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Neurological System > 1-Microbiology > Flashcards

1-Microbiology Flashcards

1
Q

3 Mechanisms of Bacterial Meningitis?

A
  1. Infect cells lining barrier
  2. Passively transported across BBB
  3. Carried across in infected leukocytes
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2
Q

Major bugs involved in neonatal bacterial meningitis?

A

Strep B, Enterics (E.Coli), Listeria

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3
Q

Major bugs involved in bacterial meningitis in infants and children?

A

Strep Pneumo, Neisseria Meningitidis, H. Influenzae B(vaccine now)

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4
Q

Major Bug for Teens/Adults?

Elderly?

A

Teens/Adults: N. Meningitidis

Elderly: S. Pneumoniae

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5
Q

What is the most important virulence factor for the bacteria that commonly cause meningitis?

A

Capsule

N. Menin, H. Influenzae, S. Pneumo, Group B strep, E.Coli

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6
Q

Which bacteria should be suspected if there is a petechial skin rash?

A

Meningococcal Meningitis

Niesseria Type

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7
Q

What population types are at highest risk for Pneumo Meningitis?

A

Pediatrics, Immunocomprimised, Elderly, Sickle Cell

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8
Q

Discuss the proper dx techniques for Pneumococcal meningitis.

A

Culture, Gram Stain, Increased PMNs in CSF

Gram + Diplococci

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9
Q

What is the proper treatment for pneumococcal meningitis?

A

Combo therapies are the DOC.

Ceftriaxone + Ampicillin

Ceftriaxone + Vancomycin if prevalence is >2% in community

DONT USE FLOUROQUINOLONES in children

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10
Q

Discuss the dx info for niesserial meningitis?

A

Gram (-) diplococcus
Increased WBC
Culture

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11
Q

Which serotype of N. Meningitis is not protected against with the vaccine?

A

B

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12
Q

Discuss treatment options for Neisserial meningitis?

A

Ceftiraxone + Ampicillin

  • Give chloramphenicol to pts. who are allergic to penicillins
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13
Q

What type of prophylaxis should be given to the family members of pts. dx with niesserial meningitis?

A

2d of Rifampin prophylaxis to clear the nasopharyngeal carriage of the bug.

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14
Q

When is a H. Influenza B meningitis infection most likely seen?

A

In unvaccinated children. Will be cultured on chocolate agar with x-heme and NAD factors.

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15
Q

How should a H. Influenza B meningitis infection be treated?

A

DOC is Cephalosporins (Ceftriaxone)

RIfampin prophylaxis for family in contact

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16
Q

What is the most common way of transmitting neonatal meningitis?

A

Maternal vaginal tract where there is a rupture of membranes.

Group B strep = most common

Ecoli, Listeria

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17
Q

What are the key dx characteristics for groub B strep meningitis in neonates?

A 
Gram + cocci
B-Hemolytic on blood agar
Optochin/Bacitracin Resist.
CAMP positive
CSF Antigen
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18
Q

Describe treatment for Group B Strep

A

DOC is Penicillin G

- vanco for allergic patients.

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19
Q

Describe key dx information for E. Coli meningitis?

A

CSF culture - Gram (-) rods, MacConkey, Lactose fermenting, Indole +

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20
Q

Describe proper treatment for an E. Coli meningitis infection?

A

DOC - Ceftriaxone

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21
Q

Describe key dx information for Listeria causing meningitis?

A

Neonate late onset

Culture - gram (-) rods
but gram stain usually negative
COLD SELECTION!!

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22
Q

Proper course of treatment for Listeria?

A

Ampicillin is DOC

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23
Q

What are the to major neurotoxins discussed by keller?

A

Clostridia spp.

Botulinum/Tetani

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24
Q

Describe the dx. of C. botulinum?

A

Based on presentation usually

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25
Q

Treatment for C. Botulinum?

A

Antitoxin, Stomach lavage, DO NOT TREAT INFANT BOTULISM WITH ANTIBIOTICS

26
Q

Describe dx of C. Tetani?

A

Works via blocking glycine and GABA release, causes spasm and lock-jaw.

CSF usually normal

27
Q

Describe Treatment for C. Tetani?

A

Supportive care.
DOC - metronidazole
Tetanus Booster

28
Q

What is the meaning of Aseptic meningitis?

A

Caused by bacteria and viruses, but there is no evidence of bugs in the CSF

29
Q

Describe proper dx of neurosyphilis (aseptic meningitis?

A

+ VDRL in CSF
Increased WBC
Decreased Glucose
Increased Proteins

30
Q

Describe the best treatment for neurosyphilis?

A

High dose Penicillin G must be attained in the CSF.

31
Q

Describe proper dx of Lyme disease (b. bergdorferi)

A

Kernig and Brudzinski will be negative, because it is milder than typical meningitis.

Ab titer followed by immunoblot

History of tick bite

32
Q

Describe proper course of treatment for Lyme meningitis?

A

Ceftriaxone is DOC
maybe Penicillin G alternative

Most Treatments aren’t highly effective.

33
Q

Describe the proper dx. of Leptospira-caused aseptic meningitis.

