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BMB Test 3 > B7-056 Meningoencephalitis > Flashcards

B7-056 Meningoencephalitis Flashcards

1
Q

tough connective tissue that divides the hemispheres into left and right

A

falx cerebri

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2
Q

tough connective tissue separates the cerebrum from the cerebellum/brainstem

A

tentorium

(used to divide the supratentorial compartment from the infratentorial compartment)

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3
Q

the enlargements of intra-axial CSF spaces are called

A

cisterns

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4
Q

CSF is produced in the

A

choroid plexus

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5
Q

rate of production of CSF by the choroid

A

500ml per day

(normal volume is 125, so completely replaces volume several times a day)

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6
Q

CSF circulation enters the extra-axial space via medial and lateral apertures at the […]

A

medulla

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7
Q

CSF is reabsorbed over the […] at the superior sagittal sinus

A

arachnoid granulations

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8
Q

for normal CSF flow, the pressure in the […] has to be greater than pressure in the […]

A

ventricles
subarachnoid space

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9
Q

[…] between capillary endothelial cells forms the BBB

A

tight junctions

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10
Q

tight junctions of the […] cells prevent solutes from moving from CSF into the brain

A

ependymal cells

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11
Q

locations in the brain where the BBB is interrupted [3]

A

pineal gland
neurohypophysis of pituitary
area postrema

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12
Q

types of herniation [4]

A

sub-falcine
central
uncal
tonsillar

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13
Q

midsize bilateral, non reactive pupils

[…] herniation

A

central herniation

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14
Q

unilateral dilated, non-reactive pupil

[…] herniation

A

lateral (uncal)

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15
Q

most vulnerable CN to meningitis

A

VIII

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16
Q

treatment for suspected acute bacterial meningitis

A

ampicillin and ceftriaxone

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17
Q

CSF WBCs are less than 100

A

non-acute meningitis (viral, aseptic, fungal, cancer, autoimmune, etc)

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18
Q

CSF WBCs are more than 200

A

consider acute bacterial meningitis

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19
Q

neutrophils in CSF fluid

A

acute bacterial meningitis

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20
Q

obstruction to CSF flow is intra-axial

A

non-communicating hydrocephalus

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21
Q

most common location of a lesion causing non-communicating hydrocephalus

A

cerebral aqueduct

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22
Q

enlarged ventricles, but 4th ventricle is not enlarged

A

non-communicating hydrocephalus

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23
Q

obstruction to CSF flow is extra-axial

A

communicating hydrocephalus

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24
Q

all ventricles enlarged, even 4th

A

communicating hydrocephalus

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25
Q

typically due to interruption of CSF flow percolating trough subarachnoid space

A

communicating hydrocephalus

(ex. scarring from meningitis)

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26
Q

symptoms of hydrocephalus [3]

A

gait problems
incontinence
cognitive issues

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27
Q

in acute or subacute hydrocephalus the opening pressure will likely be

A

high

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28
Q

in chronic hydrocephalus the opening pressure will likely be

A

normal

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29
Q

very chronic communicating hydrocephalus is called

A

normal pressure hydrocephalus

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30
Q

hydrocephalus secondary to atrophy of the brain
no derangement in CSF flow

A

hydrocephalus ex vacuo

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31
Q

increased ICP due to poor absorption of CSF
no enlargement of ventricles

A

idiopathic intracranial hypertension

32
Q

cause of idiopathic intracranial hypertension

A

poor absorption of CSF by arachnoid villi

33
Q

idiopathic intracranial hypertension is associated with [4]

A

obesity
tetracycline
vitamin A
venous sinus thrombosis

34
Q

headache
episodic blurred vision, diplopia
papilledema
normal head imaging

A

idiopathic intracranial hypertension

35
Q

treatment of idiopathic intracranial hypertension [3]

A

diamox (decreases CSF production)
optic nerve fenestration
CSF shunt

36
Q

lumbar puncture is contraindicated in patients with

A

focal mass lesions causing ICP

(not contraindicated in idiopathic intracranial hypertension because pressure is increased diffusely)

37
Q

causes of intracranial hypotension [4]

A

post traumatic
encephalocele
tarlov cyst
idiopathic

38
Q

orthostatic headaches
low opening pressure

A

intracranial hypotension

39
Q

treatment for intracranial hypotension [2]

A

repair leak
blood patch

40
Q

CN most likely to be affected by idiopathic intracranial hypertension?

