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NSB Biweekly 1 > Audia- Meningitis/Encephalitis > Flashcards

Audia- Meningitis/Encephalitis Flashcards

1
Q
A

Neisseria meningitidis

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2
Q
A

E. coli

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3
Q

is an inflammation (swelling) of the protective membranes covering the brain and spinal cord (the meninges). A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling

A

Meningitis

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4
Q

is inflammation of the brain

A

Encephalitis

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5
Q

_____encephalitis results from direct infection of the brain (e.g., rabies)

A

Primary Encephalitis

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6
Q

______encephalitis results when infection spreads from meninges to the brain

A

Secondary Encephalitis

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7
Q

where to obtain CSF

A

L3-L5 (lumbar puncture)

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8
Q

mostly lymphocytes
normal glucose
normal or mildly elevated protein
(CSF)

A

viral infection

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9
Q

mostly PMNs (neutrophils seen)
decreased glucose
elevated protein
(CSF)

A

bacterial infection

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10
Q

what should be on differential if patient is immunocompromised

A

fungal infection

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11
Q

major causes of bacterial meningitis in the US

A

S. pneumoniae
group B strep
N. meningitidis
H. influenzae
Listeria monocytogenes
E. coli

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12
Q

capsular K antigen—protects from complement (anti-phagocytic) and can disseminate

A

neonatal meningitis from E. coli

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13
Q

obligate intracellular, actin rocket, lunchmeat, and transmitted from mom to child

A

neonatal meningitis from Listeria

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14
Q

risk factors include:
age
group setting
medical hx
healthcare workers

A

bacterial meningitis

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15
Q

how do Group B strep and E.coli transmit bacterial meningitis

A

vertical (mother to baby)

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16
Q

H. influenzae and S. pneumoniae transmission of bacterial meningitis

A

horizontal via resp. droplets and aerosols

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17
Q

Horizontal transmission by direct sharing of respiratory or throat secretions (saliva/spit) – kissing, sharing drinks, lengthy contact (cohabitants)

A

N. meningitidis

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18
Q

also has oral-fecal transmission

A

E. coli

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19
Q

can cause meningitis by contaminating food

A

E. coli and Listeria

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20
Q

sudden onset fever, HA, stiff neck (3-4 days post-exposure)

A

bacterial meningitis

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21
Q

Other symptoms include nausea, emesis (vomiting), photophobia (light sensitivity), altered mental status

A

bacterial meningitis

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22
Q

may not present classically and instead may be slow/inactive, irritable, vomit, poor feeding, abnormal reflexes (if infected with bacterial meningitis)

A

newborns and babies

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23
Q
A

S. pneumoniae

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24
Q

gram + lancet shaped cocci
capsule-producing (can disseminate well)

A

S. pneumoniae

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25
Q

alpha hemolytic; grows on blood agar

A

S. pneumoniae

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26
Q

to treat:
vancomycin + ceftriaxone

A

S. pneumoniae

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27
Q

interacts w/ D-Ala D-Ala, and blocks building of peptidoglycan and cross linking

A

Vancomycin

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28
Q

(hit the penicillin binding proteins)—PBPs are crucial for bacteria to build cell wall

A

Ceftriaxone

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29
Q

why use vanco + ceftriaxone

A

empiric therapy for the other causes of meningitis before you get the results

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30
Q

type of vaccine that will only generate IgM response

A

polysaccharides

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31
Q

conjugate ______ to a protein in order to get system turned on and get T cell engagement (T cells are important for inducing, class switching, and affinity maturation)

A

polysaccharide

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32
Q

to prevent S. pneumoniae

A

Vaccination (polyvalent conjugate against capsular polysaccharide or polysaccharide vaccine)

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33
Q

gram - diplococci
capsule producing (can disseminate well)

A

N. meningitidis

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34
Q

grows on blood agar
can have sequalae of limb loss, deafness, nervous system damage, brain damage

A

N. meningitidis

35
Q

treat with ceftriaxone
penicillin G upon definitive diagnosis

A

N. meningitidis

36
Q

to prevent ______: Vaccination (tetravalent conjugate against capsule or monovalent recombinant protein vaccine)

A

N. meningitidis

37
Q

gram - pleomorphic coccobacillus

A

H. influenzae

38
Q

type b (Hib) and Non-b
grows on chocolate agar

A

H. influenzae

39
Q

treat with third-generation cephalosporins (cefotaxime and ceftriaxone)

A

H. influenzae

40
Q

to prevent H. influenzae (type b only)

A

polysaccharide conjugate

41
Q

20% of _____ survivors suffer permanent hearing loss or other neurological issues

A

H. influenzae type b

42
Q

mild cases of this are usually self-limiting
treat with supportive care

A

viral meningitis

43
Q

Enteroviruses (coxsackieviruses, echoviruses, non-polio enteroviruses) are the major cause of this in the US

A

viral meningitis

44
Q

Measles
Mumps
Influenza
Herpes viruses (EBV, HSV, VZV)
Arboviruses (vector-borne disease)

A

other causes of viral meningitis in the US

45
Q

coxsackieviruses, echoviruses, non-polio enteroviruses

A

Enteroviruses (oral-fecal route)

