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MBBS III Sem II > Case 3: Meningitis Pathology > Flashcards

Case 3: Meningitis Pathology Flashcards

1
Q

How may microorganismenter the meninges?

A

Ears, nasopharynx (extension)
cranial injury (direct implantation)
Blood (haematological dissemination)
Peripheral nervous system

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2
Q

Name 4 major bacterial agents for meningitis?

A

Neisseria Mengitidis
Strep Pneumonia
Staph Aureus
Step gORUP b

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3
Q

Name 4 major viral causes of meningitis?

A

Enterovirus
Herpes
Mumps
HIV

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4
Q

Name 2 major fungal cause of meningitis

A

Crypt neoformans

candida Albicans

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5
Q

What is the gram status of H influenza?

A

Gram Negaive

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6
Q

What conditions is H. influenza most associated with?

A

OM and sinusitis

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7
Q

Where is H influenza commonly found?

A

The nasopharynx

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8
Q

When is strep pneumococcal the most common type of meningitis?

A

In patient with truama, ASSOCIATED WITH ALCOHLISM, MALUTRITION AND dm

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9
Q

What is the gram status of strep Pnemococcal

A

Gram Positive

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10
Q

What is the gram status of n. meningitides?

A

Gram Negative

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11
Q

hy is leiseria monocytogens so important?

A

High mortality rate

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12
Q

What changes in the pie-arachnoid space are observed in meningitis?

A

congestion of polymorphs and development of pus

brain become covered wit grey-green exudate

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13
Q

What changes int eh sub-arachnoid space are observed in viral meningitis?

A

lymphocytic inflammatory CSF reaction without pus formation

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14
Q

What is the difference between complicated and uncomplicated Hydrocephalus?

A

Complicated has an obstruction of CSF leading to coning, brain atrophy and widening of the ventricles

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15
Q

What are the 3 types of meningitis?

A

Acute pyogenic (bacterial)
Aseptic (acute or subacute viral)
Chronic (Tb, cryptococcus)

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16
Q

What is the leading cause of acute pyogenic meningitis in adolescents?

A

Neisseria meningitidis

17
Q

What is th leading cause of meningitis in elderly?

A

Strep pneumonia and listeria monocytogens

18
Q

What is waterhouse-friderichsen syndrome?

A

Septicaemai secondary to meningitis
Haemorrhagic infection of the adrenal glands
Cutaneous petechiae
(seen in meningococcal infeciton

19
Q

How does CSF appear in acute pyogenic meninigitis?

A

Clouding, increased pressure, increased neutrophils, increased protein and decreased glucose

20
Q

What is aseptic meningitis?

A

What there are the manifestations of meningitis without positive bacterial culture (usually is viral)

21
Q

How does the CSF appear in aseptic meningitis?

A

Lymphocytic pleocytosis, increased pressure, increased neutrophils, moderate protein and normal glucose

22
Q

What is a brain abscess?

A

Discrete lesions with liquiefactive necrosis surrounded by brain swelling
Granulation tissue at the outer margin

23
Q

What predisposes to brain abscess?

A 
Bacterial endocarditis
Congenital heart disease
Loss of pul filtration of organisms
Pul sepsis 
Immunosuppression
24
Q

Whatis subdural empyema

A

This is an infection of the subdural tissue, bacteria proliferate in the subdural tissue

25
Q

Whatis the Munro Kellie hypothesis of Intra-cranial Pressure

A

he Volume of the brain, CSF and blood is constant because th skull creates a confined space

26
Q

How is cerebral perfusion pressure calculated

A

Mean arterial pressure - ICP

27
Q

Why do vasalva manoeuvres worsen headaches?

A

Increase ICP

28
Q

What are the 3 types of herniation

A

Trantentorial (temporal lobe below the tentorium cerebella), tonsils (cerebella tonsils) and subfalcine (falx cerebri)

29
Q

What can raise ICP?

A

Mass lesions
Disturbance of CSF circulation
Diffuse brain oedema
Idiopathic

30
Q

Where is the pathology in non-communicated hydrocephalus?

A

Blockage within the ventricular system, proximal to arachnoid granulations

31
Q

What can cause non-communicating hydrocephalus?

A

Aqueduct stenosis

32
Q

What are the MRI findings on non-communicating hydrocephalus?

A

Ventricular enlargement, sulcal effacement, reduced visibility of tissue

33
Q

What is the pathology of communicating Hydrocephalus

A

Can’t properly reabsorb the CSF

34
Q

What are the presentations of acute hydrocephalus?

A

acutely elevated ICP

35
Q

What is the presentation of chronic hydrocephalus? (AID)

A

Apriaxia
Incontinenc
Dementia

MBBS III Sem II (16 decks)

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