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Micro Test 5 > Bacterial CNS > Flashcards

Bacterial CNS Flashcards

1
Q

What has decreased the incidence of meningitis?

A

Vaccines

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2
Q

What are the 3 community acquired bacteria that can cause meningitis?

A

S. pneumoniae
H. Influenzae
N. meningitidis

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3
Q

What is the classic triad of meningitis?

A

Fever
Excruciating Headache
Neck Stiffness

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4
Q

What is the appropriate treatment of Meningitis?

A

Prompt initiation of appropriate empiric therapy

Steroid to decrease swelling

Intrathecal Abx

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5
Q

Will you find a transudate or exudate in the CSF in meningitis?

A

Cloudy exudate with >5WBC’s

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6
Q

What are the Neonatal factors and the Maternal factors in Neonatal Meningitis?

A

Neonatal: immature host defense and immature organ systems.

Maternal: Urogenital infection (late) and intrauterine infection (early).

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7
Q

What are the S/S of Neonatal meningitis?

Addn’l?

A

Hyperthermia
CNS manifestations
GI disturbances
Respiratory abnormalities

Bulging fontanelle/ High pitch cry/ Paradoxic irritability. Crying when held and quiet when stationary

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8
Q

What are the 3 predominant Agents of Neonatal meningitis?

A

Strep agalactiae

E. Coli

Listeria moncytogenes

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9
Q

What is the most common cause of neonatal meningitis?

A

S. agalactiae

Group B streptococcus

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10
Q

Early onset disease: for Neonatal GBS

Obstetric complications are ______.

Sx’s develop within the first ___ days.

Major clinical manifestations are ________, __________, and _______.

A

Common

5 days

bacteremia, pneumonia, and meningitis

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11
Q

Neonatal GBS: Late onset:

obstetric complications are ___________.

S/x’s develop from ____ to _____ of age.

Major clinical manifestations are ________ infections, and ________ with fulminant meningitis

A

uncommon

7 days to 3 months

bone/joint/ bacteremia

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12
Q

Which strain of E. coli is encapsulated and associated with meningitis?

A

K1.

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13
Q

What bacteria has a Tumbling motility and grows at temperatures from 0-50 celsius, and is an intracellular pathogen?

A

L. moncytogenes.

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14
Q

What are the 2 cells that L. monocytogenes infect?

A

Epithelial cells

Macrophages.

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15
Q

What are the 2 virulence factors of Listeria moncytogenes?

A

1) LPS: antiphagocytic, causes hemolytic antibodies.

2) LLO: disrupts phagolysosome membrane, (-)’s Ag prduction. Causes apoptosis.

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16
Q

What are the 2 main manifestations of Listeria?

A

Sepsis and Meningitis.

Neonatal:Acquired inutero

Adult: leading cause of meningitis in Cancer and Renal transplant patients.
Brain stem encephalitis.

17
Q

Hib contains what virulence factors?

Is Hib hemolytic?

A

LOS/ fimbriae/ Neuraminidase and IgA protease/ PRP capsule.

No it is not, but requires factors from RBC’s for growth.

18
Q

What is the pathogenesis of Hib?

A

Nasopharynx–> epithelium–> blood or lymph–> CSF.

19
Q

Which strain of Hib posses adhesins?

A

Non-encapsulated strains.

20
Q

What is the treatment of Hib?

What is the Prevention of Hib?

A

Beta-lactams

6 different Hib conjugate vaccines.

21
Q

What is the most common cause of bacterial meningitis?

A

S. Pnemoniae.
Alpha-hemolytic with green colonies.

Optochin sensitivity.

Encapsulated strains are virulent.

22
Q

What would increase the risk of pneumoncoccal pneumonias?

A

Viral infections.

23
Q

What are the virulence factors for pneumococcus?

Autolysin?

Pneumolysin?

A

IgA protease, H202, pili, peptidoglycan-teichoic acid, bacterial capsule.

Autolysin: lysis of of bacteria will release this to dampen host immune response.

Pneumolysin: forms pores in target cell, causes cell lysis and activates complement.

24
Q

DIagnosis of S. pneumoniae?

A

Optochin sensitivity

Bile solubility test

Quellung reaction to observe capsules.

25
Q

Which strains of the encapsulated serogroups of Meningococcal meningitis?

A

A, B, C, Y, W135.

26
Q

What are the characteristics of meingococcus in infants?

A

Apnea, seizures, coma.

27
Q

What are the characteristics of meningococcus in older children and adults?

A

Sever headache, vomiting, neurologic signs.

28
Q

What is meningitis?

Encephalitis?

A

inflammation from infection within the subarachnoid space

Inflammation in the parenchyma

Micro Test 5 (7 decks)

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