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Neurology > CNS infection > Flashcards

CNS infection Flashcards

1
Q

What pathogens tend to cause viral meningitis?

A

Enteroviruses e.g. ECHO virus

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2
Q

What viruses can cause encephalitis?

A

Herpes simplex

Varicella zoster

HIV

CMV

Measles

Travel e.g. west Nile virus

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3
Q

What is the treatment for viral encephalitis?

A

IV aciclovir

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4
Q

How does viral encephalitis present?

A

Insidous onset; sometimes sudden

Meningismus

Stupor, coma

Seizures, partial paralysis

Confusion, psychosis

Speech, memory symptoms

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5
Q

What condition is cryptococcal meningitis associated with?

A

HIV

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6
Q

What condition does testing a lumbar puncture sample with India Ink show positive?

A

Cryptococcal meningitis

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7
Q

What might be seen on lumbar puncture results for cryptococcal meningitis? (Opening pressure, cell type, glucose, proteins)

A

Opening pressure increased

Lymphocyte predominant

Glucose decreased

Proteins increased

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8
Q

What meningitis might the following lumbar puncture report indicate?

Opening pressure - normal

Lymphocyte predominant

Protein - normal

Glucose - normal

A

Viral meningitis

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9
Q

What meningitis might the following lumbar puncture report indicate?

Opening pressure - increased

Neutrophil-predominant

Protein - increased

Glucose - decreased

A

Bacterial meningitis

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10
Q

In which condition is elevated levels of 14-3-3 proteins elevated?

A

Creudtzfelt-Jakob disease

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11
Q

What do the prions in Creudzfelt-Jakob disease do to cause neurological dysfunction?

A

Convert normal alpha-helical prion proteins into abnormal beta-sheet proteins

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12
Q

What are the common causes of bacterial meningitis in neonates?

A

Listeria

Group B strep

E. Coli

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13
Q

What are the common causes of bacterial meningitis in children?

A

H. influenza

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14
Q

What is the most common cause of bacterial meningitis in ages 10-21?

A

Meningococcal

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15
Q

What tends to be the most common cause of bacterial meningitis in those >21?

A

Pneumococcal>meningococcal

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16
Q

What tends to be the most common cause of bacterial meningitis in the elderly?

A

Pneumococcal > listeria

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17
Q

What infection is associated with fracture of the cribiform plate?

A

Pneumococcal meningitis

18
Q

Which bacteria are associated with infection of a CSF shunt causing meningitis?

A

S. epidermidis

S. aureus

aerobic GNR

Propionibacterium acnes

19
Q

What are some of the disabilities caused by meningitis?

A

Limb loss

Deafness

Blindness

Cerebral palsy

Quadriplegia

Severe mental impairment

20
Q

What are some of the causal bacteria in meningitis in the immunocompromised?

A

Listeria monocytogenes

Mycobacterium tuberculosis

Nocardia asteroides

Cryptococcus neoformans (AIDS)

21
Q

What is the causal bacteria of meningococcal meningitis?

A

Neisseria Meningitis

22
Q

Where is Neisseria Meningitis found?

A

In the throats of healthy carriers

23
Q

What causes the symptoms in Neisseria Meningitis infection?

A

Endotoxin

24
Q

What is the most common causal bacteria of meningitis in children under four?

A

H. influenzae type b

25
Q

What prevention of meningitis due to haemophilus influenzae can be taken?

A

A conjugated vaccine directed against the capsular polysaccharide antigen is available

26
Q

What is the causal bacteria of pneumococcal meningitis?

A

Streptococcus pneumoniae

27
Q

Which patients are most susceptible to pneumococcal meningitis?

A

Hospitalised patients

Diabetics

Alcoholics

Young children

Patients with CSF skull fractures

28
Q

What is the antibiotic of choice for listeria monocytogenes?

A
  • IV Ampicillin/amoxicillin:
  • Ceftriaxone no value as intrinsically resistant
29
Q

Who is most likely to get infection from listeria monocytogenes?

A

Neonates

Elderly

Immunosuppressed especially malignancy

30
Q

How does tuberculous meningitis present?

A

Reactivation in the elderly

Non specific ill health

31
Q

How should cryptococcal meningitis be treated?

A

IV amphotericin b/flucytosine

Fluconazole

32
Q

What are the signs and symptoms of meningitis??

A

Headache

Vomiting

Pyrexia

Neck stiffness

Photophobia

Lethargy

Confusion

Rash

33
Q

What is the emprical antibiotic therapy in meningitis?

A

IV ceftriaxone

Add IV ampicillin/amoxicillin if listeria suspected

34
Q

What should also be given alongside antibiotics to treat suspected bacterial meningitis?

A

IV steroids

35
Q

What drug should be given alongside empirical treatment in age >55 and why?

A

Ampicillin

Listeria coverage

36
Q

What antibiotics should be given if pneumococcal penecillin resistance suspected?

A

Vancomycin + rifampicin

37
Q

What antibiotics should be given for meningitis with history of penecillin allergy?

A

Chloramphenicol and vancomycin

38
Q

What antibiotic should be given for listeria infection if penecillin allergy known?

A

Co-trimoxazole

39
Q

Which type of bacterial meningitis has administration of steroids with antibiotics been most successful in?

A

Pneumococcal

40
Q

When should steroids not be given to treat meningitis?

A

Post-surgical meningitis

Severe immunocompromise

Meningococcal or septic shock

Hypersensitivity to steroids

41
Q

What antibiotics are used for contact prophylaxis for meningitis?

A

Rifampicin 4x

or

Ciprofloxacin (adults and children >12)

Neurology (17 decks)

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