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A-CNS MICRO > Bacterial meningitis > Flashcards

Bacterial meningitis Flashcards

1
Q

بسم الله الرحمن الرحيم وبه نستعين
_________________________
infections affectin muscle tone

A

C,tentai spastic
c,botulinum flaccid parlaysis

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2
Q

Mention bacteria casuing meneingitis

A

NHS PAL
Nessiria menigitidis
Hemoplilus infulucnazer
Sterptococcus pnemoniae and aglagctae
Listera monocytogens

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3
Q

Mention Modes of infectos of meniegitis

A

PDLH
=Peripheral nerves as rabis + herpes zoster
=Direct implanatation iatrogenic as lumbar puncture
=Local extension from skull and spine
=Hematogenous spread :-
By arterial blood supply and Connections between facial veins and Venous sinuses

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4
Q

Classify meiengitis

A

According to speed of intial presentation and speed of progerssion :
Acute from hours to days and by pyogenics as S,penumoniae + Neissiera mengitifdis

Subacute from days to few weeks and by CM? fungal cryptococcus and Mycobacterium tuberclosis

Chronic reaching 4 weeks by
Complications of mentioned above or
Viral infections

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5
Q

Menigintis symptoms and signs causes

A

Fever due to inflammation
Edema causeing increased ICP interfering with brain functions
causing Confuson dorwiness nause pain
___________________________________
Spinal meningits casuign motor and sensory defecits
Stiffness of Neck

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6
Q

Fatal meningitsi killing within six hours of intial symtptoms with little time for treatment ?

A

as meningococcal meningitis

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7
Q

small drak purplish hemohhrages of blood vessels of skin apeear in menigitis this called ?

A

Petichae

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8
Q

Describe lumbar puncture cc in case of acute bacterial meinigits /

A

Milky turbid
leaving rapidly due to increased ICP

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9
Q

After centrifugation of the CSF what resultis ?

A

Sediment for culture
Supernatant has WBCs
and glucose and protein
Detecton of Capuslar polysaccradie antigens

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10
Q

Compare between bavteral viral fungal menigits supranatant

A

Bacterial and fungal increased protein and pressure with decreased glucose bacterial with PMNL , but fungal with Lymphocytes
______________________________–
Viral normal or increased protein and pressure with normal glucose and Lymphocyte infilatraion

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11
Q

When you cannot perform Lumbar puncture in MENIGITIS ?

A

In case of patient with papilledema or Focal Neurological defecits
due to increased pressure may casue brain herniation
___________________________
in case of MASS lesion in CT scan whether abscess or tumor

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12
Q

Endotoxin of N,menigitdis is ?

A

LipooligoSaccharides

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13
Q

describe nessirea

A

Polysaccardide Capusleted Oxidase + gram - diplococci with lipooligosaccardi endotoxin on the outer membrane.
menigniococcus
Non motile non spore forming
and appear in pairs

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14
Q

The most common cause of purulent meningits is ?

A

Nessieria Menigitids called
Epidemic cerebrospinal Meningitis

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15
Q

how to classify N,menigitids

A

According to capsular polysachharide antigen to 13 serological types
______________________
The most common are
ABCY W135
A C MOST epidmeic menigitis world wide
B sporadic

Carriage rate increased in close quarters as military camps

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16
Q

Mention virulence factors of the Nessieria meningitids

A

P2LIF
Polysaccardia capusle : antiphagocytic + antigenic for capsule
Pili for attachment to mucosa
Lipooligosaccardia capsule endotoxin for fulminant meningococcemia + septic shock
IgA proteases helping to attach to upper respiratory tract mucous degrading IgA
Factor H binding protein :
inhibiting c3b precenting Membrane attack complex and lysis = Immune evasion + used in developend of vaccine against group b meniniogcoci

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17
Q

used in developend of vaccine against group b meniniogcoci

A

Factor H binding Protein

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18
Q

Host of menigococciN,menengitids

A

Humans only

19
Q

mode of transmission of N menigitisds

A

By droplets to colonize in nasppharynx as normal flora transient

in 5-10 % of noraml population
carries are asymptompatic

20
Q

Explain pathogensis of Nessiera meningitidis

A

From the nasopharynx to CNS how ?
Hematogenosu to subarachanoid space
Through olfactory nerve sheath direct spread
CC by fever sore thoracth headache coma death
nucal rigidity vomiting
it is
Epidiminc+ higly contagious + rapidly progressive
-fulminant Menignicoocemia
-chronic carriesrs

21
Q

Explain Fulminiant meniogicocemia in the pathogenisis of the n menigitis mentnigitsi

A

Due to severe inflammatory responese to the Lipooligosaccaride endotoxin of the N,menigitis casuing ?
=Severe fever HEADACHE SDSA
=DIC and throbocytopenia and purpra
=Shock and hypotension and cirulatory collapse
=Adrenal insufficiency
water house friedrechsen syndrome
death

22
Q

mENTION IMP OF supranantan after centifugation

A

-For Leckocytic count esp neurtophils
-Increased glucose and protein
-Detection of capsular polysaccaride antigen by latex agglutinations or ring periceptiation test

23
Q

Laboraty diagnosis of the N,menigtidis by speciments of ?

