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Neurology > Brain infections > Flashcards

Brain infections Flashcards

1
Q

How can you distinguish a traumatic tap from a bloody tap?

A

expect only 1 WBC per 700 RBC in a traumatic tap

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2
Q

What is on the differential for acute lymphocytic predominant meningitis?

A

enterovirus, HSV, VZV, HIV, Lyme, VDRL, EBV

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3
Q

How can you distinguish enterovirus from lyme meningitis?

A

enterovirus is more common, EBV has a shorter prodrome (1 day); facial palsy occurs in lyme

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4
Q

What are causes of lymphocytic meningitis you should especially consider in immunocompromised hosts?

A

VZV, cryptococcus, T gondii, NSAIDs

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5
Q

A patient treated for cryptococcal meningitis returns one month later with severe headache, seizures and an LP showing 230 WBC. What should you give?

A

steroids for immune reconstitution syndrome

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6
Q

A patient with HIV presents with a large area of white matter enhancement and tests positive for JC virus.. this is..

A

PML

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7
Q

A patient with HIV presents with a ring enhancing lesion. First test?

A

toxo blood test

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8
Q

What is the best tx for bells palsy?

A

steroids

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9
Q

What are the most common culprits in bacterial meningitis?

A

strep pneumo, neisseria, listeria - tx with steroids and then antibiotics

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10
Q

The roommate of a patient who had meningitis should receive what form of prophy?

A

rifampin or cipro

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11
Q

A young patient presents with psychotic features and smell hallucinations. Suspect..

A

HSV1

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12
Q

A patient who travels a lot presents with low grade myalgias and fever and presents areflexic in both legs, mild bilateral weakness, mild facial weakness. MRI shows inflammatory changes in the anterior horns. This is…

A

west nile encephalitis

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13
Q

A patient who was previous well presents unsteady, forgetful with enlarged ventricles, rapid deterioration. She becomes nonverbal and has an occasional myoclonic jerk. This is..

A

cjd

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14
Q

What is the typical presentation for TB meningitis?

A

brain stem infarcts due to basal meningeal involvement

often hydrocephalus

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15
Q

What are some of the symptoms of late neuro lyme?

A

early - aseptic meningitis

cranial nerve palsies, polyneuropathy, polyradiculopathy, encephalopathy

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16
Q

A patient presents with complex partial seizures of the temporal lobe, olfactory hallucinations and a CSF count that shows an elevated RBC. Think

A

HSV1

17
Q

What is the treatment for HSV1 encephalitis?

A

acyclovir

18
Q

A patient presents with seizures, heaache and increased ICP with imaging showing enhancing cysts. Treatment?

A

neurocystericosis - treat with albendazole

19
Q

A patient with HIV develops loss of vibration and joint position sens, sensory ataxia. This is…

A

vacuolar myelopathy due to severe immunosuppression

20
Q

A 27 year old patinet comes in with tingling in his limbs and weakness after completed Hep B vaccinations. LP shows no whites and a protein of 450. This is..

A

GBS

21
Q

A young girl develops is treated for a CNS infection with antbiotics and has bilateral sensorineural hearing loss. What would her LP show?

A

elevated polys, elevated protein, low glucose

22
Q

A man who emigrated from Mumbai has double vision, stiff neck and a 6th nerve palsy. What would LP show?

A

low glucose, high protein, high WC - Tb meningitis

23
Q

A young boy on chemo develops ear pain, inability to close left eye, flattening of nasolabial fold. His external auditory canal shows red lesions. This is..

A

VZV - Ramsay Hunt

24
Q

A young woman on steroids has a headache and stiff neck. Her OP is very high and she has elevated lymphocytes with neg. gram stain. this is..

A

crypto

25
Q

What are the consequences of congenital CMV?

A

bilateral hearing loss, spasticity, hyperintensities on MRI margins

26
Q

What antibiotic should be added to cover for listeria?

A

ampicillin

Neurology (24 decks)

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