Bacterial meningitis Flashcards
1
Q
signs of meningitis
A
HA fever vaomiting photophobia irritability neurologic dysfunction (varying degrees)
2
Q
even if treated infants with meningitis may suffer from
A
irreversible neurological damage
learning deficits to mental retardation, deafness
3
Q
CSF findings of meningitis
A
> bunch of poly’s
reduced CSF glucose
elevated ptoetin content of CSF
4
Q
0-3 months meningitis is caused by
A
> GBS
GN enteric bacteria-E coli, klebsiella, enterobacter salmonella
Listeria
5
Q
3 months-2 years of age causes
A
> Strep pneumo
Nisseria meningitides
H flu type B
6
Q
2-18 years old meningitis causes
A
Nisseria meningitides
Strep Pneumo
7
Q
Immunocompromised host
A
Staph
GN enterics
P aeruginosa
8
Q
ID of bacterial meningitis techniues
A
Gram stain of centrifuged CSF
CUlture CSF andf blood (BAD and CAP
antibiotic susceptibility
9
Q
most common cause of bacterial meningitis in the US–> 47%
A
Strep pneumo
10
Q
all strep is sensitive to what drug at the moment
A
poeniciliin G
11
Q
most important risk factors for strep pneumo meningitis
A
1. SPLENIC DYSFUNCTION removal or autoinfarct seen in SSDz 2. Skull fracture 3. Severe ear infections 4. AIDS 5. Cochelar implants
12
Q
tx of strep penumo meningitis
A
pen. g
cephalosporins
13
Q
combo often used for strep pneumo meningitis
A
vanc and cephalosporins
14
Q
adjunct therapy prior to Abx with strep pneumo meinnigitis
A
dexamethasone
15
Q
23 serotypw vaccine
A
pnuemovax
- multivalent
- non-conjugated
- last 5-7 years
- protects against invasive streptococcal dz
16
Q
13 serotype vacine
A
prevnar, heptavalent, conjugate
17
Q
recommended groups to get pneumovax 23
A
over 65 HIV splenic disorders cardiopulmonary disorders transplatees
18
Q
strep pneumo vaccine not effective in children
A
pneumovax-23
19
Q
abs in children as young as 2 months with memory response
A
Prevnar-13
20
Q
gram negative kissing kidney bean shaped diplococci
A
N meningitides
21
Q
oxidase positive
A
N meningitides
22
Q
virulence factors of N meningitides
A
Polysacchaaide capsule-antiphagocytic, basis of immunogrouping, rapid lab dx
- anticapsular ab’s are protective
- also pili and LPS
23
Q
there is no vaccine for group
A
B
24
Q
are materal AB’s protective for N meningitides
A
yes
25
risk factor for N meningitides
Compliment C6 defficiency
alcoholism
26
is N gonorrhea capsulated
no
27
outbreaks of N meninigitis occur in
crowded conditions
jails nursing homes, military barracks
28
60% of meningitis cases of patients 11 or older are due to
N meningitides
29
epidemics that occur in US are mostly what subtyopes
B and C
no vaccine for B
30
signs in meningicocca infection and in the CNS
RAPID FROM INFECTION TO DEATH
- PETECHIAL HEMORRHAGE
- FEVER
- NECK STIFFNESS
- HA
- DELERIUM
31
whats more rare and life threatening than meningitis
menginiococcemia
32
dx of N meningitides
Gram stain on csf
RADT on CSF latex
culture CSF on CAP
33
tx of N meningitides
penicillin
cefotaxime
ceftriaxone
+/- corticosteroids
34
ACYW135 vaccine
N meningitides-conjugated with diptheria toxin
35
n meningitides recomended for which patients
all 11-12 years old
36
those exposed to n meningitides give
Cipro
37
small grand negative rod
very similar ot pneumo
"little pink penumococcous"
H flu type B
38
6 months and younger and the elderly, immune def, and etoh
non vaccers
H flu,
| incidence has been cut by 97%
39
H flu culture
CAP only
does not grow on blood agar
40
small nonmotile gn bacillus
H flu
41
requires factors X (hemin) and V (NAD/NADP)
H flu B
these facotrs found in CAP
42
virulence factors for H flu B and f which cause sytemic disease
invasive
| capsule is antiphagocytic
43
disease that can be caused by invasive H flu strains such as B
meningitis and epiglotitis in 6 months-5 years
arthirits cellultite ostemyelitis
CAPnemonia in children and adults whoa are ImmunoC
44
enencapsulated HFLu strains cause
otitis media, conjunctivitis, in young chldren and infants
resp diz in adults
