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BRAIN BATTACK > CH31: Bacterial, Fungal, Spirochetal, Parasitic Infections > Flashcards

CH31: Bacterial, Fungal, Spirochetal, Parasitic Infections Flashcards

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1
Q

Most common spontaneous or community-acquired pathogenic organisms (p. 719)

A

S pneumoniae, N meningitidis, group B strep, Listeria monocytogenes, Staphylococcus

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2
Q

Most common spontaneous or community-acquired pathogenic organisms in neonates (p. 719)

A

E. coli, group B strep

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3
Q

Most common spontaneous or community-acquired pathogenic organisms in infants(p. 719)

A

H influenzae

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4
Q

Released by macrophages believed to stimulate and modulate the local immune response affecting neurons (p. 721)

A

interleukin-1, TNF

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5
Q

Most prominent finding in the later stages in meningitis (p. 721)

A

infiltration of the subependymal perivascular spaces

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6
Q

Most significant factor in the pathogenesis of meningitis in infants and newborns (p. 723)

A

Maternal infection

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7
Q

Pressure over approximately what value suggest the presence of brain swelling and potential for cerebellar herniation (p. 724)

A

350mmH20

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8
Q

Cell counts of more than what value raise the possibility of a brain abscess having ruptured into a ventricle? (p. 724)

A

50,000

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9
Q

Cutoff for protein and glucose in bacmen?

A

higher than 45mg.dL protein, 40mg/dL glucose of 40% of blood glucose concentration

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10
Q

A clinical prediction rule was made to classify children at very low risk for bacmen if the have the following (p. 725)

A

negative CSF gram stain
CSF absolute neutrophil count under 1,000 cells/ mL
CSF protein under 80mg/dL
peripheral absolute neutrophil count under 10,000 cells/ mL
no history of seizure

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11
Q

blood cultures positive up to how many percent of patients w H influenza, meningococcal and pneumococcal meningitis? (p. 725)

A

40-60%

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12
Q

Most specific and sensitive test for CSF otorrhea and rhinorhea (p. 726)

A

b2- transferrin

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13
Q

Recurrent meningitis, iridocyclitis, depigmentation of hair and skin (p. 726)

A

Vogt- Koyanagi- Harada

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14
Q

Best initial therapy for the three major types of community acquired meningitis (p. 727)

A

Ceftriaxone + Vancomycin

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15
Q

Corticosteroids decrease this in patients with H influenza meningitis (p. 728)

A

sensorineural hearing loss

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16
Q

How to give steroids is bacmen (p. 728)

A

Dexamethasone 10mg IV now theN Q6 FOR 2 DAYS

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17
Q

Prophylaxis for meningococcal exposure (p. 728)

A

Single dose of Ciprofloxacin or daily oral dose of rifampin 600mg q12 in adults, 10mgq12 in children for 2 days

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18
Q

Osler triad carrying high fatality rate (p. 729)

A

pneumococcal meningitis, pneumonita, endocarditis

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19
Q

Etiologic agent of Melioidosis (p.731)

A

Burkholderia pseudomallei

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20
Q

Treatment for melioidosis (p. 631)

A

Ceftazidime for 10 to 14 dyas then Cotrimoxazole

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21
Q

Unilateral axillary or cervical adenopathy occuring after a seemingly innocuous scratch (p. 732)

A

Catscratch fever

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22
Q

Treatment for catscratch fever (p. 732)

A

Azithromycin or doxycycline

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23
Q

Treatment for Anthrax (p. 732)

A

Ciprofloxacin with clindamycin, rifampin or meropenem

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24
Q

Ingestion of raw milk (p. 732)

A

Brucellosis

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25
Q

Most common areas of subdural empyema (p. 733)

A

Frontal or ethmoid

26
Q

Most common areas of brain abscess (p. 736)

A

frontal and sphenoid

27
Q

Percent of congenital heart disease complicated by brain abscess; percent of brain abscess associated with congenital heart disase (p. 737)

A

5%, 60%

28
Q

Most common cardiac anomaly associated with brain abscess (p. 737)

