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Pathophysiology Of Infectious Diseases > CNS > Flashcards

CNS Flashcards

1
Q

Meningitis is more commonly ______ infection

A

bacterial

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2
Q

Aseptic meningitis

A

pathogens that don’t grow on typical bacterial media (virus, fungi, parasites, non infectious causes)

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3
Q

Chronic meningitis is more likely caused by…

A

mycobacterium or fungi

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4
Q

Meningitis @infants is most commonly caused by

A

E.coli
S.pneumonniae type B

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5
Q

Meningitis @children is most commonly caused by

A

H.influenzae & S.pneumoniae

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6
Q

Meningitis @young adults is most commonly caused by

A

N.meningitis

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7
Q

Meningitis @elderly is most commonly caused by

A

S.pneumoniae

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8
Q

Meningitis by Retrograde infection is transported by _______

A

cranial and peripheral nerves

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9
Q

Retrograde transport @meningitis is present @

A

viral illness

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10
Q

Common etiology of Meningitis

A

Otitis media
Sinusitis
CSF leak after trauma/surgery
Sepsis

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11
Q

What pathogen causes Neonatal meningitis

A

E.coli

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12
Q

Risk factors for meningitis infection

A

Crowded occupational/living conditions
Immunocompromised
Close contact with infected

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13
Q

Pathophysiology of Meningitis

A

Hematogenous
Contagious
Retrograde
Traumatic

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14
Q

Virulence factor of S.pneumoniae

A

Polysaccharide capsule
Neumolisins → pores

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15
Q

Virulence factor of N.meningitis

A

Pilis

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16
Q

Early and Late symptoms @Neonatal Meningitis

A

Early:
Lethargy
Muscle Hypotonia
Irritability
Poor apetite
Vomiting
Dyspnea

Late:
Fontalle buldging
High-pitchh cry
Seizure

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17
Q

T or F: In neonatal meningitis the Triad is also present

A

F

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18
Q

Meningitis Triad

A

Fever
Neck Stiffness
Headache

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19
Q

Petechial or Purpuric rash suggest…

A

Neisseria meningitis infection

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20
Q

Meningococcal

A

Neiseria Meningitis

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21
Q

WaterHouse-Friderishen Syndrome @

A

N.meningtis

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22
Q

Myalgia + Purpuric Rash suggest

A

Meningococcal infection

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23
Q

Prodrome and Flu-like symptoms followed by Neurological symptoms suggest…

A

Viral Meningitis

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24
Q

Classic Triad of Meningitis + >Sudden Onset + Lose of consciousness suggest…

A

Dx Diferencial → Subarachnoid hemorrhage

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25
Q

Clinical features @Meingismus

A

Triad
Altered mental tatus
Photophobia
Seizure
Nausea, Vomiting
Malaise
Cranial Nerve Palsies

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26
Q

Meningismus @Physical Examination

A

Neck Stiffness
Kernig + Brudzinski sign
→ Meningeal irritation

Fever
Hypotension
Tachycardia
→ Inflammation

Papiledema → Increased Intracraneal Pressure

Bulging+ Redness @timpanic memb. = Otitis Media
Skin manifestations ( petechiae, maculopapular rash)
→ Underlying infection

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27
Q

T or F: Blood culture should be taken BEFORE starting empiric antibiotics

A

T

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28
Q

Findings @CBC in Bacterial Meningitis

A

↑ WBC (specifically Neutrophils)

29
Q

When is a Lumbar Puncture contraindicated?

A

Increased Intracranial Pressure
Bleeding Disorders
Local infection or lesions

30
Q

What tests are preformed with the sample of CSF

A

CSF analysis
PCR
Gram stain

31
Q

CSF analysis @Bacterial Meningitis

A

Cloudy/Purulent

↑ Leukocytes (PMN)
↑ Granulocytes
↑ Openning Pressure (because of edema)
↑ Protein
↑ Lactate
↓ Glucose

32
Q

CSF analysis in a Viral infection

A

Clear

↑Lymphocytes
Normal Glucose

33
Q

Where is a Lumbar Puncture preformed?

