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IDBR > CNS > Flashcards

CNS Flashcards

1
Q

Methods for HSV Encephalitis diagnosis

A

EEG
MRI
Brain biopsy
CSF analysis with PCR

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2
Q

EEG findings in HSV encephalitis

A

periodic lateralizing epileptiform discharges

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3
Q

Diagnosis of VZV encephalitis

A

send CSF PCR and antibodies
PCR has low sensitivity

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4
Q

MR findings in VZV encephalitis

A

large vessel vasculitis and ischemia

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5
Q

Steroid indication with VZV encephalitis

A

if there is evidence of vasculopathy

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6
Q

HHV-6 encephalitis treatment

A

Ganciclovir or Foscarnet

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7
Q

MR findings in CMV encephalitis

A

subependymal gadolinium enchancement and non specific white matter changes

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8
Q

CMV encephalitis treatment

A

Ganciclovir and foscarnet

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9
Q

Three features of severe WNV

A

meningitis
encephalitis/meningoencephalitis
poliomyelitis with flaccid paralysis

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10
Q

Diagnosis of WNV

A

serum IgM antibody
CSF IgM
PCR CSF sensitivity less than 60%

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11
Q

Unique presenting feature of St Louis Encephalitis Virus

A

urinary symptoms, SIADH

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12
Q

Diagnosis of SLEV

A

Serology, CSF IgM

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13
Q

Clinical features of Japanese Encephalitis Virus

A

Seizures and parkinsonian features, poliomyelitis like flaccid paralysis

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14
Q

Classic patient population for JEV

A

children, rice field association

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15
Q

powassan virus vector

A

ixodes scapularis tick

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16
Q

clinical features of powassan virus

A

Parkinsonism, involvement of basal ganglia and thalamus

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17
Q

Tick borne encephalitis virus location

A

eastern Russia, central Europe

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18
Q

Tickborne encephalitis virus risks

A

unpasteurized milk or cheeses, SOT, rituximab

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19
Q

Tickborne encephalitis presentation

A

poliomyelitis like paralysis

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20
Q

PEP for Tickborne encephalitis

A

anti-TBE Immune globulin

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21
Q

eastern equine encephalitis virus feature of CSF

A

high WBC count >1000 with neutrophilic predominance

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22
Q

incubation period of rabies

A

20-90 days

23
Q

rabies clinical presentation

A

encephalitic form
paralytic form

24
Q

features off encephalitic rabies

A

agitation with alternating lucidity
hyper salivation
hydrophobia
bizarre behavior
progression to coma, death

25
Q

features of rabies paralytic form

A

ascending paralysis, early muscle weakness
later cerebral involvement

26
Q

association with NMDAR encephalitis

A

OVarian teratoma
check TVUS

27
Q

association with NMDAR encephalitis

A

HSV encephalitis and later development of NMDAR antibodies

28
Q

therapy for NMDAR encephalitis

A

Steroids, IVIG, PLEX
Rituximab or cyclophosphamide

29
Q

possible presentation of enterovirus 71

A

rhomboencephalitis
ataxia, myoclonus, CN deficits

30
Q

suppressive therapy role in recurrent HSV 2 meningitis

A

not indicated, associated with higher frequency of meningitis after cessation of drug

31
Q

animals that transmit lymphocytic choriomeningitis virus

A

rats, rodents, mice, hamsters
more common in winter

32
Q

association with enteric GN meningitis

A

disseminated strongyloidiasis in hyper infection syndrome

33
Q

empiric therapy < 1 month

A

ampicillin, gentamicin, cefotaxime or cefepime

34
Q

empiric therapy of meningitis 1-23 months

A

vancomycin plus 3rd gen ceph

35
Q

empiric therapy 2-50

A

vanc plus 3rd gen ceph

36
Q

older than 50

A

vanc, ampicillin, 3rd gen ceph

37
Q

basilar skull fracture empiric therapy

A

vanc and 3rd gen ceph

38
Q

head trauma, neurosurgery, CSF shunt empiric therapy

A

vancomycin plus cefepime/ceftazidime/meropenem

39
Q

MIC cut off to use penicillin for pneumococcus

A

< or equal to .06

40
Q

PCN MIC < 1 pneumococcus therapy

A

3rd generation ceph

41
Q

PCN MIC 1 or greater pneumococcus therapy

A

vanc and 3rd generation ceph

42
Q

Neisseria PCM MIC <1

A

penicillin or ampicillin

43
Q

Neisseria MIC .1 to 1

A

3rd generation cephalosporin

44
Q

H flu B lactase negative

A

ampicillin

45
Q

H flu B lactamase positive

A

3rd generation cephalosporin

46
Q

clinical feature of listeria meningitis

A

increased risk of seizures and focal neurologic signs

47
Q

possible clinical presentation of listeria

A

rhombencephalitis
late development of ataxia, nystagmus and cranial nerve palsies

48
Q

patient presenting with Gram Negative Meningitis. what is a possible risk for this

A

seen with strongyloides hyper infection syndrome

49
Q

duration of treatment for listeria meningitis

A

21 days

50
Q

duration of treatment for Neisseria meningitis

A

7 d

51
Q

duration of treatment for E coli meningitis

A

21 d

52
Q

what is the most common cause of viral meningitis

A

enterovirus

53
Q

lymphocytic choriomeningitis virus risk factors

A

rodent infested houses
lab personnel
pet owners

IDBR (23 decks)

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