
Q

what viruses are the main cause of viral meningitis?

A

enteroviruses

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15
Q

Hx questions for viral meningitis

A

recent travel

onset of symptoms (late summer/autumn)

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16
Q

Ix for viral meningitis

A

stool culture
throat swab
CSF PCR

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17
Q

Tx for viral meningitis

A

supportive

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18
Q

main symptom difference between encephalitis and meningitis?

A

in encephalitis you get very confused as you have cerebral cortex disturbance

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19
Q

insidious onset of symptoms, stupor, coma, severe confusion and partial paralysis…..

A

encephalitis

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20
Q

Ix for encephalitis

A

lumbar puncture
EEG
MRI

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21
Q

what virus is the most likely cause in a patient with encephalitis?

A

herpes simplex

22
Q

Tx of viral encephalitis

A

ACICLOVIR IV

23
Q

Hx q’s for suspected enceph?

A 
recent flu-like illness
new seizures
altered behaviour/cognition?
rash?
family ill?
travel?
immunocompromised?
24
Q

main symptoms of CABM

A

headache
fever
neck stiffness
mental state change

25
Q

commonest CABM bacteria in teens

A

neisseria

26
Q

commonest CABM bacteria in neonates

A

listeria, group B strep, e. coli

27
Q

commonest CABM bacteria in adults

A

strep pneumoniae

28
Q

risk factors for CABM

A

immunocompromisation

head trauma/neurosurgery

29
Q

complications of CABM

A

purulence
verebral oedema
hydrocephalus

30
Q

pathophysiology of CABM

A

nasopharyngeal colonisation or
extension of bacteria via sinuses/fractures/blood or
from far away infection eg UTI

31
Q

WCC is usually over ___ in CABM

A

2000

32
Q

what white cells are most present in CAB

A

neutrophils

33
Q

protein should be __ and glucose should be __ in CAB

A

high

low (bacteria eating it)

34
Q

in viral meningitis glucose is ___

A

normal

35
Q

do PCR to check for what viruses in a suspected encephalitis?

A

HSV1 + 2
enteroviruses
VZV

36
Q

non blanching purpura is a sign of…

A

meningococcal septicaemia

NOT MENINGITIS

37
Q

most common type of meningitis in kids under 4

A

HiB

38
Q

what co-morbs are associated with strep pneumo meningitis?

A

alcohol addiction
diabetes
skull fractures

39
Q

how is listeria spread?

A

via blood

40
Q

antibiotic for listeria monocytogenes?

A

IV ampicillin/amoxicillin

NOT CEFTRIAXONE

41
Q

if you have a risk factor for listeria but have strep pneumoniae meningitis what should be given

A

ceftriaxone AND amoxicillin to cover potential listeria

42
Q

HIV patient with a CD4+ level under 100 who has meningitis could have what bacteria?

A

cryptococcus

43
Q

low glucose, high protein and high neutrophils always means CABM T or F

A

F, can be a false-positive

44
Q

non-infectious causes of aseptic meningitis?

A

sarcoid
migraine
vasculitis
drugs eg co-trimoxaole, NSAIDs

45
Q

if a patient has strep pneumo what drug should you give along with an antibiotic and why

A

steroid eg dexamethasone as it calms down the immune response

46
Q

pen allergic antibiotic for CABM?

A

chloramphenicol IV

47
Q

1st steps in treatment for bacterial meningitis (ABCDE is fine)

A

blood cultures and coag screen
give treatment
take a throat and skin (if applicable) swab

48
Q

main Ix for meningitis

A

lumbar puncture!!

do CT first if seizures/signs of SOL/immunocompromised

49
Q

dose and freq for ceftriaxone?

A

2g bd

50
Q

dose and freq for amoxicillin

A

2g qds

51
Q

in viral meningitis the main white cells are..

A

lymphocytes

3 Neurology (41 decks)

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