A

CSF
Blood
Naspaygneal swab

24
Q

Hoow to benfit from sediments

A

1-Gram stain : gram - diplococci
2- Culture on chocolate blood agar or Selevtive chocolate : thayr martin 5-10% CO2
Ferminting glucose and maltose with acid only
Oxidase = +
__________________________________

25
Q

Preesumpative diagnosis of meninigococaal menigits if ?
Rapid diagnosis by?

A

if Gram-diplccis + oxidase +
____________________
Rapid diagnosis by Latex agglutination test

26
Q

sensitive and specific diagnosis by ? of menigocooal menignits

A

PCR

27
Q

How to diagnose Carrier asympoomatic

A

By nasopharyngeal swab
it will be mixed with commensal so cultured on selectiv media thayr - martin medium 5-10 %co2
then by gram and oxidase and sugar utilization tests
________________________

28
Q

Compaer between Commensal nessiera and N,menigitis ?

A

Commensal :-
-Grow in ordinary media without co2 enrichment at room temp.
-Sugar utilizton differ
-no reacton with Specific antisera as Antibodes for Capsular polysaccardie anitgen

28
Q

HOW To prevent MENIGNIOCOCCAL MENINIGTS ?

A

-CHEMOPROPHYLAXIS :
Rifampicin in close contacrs
Ciprofloxacin single dose in adolescents
_________________________________
-Vaccination :
Unconjugate menigococcal vaccine inclduing ACY W135 Serotypes
- quadrivalnet Conjugate menigococcal vaccine conjugated with protein for high titres of antibodies in children

29
Q

Vaccin agains Group b N ,meneigitids contains ?

A

Factor H binding protein

30
Q

Describe s.penomnia

A

Gram + streptococci catalse -
-non motile
-non spore forming
-lanceolate in pairs
-polysaccharide capsule
-Alpha hemolyic in blood agar

31
Q

Mentions ways of spread of S.penumoniae to meiniges?

A

From lobar pnemnina hematogenous to the Meninges
From Otitis media to mastoid bone to meninges as direct spread

32
Q

Qulleng reaction or capsulear swelling reaction marns ?

A

Each one of 90 serotypes ofs,pnemoniae has specifica antisera to the polysaccharide capsule antigne when added to the culture will cause sewlling of the capsule

33
Q

Mention virulence factors of Streptococcus pnemoniae

A

CIPA
_________________
Capsule : antiphagocytic
IgA protease : enabling attachment to the upper respiratory tract mucosa
Pneumolysin : destructing membrane of the host cell
Autolysin : Destruction of peptidoglycan of the bacteria itself being fragments casuing sever inflammatory reaction causing tissue damage and necrosis

34
Q

How to dGriangose S,penmoiae ?

A

CSF OR BLOOD SPEMCIEN
________________________
Blood agar cc by ? agdoc
1-Alpha hemolysis
2-gram + diplococci
3-draugths man appearcnce due to autolysin
4-Optochin inhibiting growth
5-Catalase Negative

35
Q

Rapid and accurate detection of peunomcoccal meningiits bY?

A

Detection of polysaccradie capsule antigne in CSF

36
Q

Vaccination of s.pemnoniae

A

-Polysaccaride 13 valent pnemocaocal vaccine :
conjugated + to immounpcmprided as spleenetomized and children under 5
-polysaccharid 23 valent pneumococcal vaccine healyhy individulas age 65 without conjugation
chrmoinc heart and lung and other conditions

37
Q

Hemophilus influnzae
S small gram……. ……..
most virulent H .iflunzar have…….
The capsulated strain has ,,,,,types from ….. to …… the most virulent is …… casuing meninigts in children from ….to……..
transmitted from person to person by……..

A

Negative coccobacilli
Capsule
6 a-f most b
6months to 6 yeears
Respiratory droplets

38
Q

gorwht media of H,influenzae requirements speical ?

A

Heme Factor x
NAD Factor V

39
Q

mENTION VIRULERNCE FACOTRR OF H,influncae

A

CI2P
antiphagocytic acpusel most imp
IgA protease
Inflammatory PROCESS: lIPOPOLYSACCRIDE ENDOTOXIN
Pilli

40
Q

Lab diagnosis of H.influnzae

A

specme,nm : CSF blood
Direct gram smear: Gram - coccobaclli
__________________________
in 5-10 con2 enriched media aerobic for 1-2 days
cannot grow on ordinary media requiring ?
Hemin facot x
NAD factor V
ON CHOCLATE AGAR (hEated blod agar )
_____________________
rapid capuslear antigen by latex agglutination IF ELISA
PCR

41
Q

Stellatism

A

In mixed culture with staph the H.influnzea has a good growth around staps

42
Q

vACCINATION OF H.infulenzae

A

Polyribosylribito phospahte
PRP
___________________________________
POLYSACCARDIE ANTINGEN OF Hib + Protein conjugation
Preventing invasive Hib disease
reducing nasopharyngeal carriage
for infants bet 2 and 15 months

43
Q

الحمدلله كثيرًا وسبحان الله بكرًة واصيلًا

A

A-CNS MICRO (7 decks)

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