46
Q

hand-foot-mouth disease

A

Coxsackie type A

47
Q

require T cells to “help” B cells * elicited by protein antigens * involve follicular B cells (reside in follicles of secondary lymphoid organs)

A

T cell dependent antibody response

48
Q

do not require T cells to “help” B cells * elicited by polysaccharide, lipid & nucleic acid antigens * involve B-1 B cells (mucosal tissues, peritoneum) and marginal zone B cells (spleen)

A

T cell independent antibody response

49
Q

Immunosuppression is a major risk factor (steroids, HIV, organ transplants)
Geographic risk factors

A

fungal meningitis

50
Q

Cryptococcus (meningoencephalitis)
Histoplasma (central and eastern US)
Blastomyces (Midwest, south central, southeastern US)
Coccidiodies (southwest, south-central Wa, parts of Mexico and Central/South America)
Candida (highest yield)

A

major causes of fungal meningitis in US

51
Q

endemic in mississippi and ohio river valleys
hides in macrophages
bat and bird droppings
systemic

A

Histoplasmosis

52
Q

endemic in eastern and central US, great lakes
broad based budding
soil and decaying leaf matter
systemic

A

Blastomycosis

53
Q

opportunistic
adhesion and yeast to hyphal transition

A

candida

54
Q

toxicity of anti-fungals

A

liver and renal

55
Q

target cell wall
fungicidal
(polyenes—-targets cell wall)

A

Amphotericin B and Nystatin

56
Q

targets ergosterol synthesis
fungistatic
(-azoles)

A

Fluconazole

57
Q

targets ergosterol synthesis

A

Terbinafine

58
Q

least toxic
targets beta1,3 glucan

A

Echinocandins

59
Q

targets fungal DNA/RNA synthesis

A

Flucytosine

60
Q

Rare form of meningitis called eosinophilic meningitis/meningoencephalitis (EM)
travel hx important

A

parasitic meningitis

61
Q

Angiostrongylus cantonensis (neurologic angiostrongyliasis)
Baylisascaris procyonis (baylisascariasis; neural larva migrans)
Gnathostoma spinigerum (neurognathostomiasis)

A

major causes of parasitic meningitis

62
Q

can get this from swimming in warm fresh water w/ soil (florida and texas)
prevalence low
brain eating

A

Amebic meningitis

63
Q
A

West Nile virus causing encephalitis

64
Q
A

encephalitis

65
Q
A

Rabies virus causing encephalitis

66
Q

Often causes mild flu-like symptoms (fever, headache)
Severe cases can lead to altered mental status, seizures, loss of motor control, weakness, altered senses

A

viral encephalitis

67
Q

HSV
West Nile virus
EEEV
Rabies virus

A

causes of viral encephalitis

68
Q

2 main types of Arboviruses (transmitted by mosquitoes) causing viral encephalitis

A

West Nile Virus
Eastern Equine Encephalitis Virus

69
Q

Flavivirus family
+ve sense ssRNA; Icosahedral nucleocapsid; enveloped
Most common arboviral encephalitis in US

A

West Nile Virus

70
Q

Togavirus family
+ve sense ssRNA; Icosahedral nucleocapsid, enveloped
Rare in the US, but severe disease (50% mortality)

A

Eastern Equine Encephalitis Virus

71
Q

________viruses are the ones that look, smell, and taste like mRNAs (once virus gets inside cell, that viral message can be immediately translated, can make one long protein that turns into active subunits of virus)

A

+ sense ssRNA

72
Q

leave host cell by a budding process and pick up membrane from that host
so the viral major glycoproteins will be in that membrane and helps get in to next cell

A

enveloped virus

73
Q

don’t get high enough viral loads that the mosquito could pick up enough and go infect another person

A

dead end hosts (humans and horses)

74
Q

to diagnose West Nile virus

A

NAAT (requires reverse transcriptase)

75
Q

normal PCR tests done in the lab only works on DNA; so for ______viruses, gotta convert RNA into DNA (like HIV and lenti viruses use reverse transcriptase to convert their RNA genome into DNA)

A

RNA viruses

76
Q

to diagnose EEEV

A

isolate virus from blood and brain tissue, CSF

77
Q

only vaccine for EEEV

A

killed vaccine for horses

78
Q

how to treat WNV and EEEV

A

supportive care

79
Q

large bullet shaped virus particle
-sense ssRNA

A

Rhabdovirus (rabies)

80
Q

_____sense ssRNA (must bring luggage with them (viral RNA dependent RNA polymerase) that will be used to make messages in order for production of viral protein); must go through transcription step first

A

negative

81
Q

major antigenic determinant is viral glycoprotein

A

Rhabdovirus

82
Q

Easily treatable if you catch it before symptoms manifest (give IVIG)—-passive transfer of immunity (IgG will neutralize virus and prevent it from spreading)

A

Rhabdovirus (rabies)

83
Q

virus replicates so slowly, can actually get vaccinated after exposure to this

A

rhabdovirus (rabies)

NSB Biweekly 1 (15 decks)

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