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MIML 240 > CNS > Flashcards

CNS Flashcards

1
Q

normal volume of CNS

A

90-150 ml

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2
Q

normal protein level in CSF

A

15-45 mg/L

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3
Q

normal CSF glucose level

A

40-80 mg/L

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4
Q

normal WBC differential in adult

A

60-80% Lymph
10-40% Mono
0-15% Neuts

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5
Q

infection of CSF is usually associated with increased_____ _______ and a change in the amount of ________&_________

A

WBC
protein;glucose

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6
Q

a semi-permeable membrane that separates brain tissue from blood; it protects brain from toxins, pathogens while letting nutrients in

A

Blood Brain Barrier

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7
Q

a functional barrier found in the choroid plexus of the brain ventricles; separates blood from CSF& the CSF from the brain

A

Blood CSF Barrier

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8
Q

infiltration of the BBB by a microorganism

A

Encephalitis

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9
Q

infiltration of the BCB by a microorganism; can also be caused by injury, cancer, and some drugs; causes inflammation of the CSF and meninges; A MEDICAL EMERGENCY

A

Meningitis

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10
Q

organism gets into bloodstream from nearby infection in another part of the body (often a respi infection)

A

Hematogenous spread

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11
Q

organism colonizing a nearby body site like nasal or sinus mucosa gets directly into CSF; usually after a viral infection of nasal passage or sinus

A

Direct Contiguous spread

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12
Q

bacteria get in directly from an open wound due to a cranial injury or from cranial surgery

A

Direct spread via cranial trauma or surgery

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13
Q

Bacteria commonly causing meningitis by age group:
neonates <1 month

A

GNB
GBS
Listeria monocytogenes

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14
Q

Bacteria commonly causing meningitis by age group:
Infants 1 month- 23 months

A

GBS
E coli
Neisseria meningitidis
Strep pneumo
Haemophilus Influenzae type B

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15
Q

Bacteria commonly causing meningitis by age group:
Children and adults

A

Neisseria meningitidis
Streptococcus pneumoniae
Cryptococcua neoformans- adults with HIV

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16
Q

Bacteria commonly causing meningitis by age group:
Older Aldults > 65yrs

A

Neisseria meningitidis
Strep pneumo
Cryptococcus neoformans
GNB
Listeria monocytogenes

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17
Q

this group of organisms rarely cause meningitis; when they do, it’s usually because person had/has a brain abscess & organisms spread to CSF

A

anaerobes

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18
Q

this organism causes serious infection during pregnancy- ingested in contaminated food (dairy, lunchmeat, poorly washed raw veg)
- can invade cells and survive intracellularly (moves from cell to cell using actin filaments) which allows it to enter mom’s blood and cross the placental barrier

A

Listeria

19
Q

a listeria meningitis in newborn < 7 days; from intrauterine infection or during birth, causes sepsis and to a lesser extent meningitis- high mortality rate if 50%

A

Early Onset

20
Q

Listeria meningitis in newborn >7 days; infection after birth from mom or another source- manifest as meningitis; more rare and has a lower fatality rate

A

Late onset

21
Q

this organism colonize adult intestine& genital tract in women; causes more serious infection in pregnancy, babies & elderly; can infect the amniotic fluid & baby leading to premature rupture of membranes & still birth

A

GBS

22
Q

when is GBS screening done on all pregnant women? specimen type?

A

35-37 weeks gestation
vaginal/rectal swab

23
Q

GBS meningitis in newborn (prenatal & < 7 days old); baby aspirates amniotic fluid during birth; causes PNEUMONIAE OR SEPSIS and sometime meningitis- high mortality

A

Early onset

24
Q

GBS meningitis in Newborn (at least 7 days old); baby infected by mom or from the other source after birth; causes mostly meningitis, sometime septicemia or pneumonia- mortality rate is lower

A

Late Onset

25
Q

GBS
gram:
Catalase:
Bile esculin
motility at 25
Hippurate hydrolysis
Camp:

A

gpc in p&c
neg
neg
neg
pos
pos (arrowhead)

26
Q

Listeria
gram
Catalase
Bile esculin
Motility at 25
Hippurate hydrolysis
Camp

A

small gpb
pos
pos
pos (umbrella motility)
Pos
pos (rectangle)

27
Q

vaccine for infants and young children

A

HIB conjugate vaccine
13 valent conjugate pneumococcal vaccine

28
Q

vaccine for > 2 yrs old and those at high risk

A

23- valent polysaccharide pneumococcal vaccine

29
Q

vaccine for all healthy adolescents 11 or 12 yrs of age and 2-55 years old people who are at risk such as travelers to endemic areas, asplenic patients

A

Quadrivalent conjugated meningococcal vaccine

30
Q

vaccine for > 55 yr

A

meningococcal polysaccharide vaccine

31
Q

inflammation/infection of the brain; caused by invasion of an organism (most often due to a virus) but can also be bacteria, fungus or parasite

A

infectious encephalitis

32
Q

inflammation of the brain due to an autoimmune response, tumour

A

Non-infectious encephalitis

33
Q

a pus-filled pocket of infected material in the brain; usually occurs when a bacteria or fungus enter the brain;
IV drug users are also at risk
often polymicrobial infection that includes anaerobes
result in brain swelling with harmful pressure on brain tissue

A

Brain Abscess

34
Q

diagnosis of CNS infections is based on examinations of ______ &_________ __________

A

CSF
Blood cultures

35
Q

______ is obtained by inserting a sterile hollow needle into the subarachnoid space of the lower lumbar

A

CSF

36
Q

specimen for brain abscess

A

tissue biopsy or aspirates because CSF may be normal

37
Q

All CNS specimens are sterile. must be transported to the lab ASAP- must be plated to a media within __ hour; if delay <24 hrs, keep at_____ ______

A

1
room temperature

38
Q

where is the thin needle for lumbar puncture inserted during CSF collection

A

lumbar subarachnoid space

39
Q

CSF specimen collection:
collect 3-4 tubes- each containing _ to _ ml;
microbiology gets the tube that is least likely to have contamination ( tube __ or ___) for culture & AST; tube __ is sent to Chemistry; tube _ or _ is sent to Haematology for cell counts

A

1-2
2 or 3
1
3 or 4

40
Q

if only one tube is collected, it MUST go to ______ lab first to ensure sterility of culture

A

Microbiology

41
Q

a sign of bacterial meningitis, a high WBC count, presence of protein or lysed RBC

A

Cloudy CSF

42
Q

indicates presence of bilirubin & is sometime the only sign of an acute subarachnoid hemorrhage

A

Xanthochromia(yellow discoloration)

43
Q

a subarachnoid bleed or traumatic tap

A

Bloody and cloudy CSF

MIML 240 (11 decks)

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