Bacteria caused by these conditions are the only apparent predecessors to meningitis
Pneumonia and Endocarditis
T/F: Meningitis is always cerebrospinal.
True
Reaction of the CNS to bacteria
1) hyperemia of the meningeal venues and capillaries with increased permeability
2) Exudation of protein with migration of neutrophils into the pia and subarachnoid space
When does the cellular exudate becomes organised into two layers?
2 weeks
4th most common type of nonsurgical bacterial meningitis in Adults
L. monocytogenes
Seizures are encountered most often with this type of meningitis
H. influenzae meningitis
Most usual pathogen in recurrent bacterial meningitis
S. pneumoniae
T/F: Viral meningitis is far more common than bacterial meningitis
True
It is characterised by recurrent meningitis with iridocyclitis and depigmentation of nails and skin
Koyanagi-Harada Syndrome
T/F: The use of corticosteroids in bacterial meningitis was not found to affect mortality in children but reduces the incidence of sensorineural hearing loss and other neurologic sequelae especially in H. influenza meningitis.
True
The improvement after giving corticosteroids in adults with bacterial meningitis is sen largely among those infected with what organism?
Pneumococcus
Osler triad
pneumococcal meningitis, pneumonia, endocarditis
Treatment of choice in Listeria meningoencephalitis?
Ampicillin + Gentamicin
Treatment of choice in Melioidosis?
Intensive eradication with ceftazidime for 10-14 days followed by cotrimoxazole with or without doxycycline
Acute meningoencephalitis, papilledema and increased intracranial pressure attributable to ingestion of raw milk
Brucellosis
Most common incriminated organism in septic thrombophlebitis?
Streptococci and Staphylococci
The sinuses most frequently implicated in abscesses
Frontal and sphenoid
2/3 of abscesses originating in the ear lies in what part of the brain?
middle and inferior part of the temporal lobe
1/3 in the anterolateral part of the cerebellar hemisphere
T/F: In brain abscess, it is the subsequent evolution of the process that is dependent on the inherent tendency of the organism to be invasive.
True
How many % of cases of congenital heart disease are complicated by brain abscess?
5%
By far the most common congenital heart anomaly implicated in brain abscess?
Tetralogy of Fallot
Most frequent initial symptoms of intracranial abscess
Headache
T/F: The abscess capsule tends to be thinner on the side directed to the lateral ventricle.
True
This must be added as the 5th drug in case of INH and EMB-resistant organism
Ethionamide
It is the invariable accompaniment of all forms of neurosyphilis
Meningeal inflammation
T/F: Asymptomatic neurosyphilis can be recognised only by changes in the CSF.
True
Earliest change in the CSF of congenital neurosyphilis.
Pleocytosis and elevation of protein
When does the symptoms of meningeal syphilis usually occur?
Within the first two years
Most common form of neurosyphilis
Meningovascular syphilis
Severe and painful meningoradiculitis of the caudal equine in Lyme disease
Bannworth syndrome
T/F: In Cryptococcus meningitis, the administration of Amphothericin B intrathecally in addition to intravenous route appears not to be essential
True
Unlike any other rickettsioses, this is characterised with low-grade meningitis and not associated with an exanthem
Q fever
T/F: Treated mother with Toxoplasmosis can be assured that there is little carryover risk of producing a second infected infant.
True
More often characterized by chorioretinitis, hydrocephalus, microcephaly, cerebral calcifications and psychomotor retardation.
Congenital Toxoplasmosis
It is the most common cause of focal cerebral lesions in patients with AIDS
Acquired Toxoplasmosis
Cerebral malaria complicates 2% of cases of this malarial infection
Falciparum malaria
Characterised by winter bottom sign and Kerandal hyperaesthesia
Trypanosomiasis
Characterised by large fluid filled cyst and solid chitinoma
Hydatid disease (Echinococcus)
Usual trematode that infects the nervous system
Schistosoma japonicum
Type of schistosome infection which tends to localise in the spinal cord causing an acute or subacute myelitis that is concentrated in the conus medullaris
Schistosoma mansoni
Most common viral infection confined to meningeal cells
Enteroviruses
T/F: Mumps meningitis affects males 3x more frequently than females
True
T/F: Brachial neuritis may occur when parvovirus is contracted from the child by an adult.
True
It is by far the most common sporadic cause of encephalitis and has no seasonal or geographic predilection.
HSV
Most common cause of HSV Encephalitis
HSV-1
T/F: Status Epilepticus is rare in HSV Encephalitis.
True
Dose of Acyclovir in HSV Encephalitis
30 mg/kg/day x 10-14 days
This disease is distinguished with the presence of this cytoplasmic eosinophilic inclusions
Negri bodies
These are focal collections of microglia in Rabies
Babes nodules
Most common dermatome affected in Zoster
Thoracic dermatomes particularly T5-T10
Retrovirus that induce tropical spastic paraparesis
HTLV-I
Most common nonfocal neurologic complication of AIDS
CMV and Cryptococcus
This is the only clearly demonstrated mechanism of spread of the usual type of CJD
Iatrogenic
Most common isoform type of prions
MM1
This test is particularly useful in separating CJD from other non-inflammatory dementing disease
14-3-3 test
It is the most important test to establish the diagnosis of healthcare associated ventriculitis and meningitis
CSF cultures
Organisms associated with infection of pulse generators
S. aureus and propionibacterium acnes
T/F: Creutzfeldt-Jakob disease has a prdilection for both cerebral and cerebellar hemispheres.
