Clinical Flashcards

1
Q

For treatment of Bacterial Meningitis do not give which antibiotics?

A

Vancomycin, Gentamicin

You should however use Penicillin, Ceftriaxone, Meropenem, Chloramphenicol

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2
Q
What does this describe:
 inflammation of the brain
alteration of conscious level
change in emotions, personality, behaviour
focal neurological signs
A

Encephalitis

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3
Q

Name the meningism

A

Triad of symptoms
Neck stiffness
photophobia
headache

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4
Q

Name the types of Encephalitis

A

Post infectious en.
Endemic
Chronic progressive
Sporadic (most common)

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5
Q

Bacterial meningitis is caused by which organism

A

Neisseria meningitidis

S. pneumoniae,

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6
Q

Define neuritis

A

Inflammation of the nerve

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7
Q

Viral encephalitis is caused by which main organism

A

Herpes simplex virus

Type 1 most common, Type 2 occurs more in neonates

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8
Q

Which other organisms/ things that can cause meningitis

A

Fungal, parasitic, prion

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9
Q

Which diagnosis techniques are used for CNS infections

A
History- signs and symptoms
CSF sampling- Lumbar puncture or PCR or viral nucleic acid anaylsis
Radiology- CT/ MRI
Biopsy 
postmortem
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10
Q

Which drug is used to treat Viral Meningitis. How is it administered and for how long?

A

Aciclovir
I.V.
2-3 weeks

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11
Q

Viral meningitis is typically caused by which organism

A

Enteroviruses:

  • Poliovirus
  • Echovirus
  • Coxsackie A &B virus
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12
Q

Treatment of CNS infection: Supportive care

A
Airway
Breathing
Circulation
Nutrition
Physiotherapy
Rehabilitation
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13
Q

Name the likely organism involved in infections of the spinal cord, dorsal root, ganglia and brainstem

A

Poliovirus (and some other enteroviruses)

Varicella zoster virus

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14
Q

Symptoms of Aseptic (viral) meningitis

A

Sore throat precedes
Headache
Miningism triad
Nausea and vomiting

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15
Q

Describe the ways infection can spread to the CNS

A

Neuronal transfer from periphery
Spreading from cranial bones, sinus
Infections-respiratory

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16
Q

What is Parkinson’s disease

A

Loss of dopaminergic neurones from the substantia nigra

17
Q

Huntington disease

A

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

18
Q

Brown Sequard syndrome

A

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

19
Q

Define allodynia

A

Painful or unpleasant sensation evoked by low intensity (non-painful stimulus)

20
Q

Define Hyperalgesia

A

Increase pain from noxious stimulus

21
Q

Which fibres are involved in pain transmission

A

A delta fibre carries nocioception fast

C fibres- unmylinated- carry nocioception slow

22
Q

Which areas in the cortex are activated by Pain

A

Somatosensory cortex
Insular cortex (beneath temporal lobe)
Anterior portion of cingulate cortex (ACC)

23
Q

Name the subcortical structures involved in Pain

A
  • 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
24
Q

Name the 3 sites for analgesic opiod action

A
  1. Inhibit excitatory neurotransmitter release from Pre-synaptic terminal of afferent fibre.
  2. Inhibit the spinothalamic tract by ACTIVATING the K+ channels and hyperpolarising the cell
  3. Periaquaducatal Grey
25
Q

Define tolerance

A

The need to increase the dose of a drug to achieve the same effect

26
Q

Define Physical dependance

A

Long term use causes- withdrawal reaction if the drug is stopped

27
Q

Addiction

A

Craving for a drug and the involvement in obtaining and using it for means other than pain relief

28
Q

What is nociceptive pain

A

Pain that occurs due to stimulation of nociceptors

-May be somatic or visceral

29
Q

Neuropathic pain occurs…..

Complete sentence

A

Neuropathic pain occurs because of damage to the central or peripheral nervous system