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Bacterial meningitis Flashcards

1
Q

signs of meningitis

A 
HA
fever
vaomiting
photophobia
irritability
neurologic dysfunction (varying degrees)
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2
Q

even if treated infants with meningitis may suffer from

A

irreversible neurological damage

learning deficits to mental retardation, deafness

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3
Q

CSF findings of meningitis

A

> bunch of poly’s
reduced CSF glucose
elevated ptoetin content of CSF

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4
Q

0-3 months meningitis is caused by

A

> GBS
GN enteric bacteria-E coli, klebsiella, enterobacter salmonella
Listeria

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5
Q

3 months-2 years of age causes

A

> Strep pneumo
Nisseria meningitides
H flu type B

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6
Q

2-18 years old meningitis causes

A

Nisseria meningitides

Strep Pneumo

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7
Q

Immunocompromised host

A

Staph
GN enterics
P aeruginosa

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8
Q

ID of bacterial meningitis techniues

A

Gram stain of centrifuged CSF

CUlture CSF andf blood (BAD and CAP

antibiotic susceptibility

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9
Q

most common cause of bacterial meningitis in the US–> 47%

A

Strep pneumo

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10
Q

all strep is sensitive to what drug at the moment

A

poeniciliin G

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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
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12
Q

tx of strep penumo meningitis

A

pen. g

cephalosporins

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13
Q

combo often used for strep pneumo meningitis

A

vanc and cephalosporins

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14
Q

adjunct therapy prior to Abx with strep pneumo meinnigitis

A

dexamethasone

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15
Q

23 serotypw vaccine

A

pnuemovax

  • multivalent
  • non-conjugated
  • last 5-7 years
  • protects against invasive streptococcal dz
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16
Q

13 serotype vacine

A

prevnar, heptavalent, conjugate

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17
Q

recommended groups to get pneumovax 23

A 
over 65
HIV
splenic disorders
cardiopulmonary disorders
transplatees
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18
Q

strep pneumo vaccine not effective in children

A

pneumovax-23

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19
Q

abs in children as young as 2 months with memory response

A

Prevnar-13

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20
Q

gram negative kissing kidney bean shaped diplococci

A

N meningitides

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21
Q

oxidase positive

A

N meningitides

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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
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23
Q

there is no vaccine for group

A

B

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24
Q

are materal AB’s protective for N meningitides

A

yes

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25
Q

risk factor for N meningitides

A

Compliment C6 defficiency

alcoholism

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26
Q

is N gonorrhea capsulated

A

no

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27
Q

outbreaks of N meninigitis occur in

A

crowded conditions

jails nursing homes, military barracks

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28
Q

60% of meningitis cases of patients 11 or older are due to

A

N meningitides

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29
Q

epidemics that occur in US are mostly what subtyopes

A

B and C

no vaccine for B

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30
Q

signs in meningicocca infection and in the CNS

A

RAPID FROM INFECTION TO DEATH

  • PETECHIAL HEMORRHAGE
  • FEVER
  • NECK STIFFNESS
  • HA
  • DELERIUM
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31
Q

whats more rare and life threatening than meningitis

A

menginiococcemia

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32
Q

dx of N meningitides

A

Gram stain on csf
RADT on CSF latex
culture CSF on CAP

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33
Q

tx of N meningitides

A

penicillin
cefotaxime
ceftriaxone

+/- corticosteroids

34
Q

ACYW135 vaccine

A

N meningitides-conjugated with diptheria toxin

35
Q

n meningitides recomended for which patients

A

all 11-12 years old

36
Q

those exposed to n meningitides give

A

Cipro

37
Q

small grand negative rod

very similar ot pneumo

“little pink penumococcous”

A

H flu type B

38
Q

6 months and younger and the elderly, immune def, and etoh

non vaccers

A

H flu,

incidence has been cut by 97%

39
Q

H flu culture

A

CAP only

does not grow on blood agar

40
Q

small nonmotile gn bacillus

A

H flu

41
Q

requires factors X (hemin) and V (NAD/NADP)