True
The only clearly demonstrated mechanism of spread of the usual type of CJD
Iatrogenic
Most common type of CJD overall.
MM1
The pathologic changes in Fatal Insomnia, consisting of neuronal loss and gliosis, are found in which part of the brain?
Medial thalamic nuclei
Prion disease that is not found to be transmissible by inoculation of infected brain material.
Fatal insomnia
Most common cause of acute aseptic meningitis.
Enterovirus
T/F: Practically all cases of rabies are the result of transdermal viral inoculation.
True
Part of the CNS most usually involved in patients with rabies manifesting as hydrophobia and frothing of the mouth?
Tegmental medullary nuclei
The most common neurologic complication in the later stages of HIV infection.
AIDS dementia complex
What antiretroviral is purported to cause a myopathy similar to the inflammatory polymyositis caused by HIV?
Zidovudine
What is the most common focal infectious complication of AIDS?
Toxoplasmosis
The most frequent fungal complications of HIV infection
Cryptococcal meningitis and solitary cryptococcoma
Most commonly involved nerve in neurosarcoidosis
Cranial Nerve 7
First line ideal treatment in the first stage of borreliosis?
Doxycycline
First line ideal treatment in the later stage of Borreliosis.
Ceftriaxone
The most common cause of brain abscess in immunovompetent patients
Anaerobic bacteria
Probably the most frequent initial symptom of intracranial abscess
Headache
T/F: the temporal lobe lesions in HSV encephalitis are usually bilateral but not symmetrical.
True
The most frequent neurologic manifestation of poliovirus infection.
Aseptic meningitis
Most frequent presentation of neurocystocercosis
Seizure
Most commonly affected cranial nerve in tuberculous meningitis
Abducens nerve
Most vulnerable nerve affected following extensive sensory loss in leprosy.
Ulnar nerve
It is by far the most common sporadic cause of encephalitis and has no seasonal or geographic predilection.
HSV
Most common cause of bacterial meningitis in a 40 year old man two days after undergoing ventriculostomy.
Staphylococcus aureus
History of splenectomy-haemophilus influenza type b
History of ethanol abuse-acinetobacter
History of heart implantation-Listeria monocytogenes
Immunocompetent adult-streptococcus pneumoniae
T/F: Postherpetic neuralgia follows shingles in 5-10% of patients but occurs almost 3x more often among individuals older than 60 years.
True
Antibiotic added as a 5th drug in countries with high rates of resistance to INH.
Ethionamide
Cerebral malaria complicates how many percent of falciparum malaria
2%
Seizures are encountered most often in meningitis involving this organism
H. influenza
Most common manifestation of tubrrculous meningitis
Stiff neck
Probably the most frequent opportunistic fungus infection
Candidiasis
T/F: Aspergillosis does not present as meningitis but as infectious vasculitis.
True
Latency period of SSPE
6-8 years
In the early stages of subacute sclerosing panencephalitis, demyelination starts in this lobe.
Occipital lobe
Most common congenital CNS infection
Congenital CMV
Blueberry muffin baby
Congenital rubella syndrome
Most common pathogen of cranial epidural abscess
Staphylococcus aureus
The most common agent believed to cause benign recurrent lymphocytic meningitis
Herpes simplex type 2
Most common nonepidemic viral cause of viral encephalitis
HSV-1
Distinguishing feature of AIDP from idiopathic GBS?
Lymphocytic pleocytosis
Most frequent primary cause of meningitis in AIDS patients
Cryptococcus
Most common cause of aseptic meningitis
Coxsackie virus, echovirus
Most common virus associated with neonatal herpes encephalitis
HSV-2
Isolated from the CSF of patients with recurrent bouts of benign aseptic meningitis (mollaret meningitis)
HSV-1
Botulinum toxin most commonly involved in botulinism
BTX A
Most common complication of AIDS
HIV-associated sensory neuropathy
Most common cause of subdural empyema
Sinusitis
Common feature of the TORCH infections
Chorioretinitis
Most common complication of acute bacterial meningitis
Sensorineural hearing loss
By far the most common anomaly implicated in brain abscess
Tetralogy of fallot
Type of edema in the surrounding white matter of a brain abscess
Interstitial edema
Most frequent complaint in brain abscess
Headache
The most frequent sign of neurocysticercosis
Seizure
Durck nodes are associated with which CNS infection?
Malaria
Primary CNS Lymphoma can be differentiated in immunosuppressed and immunocompetent host by which characteristic?
Association with Epstein Barr virus
Brudzinski and Kernig’s signs are reflective of flexor protective reflex known as
Fulton’s nocifensive response
Calcifications are widely distributed in this TORCH infection
Toxoplasmosis
Cardiac lesions are only present in this TORCH infection
Rubella