A

aerobic, ice-tonge appearance on micro
animal handlers at risk
spirochete in blood culture.

34
Q

Discuss proper treatment for Leptospira Interrogans?

A

IV penicillins

  • G for severe
  • Ampicillin, amoxicillin, doxycycline for mild
35
Q

Describe proper dx. of M. Tuberculosis cuased aseptic meningitis.

A

Acid-Fast bacilli, Gram +
Pulmonary symptoms
PPD+
Release of IFN-gamma by lymphocytes.

36
Q

What is the proper course of treatment for aseptic meningitis caused by M. Tuberculosis? Why are these drugs all so successful?

A 
RIPES
Rifampin
Isonazid
Pyrazinamide
Ethambutol
Streptomycin

They are good because they readily enter CSF in the presence of meningeal inflammation.

37
Q

What does a tzank smear test for?

A

Herpetic viruses (VZV, HSV, CMV)

38
Q

Describe the most common CNS fungal infections/

A

Cryptococcus (non-invasive?)

Coccidioides, Histoplasma, Blastomyces

39
Q

Describe the common parasitic infections of the CNS (Protozoa and Metazoa)?

A

Protozoa - Amoeba, Malaria, Toxoplasma

Metazoa (worms) - Trichinella Spirals, Taenia Solium

40
Q

Describe the types of patients that will become infected by cryptococcus neoformans.

Proper DX?

A

Encapsulated yeast, found mainly in HIV/AIDS patients.

India Ink Staining, negative contrast.
Serology
Increase protein and WBCs in CSF

41
Q

Discuss treatment for Crytpococcus in Aids Patients.

A

Amphotericin B + Fluctosine for 4-6 weeks and

Fluconazole for LIFE

42
Q

Describe the likely infection if a patient presents with a immunocompromised patient with meningitis symptoms. CSF has increased proteins and WBCs and low glucose.

Serology KOH prep of tissue
Culture on sabouraud dextrose agar

A

Coccidioides Immitis

Treat with Amphotericin B and Fluconazole for lifetime

43
Q

Discuss dx and tx of Naegleria Fowleri?

A

Autopsy.. they die
CSF microscopy reveals trophozoites

Treat with Amphotericin B if you catch it in time…

44
Q

Discuss the dx and tx for malaria

A

Blood Smear - trophozoite(band) or gametocyte (round) under microscope

Treat with Chloroquine (DOC)

IV Quinine for severe cases

45
Q

Most common etiology for viral conjunctivitis?

A

Adenovirus

46
Q

What is the most common presentation for Toxoplasmosis

A

Encephalitis, parasitic
Most common cause of encephalitis in AIDS Patients
Dx - CT scan (ring enhancing lesions (Aids Pts.), serology

47
Q

Describe course of treatment for Toxoplasmosis

A

Sulfonamide+Primethimine

48
Q

Course of treatment for T. Brucei with CNS involvement?

A

Melarsoprol is DOC

49
Q

What is the most important eye infection worldwide?

A

Trachoma (adults) via Chlamydia Trachomatis.

50
Q

What are the differences in presntation and treatment of C. Trachomatis eye infections in adults vs. neonates?

A

Adults: Trachoma (A-C) - recurrent, causes blindness! Treat with PO azithromycin + topical doxycycline.

Neonates: conjunctivitis (D-K), treat with PO erythromycin

51
Q

Baby with conjunctivitis, Gram - diplococci, cultured on Thayer Martin Chocolate Agar!

A

Mommy had Gonorrhoeae

Severe neonatal conjunctivitis

Tx Penicillin G or Ceftriaxone if resistant

52
Q

Describe the clues for dx of HSV kerato conjunctivitis.

A

Multinucleated giant cells on tzank smear

53
Q

Describe treatment for HSV infections?

A

Acyclovoir is DOC

54
Q

Describe the dx clues for CMV

A

aids pt. or immunocomprimised
Decreased acuity/loss of visual fields
Histo - owl’s eye inclusions

55
Q

Describe tx for AIDS patient with CMV chorioretinitis?

A

IV foscarnet is DOC

non aids - IV ganciclovir

56
Q

Common fungal ocular infections in Northern states?

Southern states?

A

Northern - Candida and Aspergillus spp.

Southern - Fusarium

57
Q

Which are the notable filamentous fungi causing eye issues?

A

Fusarium(south) - satellite lesions and Aspergillus(north)

58
Q

What type of fungus is candida?

A

budding yeast with pseudohyphae and germ tubes

59
Q

What is the dx stuff and drug of choice for a Fusarium karatitis?

A

Dx - KOH prep, sabourad dextrose agar

Rx - Natamycin topical DOC

60
Q

Dx and Rx for candida albicans endopthalmitis?

A

Funduscopic exam

Rx- Amphotericin B then fluconazole

61
Q

What is the bug that causes neurocsticercosis?

A

Taenia Solium causing cysts in the eye.

62
Q

Treatment course for Taenia solium?

A

Surgical Removal of Cysts

Praziquantel or albendazole

Neurological System (10 decks)

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