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IPAP > Clinical Lab: Block 3 > Flashcards

Clinical Lab: Block 3 Flashcards

1
Q

Define Pleocytosis

A

Inc of CSF cells from infections

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2
Q

What is the first onset Sx of meningitis Sx

A

Respiratory

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3
Q

What is the classic Sx Triad of meningitis in adults and kids?

What Sx do infants present with?

A

Fever, HA and Stiff Neck

Listlessness and bulging fontanelles

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4
Q

How is meningitis diagnosed?

A

Brain imaging

LP

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5
Q

What are the Big 3 bacterial causes of meningitis?

A

Strep Pneumo
Neisseri mening.
HIB

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6
Q

What will a lab report for bacterial meningitis show?

A

High PMNs 200-20K
Low glucose
High protein

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7
Q

What types of bacteria are more likely to cause meningitis in elders?

A 
Strep Pneumo
E Coli
K pneumoniae
S agalactiae
L monocytogenes
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8
Q

What types of bacteria are more likely to cause meningitis in Adults

A 
Strep Pneumo or N Meningitidis
Staph
H influenza
G Bacilli
Strep
L monocytogenes
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9
Q

What types of bacteria are more likely to cause meningitis in children?

A

Strep pneumo
N Meningitidis
H influenzae

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10
Q

What types of bacteria are more likely to cause meningitis in neonates?

A

GBS S agalactiae
E coli
L monocytogenes
Strep

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11
Q

What are the S/Sx of Viral meningitis?

A

Mild/self limiting

Viral syndrome w/ URI and gastroenteritis

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12
Q

What viruses cause Viral meningitis?

A 
Enterovirus
Arbovirus
HSV
Adenovirus
HIV
Measles
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13
Q

Define Aseptic Meningitis

A

Under viral meningitis- seasonal usually affecting kids/infants from enterovirus (spring/summer), Arborvirus (wamr) or measles (winter)

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14
Q

What does a lab report of viral meningitis show?

A

100-1000 mostly lymphocytes
Normal glucose
High Protein

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15
Q

Other than URI/GI Sx, what nondescript Sx can appear with Aseptic Meningitis?

A

Non blanching maculo-papulo-vesicular rash

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16
Q

What are the S/Sx of Fungal Meningitis?

A

Gradual onset of HA, fever, stiff neck, drowsiness and seizure

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17
Q

What fungi microbes cause meningitis?

A

Dimorphics- Histoplasma, Blastomyces, Coccidioides
Cryptococcus
Candidia
Aspergillus

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18
Q

What type of PT usually contracts fungal meningitis?

What considerations are taken with this Dx?

A

Immune compromised

Geography and travel Hx
Pigeon raising

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19
Q

What will the lab report of fungal meningitis show?

A

100-1000 mostly lymphocutes
Low glucose
High protein

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20
Q

What parasites can cause meningitis?

A

Naegleria
Acanthamoeba
Taenia
Toxoplasma

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21
Q

What are the exposure risks of contracting parasitic meningitis?

A

Naegleria: swimming in warm fresh water
Taenia: consuming eggs
Toxo: improper cooking, litter boxes

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22
Q

What will the lab report of parasitic meningitis show?

A

100-1000 eosinophils
Normal/low glucose
High protein

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23
Q

S/Sx of chronic meningitis

A 
Hydrocephalus
HA
Fever
Meningismus
Confusion
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24
Q

How is chronic meningitis Dx?

A

Non specific S/Sx but suspected in chronic encephalopathy or hydrocephalus
MRI/CT
LP