45
causes of OM in children (order)
Strep penumo
H flu
moraxella
46
tx of H flu
3rd gen cephs
plus dexamathasone to control inflammation
give dex b4 ab's
47
vaccine for H flu
highly effetive conjugated B vaccine
2,4,6,12, months ant then in shildhood and beore college? but i think i just madfe that entirely up
48
soft chancre
H ducreyi
often confused with syphilis
49
HACEK group causes
subacute bacterial endocarditis mainly on defective hart valves
50
club shaped GPR motile at 25 degrees Celsius
listeria monocytogenes
51
faculatative intracellular parasite tat infects mucosal epithelial cells and macrophages/monocytes
lysteria monocytogenes
52
requires strong cellular immunity
lysteria- relies on cellular immune response for containing the bacteria
53
unpasteurized sot cheeses and found in environment with poultry goats and sheep
HOT DOGS AND DELI MEATS
Listeria monocytogenes
uncommon but fatal and always require hospitalization
54
can lysteria cause vertical transmission thru childbirth
yes, some ppl are carriers
infections 20x more liukley in pregnant women than nonpregnant women
55
in normal adults, listeria causes
inapparent flue like illness
56
in ImmunoC adults and neonates listeria cuases
meningitis, bacteremia,
in newborn:
stillbirth, premature birth, sepsis
57
emperic tx for bacterial meningitis
3rd gen cephs
ampicillin is listeria suspected
if resistant strep pneumo -add vanc
dexamaethasone (controversial)
58
most common cause of bacterial meninigtis (50%) int he US
Step pneumococcus
normal URT inhabitant of 5-40%
59
strep pneumo and viridans fall into what category of strep
alpha hemolytic
thus are not lancefield antigen typed
60
beta hemolytic strep are all classified how
by their lancefield antigen
a-pyogenes
b- GBS agalactiae
D- enteroccocus
61
viridans and pneumo can be distinguished how?
optochin sensitivity
viridans=resistant
62
leading cause of invasice bacterial dz in children, elderly, and IC pt.s
s. pneumoniae
63
access to BBB by strep pneumois via
binding cerbral acpillaries, transmigration and entrance into the CSF =meningitis
64
resistance to phagocytosis for s pneumo is via
interference with binding of C3b to cell surface
65
three main virulence factors for strep pnuemo
1. pili
2. antiphagocytic capsule
3. LPS components in cell wall
4. choiline binding proteins-pneumonia and meningitis-for adherence
5. hemolysins-pneumolysin-lysis and compliment aitvation
6. H202-antibacetrial against competing bactera such as Staph aureus
7. Neuraminidase and IgA protease
66
"crowded conditions"
Nisserria Meningitides
ABCY w135 strains of relevance
67
sporadic NM outbreaks-small numbers of related cases-which subtypes
B C Y
68
epidemic outbreaks of NM-large numbers large areas
A
69
" all of a sudden really bad shape"
petechial rash
die within 24 hours of hospitalization
think meningococcus
70
major toxin of N.M
LOS with endotoxin mechanism
antiphagocytic capsule
71
unique part of NM infection
PHASE VARIATION
TURNS OFF CAPSULAR GENES WHEN PENETRATING MUCOSA
TURNS THEM BACK ON WHEN IN THE BLOOD STREAM
72
DOC FOR meningococcus
penicillin
if allergic-3rd gen cef
73
non immunogenic strain of NM in humans
B strain
74
phase variation and masters of disguise and change
Nisseria gonnorrhae and meningitides
75
type of variation by the nisseria species
Phase-genes on and off at different times
antigenic-> change in genes leading to expression of different forms of similar genes
antigenic variation allows for reinfection by the same bugs
76
activates silent pilS loci during antigenic variation
Nisseria meningitides
77
virulence factors for H flu
antiphag. capsule
| polysaccharidae antigens are weak
78
describe the imporant of the polysaccharide anigens
anticap antibodies are antigenic but and T CELL INDEPENDENT-entirely B cell and saccharides mediated--thus short lived immunity
79
necessary to kill L monocytogenese
macrophage activation of cytokines
80
f actin based motility
L monocytogenes
