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Neurology > Cerebral Infections > Flashcards

Cerebral Infections Flashcards

1
Q

Mcc of Pyogenic meningitis in adolescents/ adults / epidemic/ community/ CSF leak

A 
N. Meningitidis
Pneumococcus
N. Meningitidis
Pneumococcus
N.Meningitidis
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2
Q

R/f for pneumococcal meningitis

A 
DM
Pneumonia
Splenectomy
Hypo gamma globulinemia
Chronic sinus/ear infection
HEAD TRAUMA**
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3
Q

Is sub dural effusion a complication of meningitis?

A

Yes

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4
Q

Organism in neonates, IC, elderly, pregnancy meningitis

A

LISTERIA

From infected food

  • coleslaw
  • cheese
  • milk
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5
Q

Cf of pyogenic meningitis

A

Headache
Fever
Neck rigidity
Altered sensorium

Kernig (pain)
Brudzinski (neck—> knee)
(BOTH THESE SIGNS ARE ABSENT IN EXTREMES OF AGE & IC)

Seizures (20-40%)
(Dt CVT/Ischemia/Focal edema)

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6
Q

Ixoc Pyogenic meningitis

A

CSF ANALYSIS

Divide CsF into 4 test tubes
(Biochem-pharma-patho)

1 Glucose Protein
2 culture stain
3 cell count
4 additional tests

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7
Q

CSF features of Meningiti pyogenic

Color/ cells/ gluc/ prot/ cl

A

Turbid
>1000 (N>L)
Very low glucose (HYPOGLYCORRHIZIA)
Slightl low chlorine

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8
Q

Normal glucose proteins cells cl in csf

A

40-70 mg/ dl (2/3 OF RBS)

15-45mg/dl

<5 cells

116-126

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9
Q

Tx Pyogenic meningitis

A

DEXA 1st line
Abx

(Both within 60min if arrival)

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10
Q

Empirical therapy of pyogenic meningiti

A

Adolescent- CEFTRIAXONE

Adults- CEFTRIAXONE+ VANCOMYCIN

Elderly/IC/>55 - CF + V + Ampicillin

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11
Q

N.meningitidis
S. Pneumonia
Listeria
Staph aureus (+ve jn shunts)

DOC

A

Ceftriaxone x 7d

Ceftriaxone + Vanco x 14d

Ampicillin x 21 d

Nafacillin

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12
Q

Poor prognosis in pyogenic meningitis

A 
Decreased conciousness
ICT
SZ <24hr
Infant / Elderly
Protein > 300
Glucose <40
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13
Q

Tuberculosis neuro sequale depending on immunity?

A

Good- caseous necrosis—resolves

Moderate- Caseous foci with encapsulation— reactivate if IC

Low- ruptured foci—TBM

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14
Q

Findings of TBM*****

A

Basal Cistern EXUDATES

ENDARTERITIS (infarcts+)

Hydrocephalus (exudates block)

Tuberculoma

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15
Q

CSF analysis of TBM

A 
COB WEBB app in test tube***
L>>N
Inc prot
Decrease glucose
Heavy decrease in Cl (Tb loves cl)
ADA Increase
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16
Q

GST for TBM

A

CSF culture

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17
Q

Rx TBM

A

ATT 12-18 months

Steroids (x Endarteritis)

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18
Q

Organism causing subdural empyema

A

S. Pneumoniae

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19
Q

Self limiting/ aseptic/ benign / recurrent LYMPHOCYTIC predominant meningitis

A

MOLLARET

HSV2

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20
Q

Mcc of CCMeningitis

A

HIV +
Cryptococcus neoformans
(Found in soil/ avian droppings)

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21
Q

Entry of cryptococcus in body!

