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Infectious > CNS > Flashcards

CNS Flashcards

1
Q

The most common form of suppurative CNS infection

A

Bacterial meningitis

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2
Q

Cause recurring epidemics of meningitis

A

N meningitidis

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3
Q

90% of patients with meningitis will have opening pressure CSF of

A

> 180

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4
Q

Most common. Cause of meningitis adults > 20

A

S pneumoniae

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5
Q

Abx used in the empirical therapy bacterial meningitis

A

Cefotaxime or Ceftriaxone or cefepime + vancomycin

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6
Q

Role of dexamethasone in meningitis

A

Dec CSF outflow resistance

Inhibits TNFa and IL1B

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7
Q

Rationale for giving dexamethasone prior to antibiotic therapy

A

It exerts production of TNFa by macrophages and microclimate only b fore the cells are activated by endotoxins

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8
Q

Most likely agents in viral meningitis

A

Enteroviruses

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9
Q

Causes of subacute meningitis

A 
MTb
C neoformNs 
T pallid in
H capsulatum
C immitis
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10
Q

CSF abnormalities in fungal infection

A

Mono or lymphocytic oleo cytosine
Increased protein concentration
Decreased glucose concentration

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11
Q

Rx tuberculous meningitis

A

hRZE and pyridoxine

Treat 10 months

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12
Q

Multifocal areas of demyelination of varying size sparing spinal cord and optic nerves

A

PML

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13
Q

Most common localizing sign of frontal lobe abscess

A

Hemiparesis

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14
Q

Classic triad of abscess

Found in <50%

A

Fever headache

FND

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15
Q

The most common parasitic disease of the CNS

A

Neurocysticercosis

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16
Q

Treatment CST toxoplasmosis

A

Sulfadiazine

Pyrimethamine

17
Q

MC predisposing condition to subdural empyema

A

Sinusitis

FRONTAL SINUS!!!

18
Q

Classic CSF abnormalities in Tb meningitis

A

Elev opening pressure
Lymphocytic pleocytosis
Elevated protein concentration
Decreased glucose concentration

19
Q

Combination that is HIGHLY SUSPICIOUS for TB meningitis

A 
Stiff neck
Fatigue
Night defeats 
Fever
CSF lymphocytic pleocytosis
Mildly decreased glucose concentration is highly suspicious for TB meningiti
20
Q

Phases of brain abscess formation

A

Early cerebritis
Late cerebritis
Early capsule formation
Late capsule formation

21
Q

Empiric therapy of brain abscess

A

3rd or 4th generation cephalosporin and metronidazole

22
Q

Until when should patient with brain abscess receive seizure prophylaxis?

A

3 months after the resolution of the abscess

23
Q

Most common symptom in patients with brain abscess

A

Headache

24
Q

Rx for progressive multifocal leukoencephalopathy

A

Mirtazipine 15 mg/tab OD

25
Q

Treatment of

CNS toxoplasmosis

A

Sulfadiazine
Pyrimethamine
Folinic acid

26
Q

Most common predisposing condition of subdural empyema

A

Sinusitis

27
Q

Transverse sinus thrombosis presenting with otitis media
Sixth nerve palsy
Retro orbital or facial pain

A

Gradinego syndrome

28
Q

Chronic demyelinating disease of the CND associated with no permission infection of brain tissue with measles virus

A

SSPE

29
Q

Rx SSPE

A

Is inspire

30
Q

Rx syphilitic meningitis

A

Aqueous penicillin G

31
Q

Rx meningitis C neoformans

A

AMPHOTERICIN B + flucytosine

Consolidation with fluconazole

32
Q

Test for gram negative meningitis

A

Limmulus lysate

33
Q

A CSF culture is positive in __ cases of meningitis

A

80%

34
Q

Remains the drug of choice for meningococcal meningitis

A

Penicillin G

7 days in uncomplicated course

35
Q

Regimen of meningococcal prophylaxis in close contacts

A

Rifampin 600 mg BID x 2 days

Alternative:
Azithromycin 500 OD x 1 dose
Ceftriaxone 250 mg 1 IM dose

36
Q

Rx pneumococcal meningitis

A

Cephalosporin

Vancomycin

37
Q

How to treat meningitis caused by Listeria monocytogenes

A

Ampicillin x 3 weeks

(Add gentamicin to critically ill patients)

Alternative TMP-SMX

38
Q

Dose of Pen G for pneumococcal meningitis

A

300,000 U/kg

39
Q

Bactericidal agent with antistaphylococcal activity. Novel mechanism of action: disrupts the cytoplasmic membrane

A

Daptomycin

Infectious (20 decks)

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