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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is on the differential for acute lymphocytic predominant meningitis?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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

A

VZV, cryptococcus, T gondii, NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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

A

toxo blood test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the best tx for bells palsy?

A

steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the most common culprits in bacterial meningitis?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

rifampin or cipro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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

A

HSV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the typical presentation for TB meningitis?

A

brain stem infarcts due to basal meningeal involvement

often hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some of the symptoms of late neuro lyme?

A

early - aseptic meningitis

cranial nerve palsies, polyneuropathy, polyradiculopathy, encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

17
Q

What is the treatment for HSV1 encephalitis?

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..

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..

25
What are the consequences of congenital CMV?
bilateral hearing loss, spasticity, hyperintensities on MRI margins
26
What antibiotic should be added to cover for listeria?
ampicillin