A

Tetralogy of Fallot

29
Q

CT scan finding of brain abscess (p. 738)

A

capsule of abscess is not uniform; medial paracentricular aspect is thinner

30
Q

Mycobacterium associated with neurosurgical procedures and cranial trauma (p. 740)

A

Mycobcaterium fortuitum

31
Q

Used to document previous or current TB infection (p. 741)

A

interferon-gamma-release assay

32
Q

Alternative treatment for TB (p. 743)

A

INH, PZA, high dose RMP, Moxifloxacin

33
Q

Single most effective drug for TB (p. 743)

A

INH

34
Q

Except for which drug , all anti-Kochs can be given via stomach tube (p. 743)

A

INH

35
Q

Meningitis occurs in how many percent of all cases of syphilis (p. 744)

A

25%

36
Q

If CNS not involved in 2 years, 5 years, how many percent chance of developing neurosyphillis? (p. 744)

A

5% then 1%

37
Q

Early clinical syndromes of syphilis (p. 744)

A

aseptic meningitis, meningovascular syphilis

38
Q

Late or secondary syphilis (p. 744)

A

vascular syphilis

39
Q

Tertiary syphilis ( p. 744)

A

general paresis, tabes dorsalis, optic atrophy, subacute myelitis

40
Q

CSF findings in syphillis (p. 745)

A

pleocyctosis 100cells/ mm3, elevation of gamma globulin, elevation of TP 40 to 200mg/dL, positive serologic tests

41
Q

Most reliable but expensive to perform diagnostic modality for syphillis (p. 745)

A

T pallidum immobilization

42
Q

Most common form of neurosyphilis (p. 745)

A

Meningovascular syphilis

43
Q

Most common area of infarction for MV syphilis (p. 745)

A

distal territories of medium and small caliber LS branches that arise from the stems of the MCA and ACA

44
Q

Paretic neurosyphilis syndrome– prominent focal signs, unilateral frontal or temporal lobe disease (p. 746)

A

Lissauer cerebral sclerosis

45
Q

Most prominent feature of Tabtic neurosyphilis (p. 747)

A

Ataxia

46
Q

Treatment of syphilis (p. 745)

A

PenG IV 18 to 24M units daily for 10 to 14 days [4M q4]

47
Q

painful lymphocytic meningoradiculotis in Borreliosis (p. 749)

A

Bannwarth syndrome

48
Q

Treatment for Cyrptococcal meningitis (p. 752)

A

Amphothericin B 0.7 to 1.0 mg/kg/day or 3-4 mg/kg/day liposomal amphthericin. Add Flucytosine 100mg/kg/day

49
Q

Associated with chronic sinusitis with osteomyelitis at the base of the skull (p. 753)

A

Aspergillosis

50
Q

Treatment for Aspergillosis (p. 753)

A

Itraconazole

51
Q

Most common rickettsial disease (p. 754)

A

Rocky Mountain spotted fever

52
Q

Important diagnostic sign in scrub typhus (p. 754)

A

necrotic ulcer and eschar at the site of attachment of infected mite

53
Q

Treatment for rickettsial disease (p. 754)

A

Doxycycline or chloraphenicol

54
Q

Treatment for Toxoplasmosis ( p.755)

A

Sulfadiazine and Pyrimethamine. Add Leucovorin (15 to 20mg daily)

55
Q

Trypanosomiasis: characteristic feature of posterior cervical adenopathy of subsequent CNS infection (p. 756)

A

Winterbottom sign

56
Q

Trypanosomiasis: sign pronounced pain at sites of minor injury (p. 756)

A

Kerandel hyperesthesia

57
Q

Multiple calcified lesions in the thigh, leg and shoulder (p. 758)

A

Cystecircosis

58
Q

Schistosomiasis: cerebral hemisphere (p. 759)

A

S. japonicum

59
Q

Schistosomiasis: spine (p. 759)

A

S. mansoni

60
Q

S. mansoni location in the spine (p. 760)

A

conus medullaris

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