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Internal Medicine > CNS > Flashcards

CNS Flashcards

Meningitis

1
Q

Most common cause of Bacterial Meningitis in neonates?

A
  • Group B Strep (agalactiae)
  • E. Coli
  • Listeria monocytogenes
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2
Q

Most common cause of Bacterial Meningitis in adolescents?

A

Neisseria Meningitidis

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3
Q

Most common cause of Bacterial Meningitis in adults?

A

Strep. Pneumoniae

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4
Q

Most common cause of Bacterial Meningitis in adults over 60?

A
  • S.pneumoniae
  • N.meningitidis
  • H. influenzae
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5
Q

Clinical Presentation of Bacterial Meningitis?

A
  • Fever
  • Nuchal Rigidity
  • Altered Mental Status
  • Headache
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6
Q

Complications with S. pneumoniae?

A
  • Seizures

- Cerebral Infarction

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7
Q

Complications with N. meningitidis?

A
  • Non-suppurative pharyngitis
  • Petechiae/ Purpura
  • Myalgia
  • Septic Arthtitis
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8
Q

Which clinical presentations indicate CT scan prior to a lumbar puncture?

A
  • Papilledema
  • Altered mental status
  • Focal neurologic deficit
  • Immunocompromised state
  • New-onset seizure (within 1 week)
  • History of CNS disease or head trauma
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9
Q

CSF findings indicative of bacterial meningitis:

A
  • Opening pressure >200 mm H2O
  • WBC count1000-5000/microL
  • > 80% neutrophils
  • Protein >200mg/dL
  • Glucose <40mg/dL
  • CSF:serum glucose ratio ≤0.4
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10
Q

Physical Exam tests that indicate Bacterial Meningitis?

A
  • Kernig’s sign- Unable to extend leg w/ a bent knee

- Brudzinski sign- Knees bend when head is flexed

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11
Q

Empiric treatment for Bacterial Meningitis?

A
  • Vancomycin + 3rd gen Cephalosporin (Ceftriaxone)

* Add Dexamethasone for S. pneumo or unknown

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12
Q

What treatment should be added to the regimen in patients over 50 to cover Listeria?

A

Ampicilin

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13
Q

Empiric Treatment for Neonatal Meningitis?

A

Ampicillin + Cefotaxime/Amionglycoside

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14
Q

Empiric Treatment for patients with penetrating head trauma or recent neurosurgery?

A

Vancomycin + Ceftazidine/ Cefepine/ Meropenem

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15
Q

What prophylactic treatment is recommended for people exposed to N. Meningitidis?

A
  • Rifampin
  • Ciprofloxacin
  • Ceftriaxone
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16
Q

Pathogens that cause Viral Meningitis?

A
  • Enterovirus
  • Herpes Simplex/ Varicella Zoster
  • Lymphocytic choriomeningitis virus
  • HIV
  • Mumps
17
Q

CSF analysis results that indicate viral meningitis?

A
  • Incr. WBCs
  • Mild Incr. Protein (<150)
  • Normal Glucose
18
Q

Treatment for Viral Meningitis caused by Herpes Simplex Virus?

19
Q

Patient presents with shaving half of their face or only combing one side of hair. What is the etiology?

A

Hemineglect syndrome

- Caused by lesion in the nondominant parietal lobe

Internal Medicine (15 decks)

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