A

L3-L4

34
Q

Empiric Tx @Meningitis

A

Ceftriaxone
Vancomycin
Dexamethasone (corticosteroid) = inflammation

35
Q

When is Ampicillin indicated in the Empiric Tx of meningitis

A

@High Risk of Listeria Meningitis =

  • Immunocompromised
  • > 50 yo
36
Q

Postexpousure Prophylaxis for close contact @Meningitis

A

Rifampin or Ceftriaxone

37
Q

Postexpousure Prophylaxis for close contact pf Meningitis @Pregnant women

A

Ceftriaxone

38
Q

Tx of Cyptococcal Meiningitis

A

Fluconazole or Amphotericin B

39
Q

Viral Meningitis Tx

A

Acyclovir

40
Q

Petechial Rashed Meningococo indicates….

A

Thrombocytopenia

41
Q

Point of NO RETURN @Meningococo infection

A

16 hrs

42
Q

Most common cause of Sporadic Encephalitis

A

HSV-1

43
Q

Encephalitis is more commonly caused by ______ infections

A

Viral

44
Q

CMV and EBV can cause Encephalitis @

A

Immunocompromised

45
Q

Incidence of HSV infection

A

Bimodal
<20yo
>50yo

46
Q

What type of HSV is most commonly @Neonates

A

1 and 2

47
Q

Type(s) of HSV more common @Adults

A

1

48
Q

How does HSV-1 spread towards the brain?

A

From oropharynx it spreads via Trigeminal or Olfactory nerve towards the brain

49
Q

Where does HSV stay latent in the body for future reactivation?

A

Trigeminal ganglia

50
Q

First sign of infection of HSV

A

Gingivistomatitis

51
Q

HSV mainly affects ______ lobe causing which focal neurological effect?

A

Temporal
Crisis Convulsivas

52
Q

T or F: Triad of Meningism is ONLY present @Meningitis

A

F

53
Q

What part of the brain does Enterovirus infection affects

A

ANY part

54
Q

Pathophysiology of Enterovirus Encephalitis

A

Viremia
“Caballo de Troya” = Macrofagos
Retrograda = Miocitos (via motora)

55
Q

Focal Neurological Deficit= Ataxia
Which part of the brain is affected?

A

Cerebelo

56
Q

Focal Neurological Deficit = Comportamiento Alterado
Which part of the brain is affected?

A

Frontal

57
Q

Alteraciones Oftlmologicas @Encephalitis

Which part of the brain is affected?

A

Occipital lobe

58
Q

Subacute onset of:
Psychiatric symptoms +
Seizures +
Focal Neurological Deficits
suggest….

A

Encephalitis

59
Q

Neurological Symptoms @Encephalitis

A

Altered Mental Status
Memory loss
Seizures
Focal Neurological Deficit
Dysatonomia

60
Q

Psychiatric symptoms @Encephalitis

A

Behavioral changes
Hallucinations
Anxiety
Pschosis

61
Q

Dx @Encephalitis

A

MRI with contrast
- to look for Hyperintense temporal lobe edema @HSV

Electroencephalography
@inconclusive dx of seizures

Lumbar Puncture

Tissue Analysis

62
Q

What smear is done in the tissue analysis of Encephalitis?

A

Tzanck Smear
= look for HSV @ suspicious skin lesions

63
Q

Findings of Encephalitis @Brain Biopsy

A

Cowdy Type A inclusions @HSV infection
Temporal Lobe Necrosis @HSV

64
Q

Tx for Enterovirus Encephalitis

A

Symptomatic

65
Q

Tx for HSV Encephalitis

A

Acyclovir

66
Q

Prognosis of Viral Meningitis

A

Resolves spontaneously
**There may be residual symptoms

67
Q

Prognosis @Bacterialmeningitis

A

Fatal if left untreaed

68
Q

Why is Ceftriazone contraindicated as Tx in Meningitis @Infants?

A

High risk of Kernicterus and Hiperbillirubinemia

Pathophysiology Of Infectious Diseases (4 decks)

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