10-15 L1 Neurological infections

Question 1

What is the triad for symptoms of bacterial meningitis?

Answer 1

• Headache or mental status change
• Nuchal rigidity
• Fever

Question 2

What is does are the micro-organisms that are targeted by treatment plan A+?

Whatsmakes up treatment plan A+?

Answer 2

• Organisms:
  
  • Stretpococcus pneumoniae
  • Neisseria meningitides
  • Group B strep
  • Listeria monocytogenes
• Treatment:
  
  • start IV ampicillin, ceftriaxone. vancomyicn, dexamethasone
  • draw blood cultures, CBC and renal profile
  • CT head and if no masses, get CSF (lumbar puncture)

Question 3

What is does are the micro-organisms that are targeted by treatment plan A?

Whatsmakes up treatment plan A?

Answer 3

• Orgnaisms:
  
  • Streptococcus pneumonia
  • Neisseria meningitides
• Treatment:
  
  • IV ceftriaxone, vancomycin, dexamethasone
  • Blood cultuers, CBC and renal profile
  • CT (if no head masses) get CSF (lumbar puncture)

Question 4

What is does are the micro-organisms that are targeted by treatment plan B?

Whatsmakes up treatment plan B?

Answer 4

• Organisms:
  
  • Staph aureus (MRSA)
  • Psudeomonas aeruginosa
  • Listeria
  • Group B strep
• Treatment:
  
  • Start IV ampicilin, vancomycin, ceftazidime
  • Draw blood cultures,CBC and renal proflile
  • CT head and if no mases CSF (lumbar puncture)

Question 5

Whats the Differnece in Bacterial meningitis and Viral meningitis?

Answer 5

• Bacterial meningitis
  
  • 100-100k PMNs
  • Glucose
  • Protein almost always elevated
  • CSF pressure almost always elevated
• Viral meningitis
  
  • 25-500 cells (mixed)
  • Glucose normal
  • Protein normal or slightly elevated
  • CSF pressure normal or elevated

Question 6

Viral encephalitis

• What is are the symptoms?
• Most common cause?
• Where is the viruse harbored
• What do you use to diagnosis?
• How do you treat it?

Answer 6

• Headache & fever
• HSV
• Harbored: in olfactory ganglion cells
  
  • infrior frontal lobes
  • Mesial temporal lobes
• confirmatino by PCr, not biopsy
• IV acyclovir (high dose: 30 mg/kg/day:14 days)
  *

Question 7

What are the three things you need to diagnose Neurosyphilis?

How do you treat neurosyphilis?

Answer 7

• Diagnosis
  
  • Clinical pictures
  • FTA +
  • Inflammatory CSF
• Treatment
  
  • Parenteral Penicillin G(14 days +)

Question 8

What patient population would you find PML (progressive multifocal leukoencephalopathy)? (be specific)

Answer 8

• Occcurs only in Immunosuppresed pts
  
  • 80% cases in AIDS patients
  • Hemtological malignangics, transplant pts or MS pts.