27 Clinical: CNS Infections Flashcards
1
Q
Label Each color as either
- Pia Mater
- Arachnoid Mater
- Dura Mater
A
2
Q
Fill in the Boxes
A
3
Q
Fill in the Boxes
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4
Q
What are the 2 main/basic ways that someone can get meningitis?
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5
Q
Blood Brain Barrier
- How do can bacteria that have pneumococcal proteins pass the blood-brain-barrier?
A
6
Q
Blood Brain Barrier
- What bacterial protein interacts with CD46 in order to cross the blood-brain-barrier?
- What does this attach to on the outside of cerebrovascular endothelial cells?
A
7
Q
Blood Brain Barrier
- How do Group B Strep and E. coli facilitate CNS infection?
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8
Q
Blood Brain Barrier
- What 2 things are absent in the CNS, allowing bacteria to multiply rapidly?
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9
Q
Bacterial (Pyogenic) Meningitis
- What is the most important thing to know when you encounter this condition?
- How common is this among infectious deaths?
- What type of bacterial meningitis has a fatality rate of up to 30%?
- How common do patients present with seizures?
- What are the top 3 etiologic agents that causes this condition in adults?
- Which one is especially common in immunosuppressed individuals and people over 55 years old?
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10
Q
Bacterial (Pyogenic) Meningitis
- How common do patients present with neurologic sequelae?
- What 5 conditions make up this sequela?
- What are the 4 major risk factors for this condition?
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11
Q
Bacterial (Pyogenic) Meningitis
- Classic Triad
- What 3 things make up this triad?
- How common is each individual condition?
- How does this change when considering patients who have all 3 conditions?
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12
Q
Complications of Meningitis
- What meningitis-related pathology causes hydrocephalus?
- What meningitis-related pathology causes cerebral herniation?
- Besides the answers to the above questions, what are the other 2 common complications of meningitis?
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13
Q
Physical Exam Findings w/ Meningitis
- A patient is lying supine with their thigh flexed onto the abdomen, and can not completely extend the leg.
What sign is this?
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14
Q
Physical Exam Findings w/ Meningitis
- A patient is lying supine and flexes their neck forward. When this happens, their knees/hips go into flexion involuntarily. Further, when one side of the lower extremity is passively flexed by a physician, the opposite extremity does the same movement.
What sign is this?
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15
Q
Dx of Meningitis
- What procedure is needed?
- What individuals need a head CT before the above is performed? Why?
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16
Q
Bacterial Agents
- 80% of bacterial meningitis is caused by just 3 bacteria. Other types of bacteria can affect pregnant women, infants, and/or the elderly. Of the listed bacteria assign each of the following.
A. Most Common Cause of bacterial meningitis
B. 2nd Common Cause of bacterial meningitis
C. 3rd Common Cause of bacterial meningitis
D. Common in pregnant women, infants and the elderly
E. Common in only infants and the elderly
F. Common only in infants
A
17
Q
Dexamethasone
- What is the ONLY type of meningitis that this drug been shown to decrease mortality and hearing loss in?
- This drug decreases the CSF concentrations of which 2 cytokines?
- This drug must be used in a certain timeframe, otherwise, it won’t have any benefit for a patient. What is this timeframe?
- Why does this drug impair vancomycin use?
- What other antibiotic would consider if the strain the bacteria that is causing the meningitis is penicillin-resistant or cephalosporin-resistant?
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18
Q
CSF Findings in Meningitis
- For the following tests, indicate what result would (+) for bacterial meningitis.
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19
Q
CSF Findings in Meningitis
- For the following tests, indicate what result would (+) for viral meningitis.
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20
Q
Encephalitis
- This has mostly viral etiology. However, what occurs in about 60% of all encephalitis cases?
- What virus is both the most common pathologic agent, especially in the 20 to 40 age range, as well as the most important cause of fatal encephalitis in the US?
- What do these patients present like?
- What lobes are most commonly damaged?
- Is this virus considered a primary or secondary infection?
- What do you use to treat it?
A
21
Q
Encephalitis
- HSV’s are the most common cause of encephalitis.
- What type of virus is the second most common cause of encephalitis?
- How are these viruses transmitted to humans?
- What is special about the time of year that the infection rate is particularly high?
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22
Q
Meningoencephalitis
- This is a mixture of both meningitis and encephalitis.
- What is extremely critical to initiating presumptive treatment for meningoencephalitis?
- What is notable about the mortality rate for it?
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