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
Whatis the Munro Kellie hypothesis of Intra-cranial Pressure
he Volume of the brain, CSF and blood is constant because th skull creates a confined space
26
How is cerebral perfusion pressure calculated
Mean arterial pressure - ICP
27
Why do vasalva manoeuvres worsen headaches?
Increase ICP
28
What are the 3 types of herniation
Trantentorial (temporal lobe below the tentorium cerebella), tonsils (cerebella tonsils) and subfalcine (falx cerebri)
29
What can raise ICP?
Mass lesions Disturbance of CSF circulation Diffuse brain oedema Idiopathic
30
Where is the pathology in non-communicated hydrocephalus?
Blockage within the ventricular system, proximal to arachnoid granulations
31
What can cause non-communicating hydrocephalus?
Aqueduct stenosis
32
What are the MRI findings on non-communicating hydrocephalus?
Ventricular enlargement, sulcal effacement, reduced visibility of tissue
33
What is the pathology of communicating Hydrocephalus
Can't properly reabsorb the CSF
34
What are the presentations of acute hydrocephalus?
acutely elevated ICP
35
What is the presentation of chronic hydrocephalus? (AID)
Apriaxia Incontinenc Dementia