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NSB Biweekly 1 > Audia- Meningitis/Encephalitis > Flashcards

Audia- Meningitis/Encephalitis Flashcards

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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
alpha hemolytic; grows on blood agar
S. pneumoniae
26
to treat: vancomycin + ceftriaxone
S. pneumoniae
27
interacts w/ D-Ala D-Ala, and blocks building of peptidoglycan and cross linking
Vancomycin
28
(hit the penicillin binding proteins)---PBPs are crucial for bacteria to build cell wall
Ceftriaxone
29
why use vanco + ceftriaxone
empiric therapy for the other causes of meningitis before you get the results
30
type of vaccine that will only generate IgM response
polysaccharides
31
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)
polysaccharide
32
to prevent S. pneumoniae
Vaccination (polyvalent conjugate against capsular polysaccharide or polysaccharide vaccine)
33
gram - diplococci capsule producing (can disseminate well)
N. meningitidis
34
grows on blood agar can have sequalae of limb loss, deafness, nervous system damage, brain damage
N. meningitidis
35
treat with ceftriaxone penicillin G upon definitive diagnosis
N. meningitidis
36
to prevent ______: Vaccination (tetravalent conjugate against capsule or monovalent recombinant protein vaccine)
N. meningitidis
37
gram - pleomorphic coccobacillus
H. influenzae
38
type b (Hib) and Non-b grows on chocolate agar
H. influenzae
39
treat with third-generation cephalosporins (cefotaxime and ceftriaxone)
H. influenzae
40
to prevent H. influenzae (type b only)
polysaccharide conjugate
41
20% of _____ survivors suffer permanent hearing loss or other neurological issues
H. influenzae type b
42
mild cases of this are usually self-limiting treat with supportive care
viral meningitis
43
Enteroviruses (coxsackieviruses, echoviruses, non-polio enteroviruses) are the major cause of this in the US
viral meningitis
44
Measles Mumps Influenza Herpes viruses (EBV, HSV, VZV) Arboviruses (vector-borne disease)
other causes of viral meningitis in the US
45
coxsackieviruses, echoviruses, non-polio enteroviruses
Enteroviruses (oral-fecal route)
46
hand-foot-mouth disease
Coxsackie type A
47
require T cells to “help” B cells * elicited by protein antigens * involve follicular B cells (reside in follicles of secondary lymphoid organs)
T cell dependent antibody response
48
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)
T cell independent antibody response
49
Immunosuppression is a major risk factor (steroids, HIV, organ transplants) Geographic risk factors
fungal meningitis
50
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)
major causes of fungal meningitis in US
51
endemic in mississippi and ohio river valleys hides in macrophages bat and bird droppings systemic
Histoplasmosis
52
endemic in eastern and central US, great lakes broad based budding soil and decaying leaf matter systemic
Blastomycosis
53
opportunistic adhesion and yeast to hyphal transition
candida
54
toxicity of anti-fungals
liver and renal
55
target cell wall fungicidal (polyenes----targets cell wall)
Amphotericin B and Nystatin
56
targets ergosterol synthesis fungistatic (-azoles)
Fluconazole
57
targets ergosterol synthesis
Terbinafine
58
least toxic targets beta1,3 glucan
Echinocandins
59
targets fungal DNA/RNA synthesis
Flucytosine
60
Rare form of meningitis called eosinophilic meningitis/meningoencephalitis (EM) travel hx important
parasitic meningitis
61
Angiostrongylus cantonensis (neurologic angiostrongyliasis) Baylisascaris procyonis (baylisascariasis; neural larva migrans) Gnathostoma spinigerum (neurognathostomiasis)
major causes of parasitic meningitis
62
can get this from swimming in warm fresh water w/ soil (florida and texas) prevalence low brain eating
Amebic meningitis
63
West Nile virus causing encephalitis
64
encephalitis
65
Rabies virus causing encephalitis
66
Often causes mild flu-like symptoms (fever, headache) Severe cases can lead to altered mental status, seizures, loss of motor control, weakness, altered senses
viral encephalitis
67
HSV West Nile virus EEEV Rabies virus
causes of viral encephalitis
68
2 main types of Arboviruses (transmitted by mosquitoes) causing viral encephalitis
West Nile Virus Eastern Equine Encephalitis Virus
69
Flavivirus family +ve sense ssRNA; Icosahedral nucleocapsid; enveloped Most common arboviral encephalitis in US
West Nile Virus
70
Togavirus family +ve sense ssRNA; Icosahedral nucleocapsid, enveloped Rare in the US, but severe disease (50% mortality)
Eastern Equine Encephalitis Virus
71
________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)
+ sense ssRNA
72
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
enveloped virus
73
don’t get high enough viral loads that the mosquito could pick up enough and go infect another person
dead end hosts (humans and horses)
74
to diagnose West Nile virus
NAAT (requires reverse transcriptase)
75
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)
RNA viruses
76
to diagnose EEEV
isolate virus from blood and brain tissue, CSF
77
only vaccine for EEEV
killed vaccine for horses
78
how to treat WNV and EEEV
supportive care
79
large bullet shaped virus particle -sense ssRNA
Rhabdovirus (rabies)
80
_____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
negative
81
major antigenic determinant is viral glycoprotein
Rhabdovirus
82
Easily treatable if you catch it before symptoms manifest (give IVIG)----passive transfer of immunity (IgG will neutralize virus and prevent it from spreading)
Rhabdovirus (rabies)
83
virus replicates so slowly, can actually get vaccinated after exposure to this
rhabdovirus (rabies)

NSB Biweekly 1 (15 decks)

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