A

H flu B

these facotrs found in CAP

42
Q

virulence factors for H flu B and f which cause sytemic disease

A

invasive

capsule is antiphagocytic

43
Q

disease that can be caused by invasive H flu strains such as B

A

meningitis and epiglotitis in 6 months-5 years

arthirits cellultite ostemyelitis

CAPnemonia in children and adults whoa are ImmunoC

44
Q

enencapsulated HFLu strains cause

A

otitis media, conjunctivitis, in young chldren and infants

resp diz in adults

45
Q

causes of OM in children (order)

A

Strep penumo
H flu
moraxella

46
Q

tx of H flu

A

3rd gen cephs
plus dexamathasone to control inflammation

give dex b4 ab’s

47
Q

vaccine for H flu

A

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
Q

soft chancre

A

H ducreyi

often confused with syphilis

49
Q

HACEK group causes

A

subacute bacterial endocarditis mainly on defective hart valves

50
Q

club shaped GPR motile at 25 degrees Celsius

A

listeria monocytogenes

51
Q

faculatative intracellular parasite tat infects mucosal epithelial cells and macrophages/monocytes

A

lysteria monocytogenes

52
Q

requires strong cellular immunity

A

lysteria- relies on cellular immune response for containing the bacteria

53
Q

unpasteurized sot cheeses and found in environment with poultry goats and sheep

HOT DOGS AND DELI MEATS

A

Listeria monocytogenes

uncommon but fatal and always require hospitalization

54
Q

can lysteria cause vertical transmission thru childbirth

A

yes, some ppl are carriers

infections 20x more liukley in pregnant women than nonpregnant women

55
Q

in normal adults, listeria causes

A

inapparent flue like illness

56
Q

in ImmunoC adults and neonates listeria cuases

A

meningitis, bacteremia,

in newborn:
stillbirth, premature birth, sepsis

57
Q

emperic tx for bacterial meningitis

A

3rd gen cephs

ampicillin is listeria suspected

if resistant strep pneumo -add vanc

dexamaethasone (controversial)

58
Q

most common cause of bacterial meninigtis (50%) int he US

A

Step pneumococcus

normal URT inhabitant of 5-40%

59
Q

strep pneumo and viridans fall into what category of strep

A

alpha hemolytic

thus are not lancefield antigen typed

60
Q

beta hemolytic strep are all classified how

A

by their lancefield antigen

a-pyogenes
b- GBS agalactiae
D- enteroccocus

61
Q

viridans and pneumo can be distinguished how?

A

optochin sensitivity

viridans=resistant

62
Q

leading cause of invasice bacterial dz in children, elderly, and IC pt.s

A

s. pneumoniae

63
Q

access to BBB by strep pneumois via

A

binding cerbral acpillaries, transmigration and entrance into the CSF =meningitis

64
Q

resistance to phagocytosis for s pneumo is via

A

interference with binding of C3b to cell surface

65
Q

three main virulence factors for strep pnuemo

A
  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
Q

“crowded conditions”

A

Nisserria Meningitides

ABCY w135 strains of relevance

67
Q

sporadic NM outbreaks-small numbers of related cases-which subtypes

A

B C Y

68
Q

epidemic outbreaks of NM-large numbers large areas

A

A

69
Q

” all of a sudden really bad shape”
petechial rash
die within 24 hours of hospitalization

A

think meningococcus

70
Q

major toxin of N.M

A

LOS with endotoxin mechanism

antiphagocytic capsule

71
Q

unique part of NM infection

A

PHASE VARIATION

TURNS OFF CAPSULAR GENES WHEN PENETRATING MUCOSA

TURNS THEM BACK ON WHEN IN THE BLOOD STREAM

72
Q

DOC FOR meningococcus

A

penicillin

if allergic-3rd gen cef

73
Q

non immunogenic strain of NM in humans

A

B strain

74
Q

phase variation and masters of disguise and change

A

Nisseria gonnorrhae and meningitides

75
Q

type of variation by the nisseria species

A

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
Q

activates silent pilS loci during antigenic variation

A

Nisseria meningitides

77
Q

virulence factors for H flu

A

antiphag. capsule

polysaccharidae antigens are weak

78
Q

describe the imporant of the polysaccharide anigens

A

anticap antibodies are antigenic but and T CELL INDEPENDENT-entirely B cell and saccharides mediated–thus short lived immunity

79
Q

necessary to kill L monocytogenese

A

macrophage activation of cytokines

80
Q

f actin based motility

A

L monocytogenes

Neuro (19 decks)

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