A

2

41
Q

dysfunction of short term memory requires […] dysfunction to the memory circuits

A

bilateral

42
Q

inattention requires […] dysfunction of the dorsolateral prefrontal cortex

A

bilateral

43
Q

imaging for venous sinus thrombosis

A

MRV

44
Q

treatment of venous sinus thrombosis [3]

A

anticoagulation
catheter thrombectomy
lower ICP

45
Q

basis of the BBB

A

tight junctions between endothelial cells

46
Q

what type of herniation can compress the ACA?

A

subfalcine

47
Q

what type of herniation causes caudal displacement of the brainstem?

A

central transtentorial

48
Q

what type of herniation can cause rupture of the basilar artery branches (duret hemorrhages)?

A

central transtentorial

49
Q

what type of herniation causes ipsilateral blown pupil with contralateral hemiparesis?

A

uncal herniation

50
Q

what type of herniation causes coma/death when it compresses the brainstem?

A

cerebellar tonsillar herniation

51
Q

which pupillary changes characterize central descending transtentorial herniation?

A

mid-range unreactive pupils

52
Q

which pupillary changes characterize uncal herniation?

A

unilateral fixed dilated pupil

53
Q

is the parasympathetic or sympathetic system affected by central descending transtentorial herniation?

A

both, that’s why pupil is mid-range

54
Q

treatment for viral meningitis

A

IV acyclovir

55
Q

most common form of sporadic viral encephalitis

A

herpes meningoencephalitis

56
Q

describe the flow of CSF from production to absorption

A

lateral ventricles
3rd ventricles
cerebral aqueduct
4th ventricles
lateral and medial apertures
subarachnoid space
arachnoid granulations
venous sinuses

57
Q

what structures surround the epidural space?

A

dura and skull

58
Q

what structures surround the subdural space?

A

dura
arachnoid

59
Q

what structures surround the subarachnoid space?

A

arachnoid
pia

60
Q

the anterior temporal lobes are nested of the sphenoid wing of the […] cranial fossa

A

middle

61
Q

the orbital frontal cortex is in the […] cranial fossa

A

anterior

62
Q

the brainstem and cerebellum are in the […] cranial fossa

A

posterior

63
Q

absence of hydrocephalus on MRI
severely elevated intercranial CSF pressure

A

idiopathic intracranial hypertension

64
Q

enlarged lateral and third ventricles
normal sized fourth ventricle

A

non-communicating hydrocephalus

65
Q

enlargement of all ventricles [2]

A

communicating hydrocephalus
normal pressure hydrocephalus

66
Q

appearance of increased CSF on imaging but actually due to decreased brain tissue and atrophy

A

ex vacuo ventriclomegaly

67
Q

ICP is […] in ex vacuo ventriclomegaly

A

normal

68
Q

caused by structural blockage of CSF circulation within the ventricular system

A

non-communicating hydrocephalus

69
Q

expansion of ventricles distorts fibers of the corona radiata

A

normal pressure hydrocephalus

70
Q

decreased CSF absorption by arachnoid granulation causes increased ICP, papilledema, and herniation

A

communicating hydrocephalus

71
Q

increased ICP with no obvious findings on imaging

A

idiopathic intracranial hypertension

72
Q

risk factors of idiopathic intracranial hypertension

A

female
Tetracyclines
Obesity
A- Vitamin A excess
Danazol/Dural venous sinus thrombosis

female TOAD

73
Q

associated with dural venous sinus stenosis

A

idiopathic intracranial hypertension

74
Q

common symptoms of idiopathic intracranial hypertension

A

headache
papilledema
tinnitus
diplopia

75
Q

visual field testing for idiopathic intracranial hypertension will reveal [2]

A

peripheral constriction
enlarged blind spot

76
Q

treatment of idiopathic intracranial hypertension

A

weight loss
acetazolamide (carbonic anhydrase inhibitor)

invasive procedures for refractory cases

from first aid

BMB Test 3 (18 decks)

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