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BB2 Facts Flashcards

0
Q

Meningitis causes 6mo-60yrs

A

S. Pneumoniae, N. Menigiditis, H. Influenza

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1
Q

Meningitis causes ages 0-6mo

A

Listeria, E. coli, GB Strept

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2
Q

Meningitis causes age 60+

A

S. Pneumoniae, Listeria

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3
Q

TB meningitis involves what part of brain

A

Basal aspect with cranial nerve involvement

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4
Q

Most common cause of lymphocytic aseptic meninigitis

A

Enterovirus

herpes or mumps less likely

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5
Q

Most common cause of non-herpetic viral encephalitis

A

Arbovirus (seasonal)

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6
Q

Causes of herpetic encephalitis

A

HSV1 (most common), CMV, VZV

-Bilateral, asymmetrical hemorrhagic necrosis of the temporal lobes

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7
Q

Key microscopic pathological feature of rabies encephalitis

A

Negri bodies in purkinje cells or large pyramidal cells

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8
Q

Poliomyelitis

  • What is it?
  • What causes it?
  • Microscopic pathology (key)
A
  • Enterovirus that targets spinal cord grey matter

- Neuronophagia (dying neuron surrounded by microglial cells)

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9
Q

Most common causes of viral meningitis/menigoencheph

A

Eterovirus, herpes virus, arbovirus

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10
Q

Two main histological features of viral enceph

A
  1. Perivascular chronic inflammatory infiltrates

2. Neuronophagia

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11
Q

What receptor is involved in MOA of LSD?

A

5HT-2 post-synaptic receptor

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12
Q

List 3 treatments for LSD

A
  1. Ride the wave
  2. Support/reassurance
  3. Benzos to calm them down

-no chronic damage, but can unmask psychiatric vulnerabilities like panic, paranoia or depression

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13
Q

Clinical manifestations of LSD

A
  • Unpredictable
  • Micropsia, macropsia, derealization, depersonailization, visual hallucinations, synethesia (hear colors eg), euphoria/lability, ego fragmentation
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14
Q

Clinical manifestations of PCP

A
  • Euphoria, peaceful floating sensation, disconnection from world, oblivious to surroundings
  • Flat affect (Sz like), uncommunicative, staring gaze, rigid muslces
  • Slurred speech, rotary nystagmus (arch of eyes), rolling gait, hand/feet numbness, depersonalization, distortions of body image/space/time, delusions, perceptual disturbances
  • Large doses can be lethal: hyperacusis, amneisa, hostility/paranoia, excessive salivation without a gag reflex, muscle rigidity, increased BP & pulse, coma and convulsions

-recovery can take days

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15
Q

MOA PCP

A
  • NMDA receptor antagonist (blocks glutamate activity)

- DA/5HT, sigma and K+, Na+ receptor involvement

16
Q

Treatment for PCP

A
  • No chronic use permanent damage, but do have neuro and cog dysfxn for 2-3 weeks
  • do not reassure, it doesn’t work
  1. Benzos target seizure risk
  2. Acidification of urine
  3. Antipsychotics for paranoia
  4. Gastric suction
17
Q

Clinical manifestations of MDMA

A
  • Euphoria/loving feeling, loss of boundaries between self and others, disinhibition (decreased defensiveness), increased intimacy
  • Cognitive distortions-shifts in thought form and content, slowed mentation, cognitive apathy
  • Perceptual distortions-intensified visual perceptions, visual hallucinations, altered sense of time/space
  • Increased BP, HR, dry mouth, brxism (teeth grinding)
18
Q

MOA MDMA

A

-Increased vesicular release of DA and Serotonin

19
Q

Treatment of MDMA

A
  • dehydration treatment
  • reassurance
  • support
  • edu

-Chronic use causes long lasting destruction of serotonergic pathways leading to greater risk of depression

20
Q

Clinical manifestations of anticholinergics

A

(atropine, TCAs, etc)

  • Delirium (waxing/waning of consciousness, impulsivity, impaired judgement, hallucination)
  • Hallucinations (misperceptions, dysphoria, estrangement, depersonalization, agitation)
  • Toxicity (fever, warm, dry skin, fixed dilated pupils, tachycardia, decreased peristalsis, atonic bladder)
21
Q

Treatment of anticholinergic

A
  • Discontinue offending agents
  • Protect pt against involuntary harm
  • Gastric lavage, parenteral physostigmine
22
Q

Clinical manifestations of inhalants

A
  • Stimulation
  • Disinhibition
  • Nystagmus (regular)
  • Muscular incoordination
  • Perceptual distortions
23
Q

MOA Inhalants

A

GABA-A receptor agonist (like alcohol)

24
Q

Chronic effects of Inhalants

A
  • Toxicities in various organs
  • CNS damage (demyelination, cerebellar atrophy, impaired memory, attention and concentration and non-verbal intelligence)
25
Q

ST. John’s Warts risk/benefits

A

Risks:

  • Mania in BPD
  • Don’t use with SSRI: serotonin syndrome
  • Hyperforin induces CYP3A (other drugs get metab faster)

Benefits:

  • Better than placebo
  • Equal to SSRI and TCA
  • Treats mild/moderate depression

Developmental Milestones (17 decks)

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