A

Lungs—hematogenous spread—brain

22
Q

CD 4 count for CCM

A

<100

23
Q

Which nerve palsy in CCM

A

7

24
Q

CSF analysis CCM

A

Mild pleocytosis(L>N)

Glucose NORMAL

Mild protein increase

STAINING- INDIA INK

S. Cryptococcal Ag = +ve 3 weeks prior to meningitis ***

25
Q

MRI CCM

A

Enlarged VIRCHOW-ROBBIN Spaces

26
Q

Rx CCM

A

Ampho B + Flucystosin/Fluconazole iv

F/b fluconazole life long (or till Cd4>200)

27
Q

Mcc overall/epidemic/ sporadic of VIRAL ENCEPHALITIS

A

Enterovirus

JE (arbovirus)

HSV1 > mumps > cmv > NIPAH

28
Q

Features of VE

A

Headache

Fever

Altered sensorium

Seizures

HEMORRHAGIC TEMORAL LOBE LESIONS**

NO NECK RIGIDITY

29
Q

Ix of VE

A

Xanthochromic RBC (also in SAH)

Pleocytosis (L>N)

Protein increased

Cl decreased

Glucose decreased

MRI - BITEMPORAL HYPERINTENSITIES

PCR

30
Q

Most sensitive test for VE

A

PCR for HSV

31
Q

Rx VE

A

Acyclovir iv 8 hourly for 21 days

NOT FOR ENTEROVIRUS

32
Q

PMLE Organism

A

JC virus (John cunningham)

33
Q

Which brain cells does JC virus affect

A

Oligodendrocytes —INCLUSION BODIES+
(Exc- Optic N and Spinal cord—spared)

Astrocytes- DISRUPTED BBB
(bizzare mitotic nuclei++)

34
Q

R/F pMLE

A

HIV (80%)
Tx recipients
Hematological malignancy
NATALIZUMAB/RITUXIMAB

35
Q

C:f PMLE

A 
Visual defects (mc)
HOMONYMOUS HEMIANOPIA

Confusion
Dementia
Personality changes

SEIZURES

36
Q

Ix PMLE

A

MRI- Demyelination & Hyperintensities

PCR- for JC virus

Brain biopsy

(NO PLEOCYTOSIS AS IC+)

37
Q

Rx PMLE

A

DOC- MIRTAZAPINE**

Mefloquine
CIDOFOVIR*
HAART

Death within 3-6 months

38
Q

Prion disorders in humans

A

CJD

GSS

Kuru (Ritualistic cannibalism)

Familial Fatal Insomnia

39
Q

Pathogenesis of PRION DS

A

Prp C protein (209 AA) (a»b chains) ——-AMYLOIDOSIS ——PRP-SC(b»>a chains)

40
Q

Types of CJD

A

Sporadic (mc)

Variant (Contaminated beef)

Familial (PRNP gene- Chr20)

Iatrogenic (corneal graft/EEG electrodes/Dural grafts/Human growth hormone)

41
Q

Sporadic CJD onset death Cf Ix

A

66 years
Death in 4 months

Dementia
Startle Myoclonus (mc)

EEG- Bi and triphasic waves

MRI- Cortical Ribboning

Bx- SPONGIFORM DEGENERATION **
(Vacuoles in brain cells)

42
Q

Variant CJD MRI

A

Hockey stick sign
Pulvinar sign

BOTH IN THALAMUS

43
Q

NCC organism and hosts

A

TAENIA SOLIUM

Definite- Human
Intmd- PIG*

Uncooked pork/Raw vegetables

44
Q

Cf NCC

A

SEIZURES

45
Q

CECR/CEMRI NCC

A

Ring enhancing lesion

46
Q

Stages if NCC

A

Vesicular (ABZ works)

Colloidal-dying (SZ/Edema+++)

Calcified (no rx)

47
Q

Rx NCC

A

1st steroids
Albendazole&raquo_space; praziquantel
AED x 6m — till calcified

48
Q

SSPE cause

A

Mumps virus

49
Q

SSPE cf

A

Poor school performance
Focal/ Gen MYOCLONIC SZ
VISUAL DISTURBANCES***

50
Q

SSPE DOC

A

ISOPRINOSINE

Neurology (11 decks)

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