Clinical Flashcards
For treatment of Bacterial Meningitis do not give which antibiotics?
Vancomycin, Gentamicin
You should however use Penicillin, Ceftriaxone, Meropenem, Chloramphenicol
What does this describe: inflammation of the brain alteration of conscious level change in emotions, personality, behaviour focal neurological signs
Encephalitis
Name the meningism
Triad of symptoms
Neck stiffness
photophobia
headache
Name the types of Encephalitis
Post infectious en.
Endemic
Chronic progressive
Sporadic (most common)
Bacterial meningitis is caused by which organism
Neisseria meningitidis
S. pneumoniae,
Define neuritis
Inflammation of the nerve
Viral encephalitis is caused by which main organism
Herpes simplex virus
Type 1 most common, Type 2 occurs more in neonates
Which other organisms/ things that can cause meningitis
Fungal, parasitic, prion
Which diagnosis techniques are used for CNS infections
History- signs and symptoms CSF sampling- Lumbar puncture or PCR or viral nucleic acid anaylsis Radiology- CT/ MRI Biopsy postmortem
Which drug is used to treat Viral Meningitis. How is it administered and for how long?
Aciclovir
I.V.
2-3 weeks
Viral meningitis is typically caused by which organism
Enteroviruses:
- Poliovirus
- Echovirus
- Coxsackie A &B virus
Treatment of CNS infection: Supportive care
Airway Breathing Circulation Nutrition Physiotherapy Rehabilitation
Name the likely organism involved in infections of the spinal cord, dorsal root, ganglia and brainstem
Poliovirus (and some other enteroviruses)
Varicella zoster virus
Symptoms of Aseptic (viral) meningitis
Sore throat precedes
Headache
Miningism triad
Nausea and vomiting
Describe the ways infection can spread to the CNS
Neuronal transfer from periphery
Spreading from cranial bones, sinus
Infections-respiratory
What is Parkinson’s disease
Loss of dopaminergic neurones from the substantia nigra
Huntington disease
Condition which occurs when there is a genetic mutation on chromosome 4 which cause change in the huntingdin protein. Affects the Caudate nuceus
mneumonic -HUNT 4 DATE
Brown Sequard syndrome
Sensory loss due to lesion on lateral part of spinal cord
There is a total ipsilateral loss of position, light touch and vibration sensation at the level of the lesion.
There is contralateral loss of pain and temperature beginning a few segments below the lesion
Define allodynia
Painful or unpleasant sensation evoked by low intensity (non-painful stimulus)
Define Hyperalgesia
Increase pain from noxious stimulus
Which fibres are involved in pain transmission
A delta fibre carries nocioception fast
C fibres- unmylinated- carry nocioception slow
Which areas in the cortex are activated by Pain
Somatosensory cortex
Insular cortex (beneath temporal lobe)
Anterior portion of cingulate cortex (ACC)
Name the subcortical structures involved in Pain
- Hypothalamus- nausea, sweating vomiting
- Pons and Medulla
- Periaquaductal grey (PAG)
- Amygdala- fear and anxiety associated
- Parabrachial- projects to many of the structure above. Integration of nociception & homeostatic afferents
Name the 3 sites for analgesic opiod action
- Inhibit excitatory neurotransmitter release from Pre-synaptic terminal of afferent fibre.
- Inhibit the spinothalamic tract by ACTIVATING the K+ channels and hyperpolarising the cell
- Periaquaducatal Grey
Define tolerance
The need to increase the dose of a drug to achieve the same effect
Define Physical dependance
Long term use causes- withdrawal reaction if the drug is stopped
Addiction
Craving for a drug and the involvement in obtaining and using it for means other than pain relief
What is nociceptive pain
Pain that occurs due to stimulation of nociceptors
-May be somatic or visceral
Neuropathic pain occurs…..
Complete sentence
Neuropathic pain occurs because of damage to the central or peripheral nervous system
