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CNS Microbiology > Clinical CNS Microbiology > Flashcards

Clinical CNS Microbiology Flashcards

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1
Q

What differs meningitis caused by craniopharyngioma breakdown and bacteria?

A

NORMAL glucose in craniopharyngioma meningitis

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2
Q

What two electrolyte abnormalities would you look for in bacterial meningitis?

A

SIADH, metabolic acidosis

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3
Q

What two serum markers are much higher in bacterial meningitis than viral?

A

Serum procalcitonin (>2ng/mL), C-reactive protein (>40ng/mL)

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4
Q

What should ALWAYS do before obtaining an LP in cases of meningitis?

A

Cranial CT to ensure no structural abnormalities

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5
Q

How do you identify bacterial etiology of meningitis on CSF analysis?

A

PCR for bacterial 16S ribosomal DNA

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6
Q

How do you identify Herpes or TB as specific etiology of meningitis?

A

PCR

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7
Q

How do you identify West Nile as the specific cause of meningitis?

A

IgM

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8
Q

Abx for bacterial meningitis?

A

Vanco, 3rd or 4th gen Cef or Meropenem, Amicillin (if Listeria), Acyclovir for HSV, Doxy for tick-borne

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9
Q

Steroids before abx in meningitis?

A

YES

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10
Q

Four CNS sequelae of infective endocarditis?

A

1) Metabolic encephalopathy, 2) Ischemic Stroke, 3) Cerebritis leading to abscess, 4) Mycotic aneurysm leading to subarachnoid hemorrhage

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11
Q

Why does an abscess or any mass (e.g., tumor) cause a headache to be worse at night?

A

Lose effect of gravity on CSF drainage –> increased total content with unchanged volume of space causes increased tension on pain sensing structures (dura)

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12
Q

MC causal organism of subacute bacterial endocarditis?

A

Strep viridans

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13
Q

Four key clinical clues to bacterial endocarditis?

A

Splinter hemorrhage, Osler nodes, Janeway lesions, Roth spots

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14
Q

Retinal hemorrhage with central clearing

A

Roth spot

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15
Q

Tender papulopustules on the pulp of the finger in bacterial endocarditis

A

Osler nodes

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16
Q

Erythematous painless macule on the palms of the hand and soles of the feet in bacterial endocarditis

A

Janeway lesions

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17
Q

What do you treat cerebral abscesses with? What if Bacteroides fragilis is the causal org?

A

Cephalosporins; Metronidazole

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18
Q

What parts of the spine does a spinal epidural abscess involve and spare in contrast to a tumor?

A

Disc(itis); spare bone

19
Q

Why is pain worse on recumbency with spinal epidural abscess?

A

Increased venous back pressure in Batson’s plexus on inflamed part of dura

20
Q

MC pathogen of spinal epidural abscess?

A

Staph aureus

21
Q

Rx spinal epidural abscess?

A

High dose roids, Abx, surgery

22
Q

Causal organism of RMSF?

A

Rickettsia

23
Q

Structure of Rickettsia

A

G- obligate IC coccobacilli

24
Q

Tropism of Rickettsia

A

Vascular endothelial cells

25
Q

Hallmark clinical sign of RMSF?

A

Early petechial rash in distal extremities

26
Q

Rx RMSF

A

IV Doxy

27
Q

CSF normal/abnormal with RMSF?

A

Normal

28
Q

Causal organism of Lyme?

A

Spirochete; Borrelia burgdorferi

29
Q

First clinical hallmark of Lyme?

A

Target Rash

30
Q

Symptoms of Lyme that dev. over weeks?

A

FLS, heart, myalgias, Bell’s, aseptic meningitis

31
Q

How to dx and confirm Lyme, respectively?

A

ELISA, Western Blot

32
Q

Rx Lyme?

A

IV Ceftriaxone

33
Q

serum FTA+ and CSF VDRL+ in an HIV patient means?

A

Definite neurosyphilis

34
Q

Serum FTA+ and CSF VDRL- with CSF lymphocytic pleocytosis or elevated CSF protein in an HIV patient means?

A

Probably neurosyphilis

35
Q

What part of your spinal cord does tabes dorsalis (neurosyphilis) knock off?

A

Dorsal Column – Loss of proprioception and fine touch

36
Q

How do you confirm dx of TB meningitis?

A

Stain for acid fast bacilli + send away for culture; immunofluorescence

37
Q

What region of the brain does TB love to attack? Sequela?

A

Base; Block CSF flow leading to hydrocephalus (also can have arachnoid granulations scar over), CN palsies

38
Q

MC abnormal finding in TB meningitis? 2nd MC?

A

Chest X-ray; PPD

39
Q

Rx TB meningitis?

A

RIPES + corticosteroids

40
Q

Which viral meningitis shows Mollaret cells?

A

Chronic viral meningitis D/T HSV-2

41
Q

Lobe involvement of HSV1 encephalitis?

A

Temporal

42
Q

Type of necrosis in HSV1 encephalitis?

A

Hemorrhagic

43
Q

How to make definitive clinical dx of HSV1 encephalitis? Confirmatory test?

A

MRI; PCR

44
Q

What do you need to watch out for if HZV reactivates in ophthalmic division of CN V? Rx?

A

Corneal ulceration; acyclovir + steroids

CNS Microbiology (14 decks)

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