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25
What type of organisms cause chronic meningitis
Slow growers- Crypto Neoformans common
26
What are the S/Sx of encephalitis?
Confusion/AMS Personality changes Aphasia/ataxia Myoclonic jerk
27
How is encephalitis Dx?
PCR of CSF for herpes | Imaging, LP, Hx, PE
28
What animals carry rabies and which ones are low probability carriers?
Racoon, skunk, fox, bat, coyote Dogs, cats, ferrets
29
How is rabies Dx in humans?
Saliva, Serum, CSF and Skin biopsies of neck hair follicles Saliva- PCR Skin- Atg CSF- Abs
30
How is a rabies infection identified from brain tissue?
Negri bodies | Babes nodes
31
What are the S/Sx of a brain abscess?
HA/focal neuro deficit | Papilledema, N/V w/ Inc ICP
32
How is a brain abscess Dx?
Focal neurologic deficit or seizure suggests focal brain lesion CT w/ contrast NO LP
33
What microbes can cause brain abscesses?
Bacterial- polymicrobial= Staph A w/ infective endocarditis | Parasitic- Taenia Solium, Toxoplasma Gondii
34
Define Subdural Empyema
Collection of pus between dura and arachnoid membraines typically after sinus infection or surgery
35
What microbes can cause subdural empyema? What are the S/Sx?
Strep, Staph, Enterobacteriaceae Fever, worsening HA after sinus infection
36
How is subdural empyema diagnosed?
Imaging Culture NO LP
37
When are LPs mandatory?
If bacterial meningitis is suspected
38
When are LPs contraindicated? What is the next step for the PT?
Inc ICP, Coagulopathy, Brain abscesses Blood culture and empirical therapy
39
How many tubes of CSF are collected during an LP?
``` 4 tubes of 1-2ml 1- glucose and protein 2- micro for stain/culture 3- hematology for count and differential 4- immunology and serology ```
40
What are the characteristics of CSF that are examined?
Turbidity Color Cell count Gram stain
41
What type of meningitis causes CSF to be thick and cloudy with a high cell count?
Bacterial
42
What does it mean if during an LP each tube becomes progressively clearer?
Traumatic tap
43
Define Xanthochromia
Yellow/red discoloration of spinal fluid from breakdown of RBCs that when centrifued looks like cherry Kool-Aid
44
What is the most important information that can be received to help link Sx with causative agents?
Cell count- count of RBCs and WBCs and exam of RBC morphology
45
When is glucose altered in CSF?
Normal- viral, chornic | Low- bacterial
46
When is protein altered in CSF?
High- bacteria | Moderate elevation in viral
47
When is the WBC count altered in CSF?
Increased in septic meningitis w/ polymorphonuclear forms | Septic meningitis- mononuclear (lymphocytes) predominate
48
What CSF antigen screen is an AIDS defining illness?
Cryptococcal Ag kit
49
Since CSF Antigen screenings are so expensive, what other test is just as reliable and not as expensive?
Gram Stain
50
What lab test is the gold standard for diagnosing bacterial meningitis?
CSF cultures
51
PTs with meningitis are also ? so what other test may also be useful?
Blood cultures are usually positive
52
What organisms is responsible for meningitis in neonates born by vaginal birth?
GBS
53
What organisms is responsible for meningitis in neoneates with K1 Ag?
E coli
54
What organisms is responsible for meningitis in neonates, elderly and immune compromised PTs?
Listeria monocytognes
55
What organisms is responsible for meningitis in children from 6mon to 5yrs?
H. Influenzae
56
What organisms is responsible for meningitis in toddlers and young adults?
Neisseria meningitis
57
Polysaccharide vaccines are available for what serogroups of N Meningitidis?
A C Y W135
58
What organisms is responsible for meningitis in all age groups but have a higher prevalence in elderly PTs? This form also occurs with what other issues?
Strep Pneumo | Pneumonia, mastoiditis, sinusitis, basilar skull fracture
59
What organisms is responsible for meningitis in AIDS PTs?
Cryptococcus neoformans
60
Recognize condition, manifestation and tests for organism
asdf
61
Characteristics of Strep Pneumo
Capsule transmitted by droplet/extension | Risks in splenectomy, CSF leaks, pneumococcal pneumonia or cochlear implant
62
Characteristics of Neisseria Meningitidis
Causes meningitis from a capsule of IgA protease transmitted through respiratory drops in close quarters or unvaccinated persons
63
Characteristics of Haemophilus influenza
Causes meningitis in unvaccinated kids as a capsules that colonize in URT from droplet spread in PTs w/ head trauma, otitis media or CSF leaks
64
Characteristics of Listeria Monocytogenes
Meningitis, still birth or rhomboencephalitis causing microbe that survives in phagocytic cells from unpasteurized milk/cheese in PTs that are immune suppressed or pregnant
65
Characteristics of Streptococcus Agalactiae
Causes meningitis from B hemolysin and hyaluronidase transmitted to neonate by GBS in pregnant/vaginal births
66
Characteristics of anaerobes
Cause of brain abscess from adhesions from oral flora in PTs w/ poor oral hygiene
67
What are the CNS slow bacteria?
Mycobacteria TB Borrelia burgdoferi Treponema pallidum
68
Characteristics of Mycobacterium Tuberculosis
TB Meningitis or CNS Tuberculoma that is transmitted by droplet and survives in lung tissue until immune suppression allows growth in kids/AIDS
69
Characteristics of Borrelia Burgdorferi
Neuroborreliosis, subacute meningitis or facial palsy caused by microbe that changes outer surface proteins from a Deer Tick
70
Characteristics of Treponema Pallidum
Neurosyphilis or Gummas in PTs with untreated syphilis
71
Characteristics of Arboviruses
Example- West Nile | Transmitted by arthropod vector mosquito that results in encephalitis

IPAP (212 decks)

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