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Sam Clin Path > CNS infection > Flashcards

CNS infection Flashcards

1
Q

Encephalitis means what?

A

Inflammation of brain matter

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2
Q

Aseptic meningitis clinical picture?

A

WCC >5 in CSF

negative bact culture

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3
Q

Most common aseptic meningitis?

A

Viral, or partially treated bacterial

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4
Q

Individual virus particle?

A

Virion

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5
Q

Is herpes virus enveloped?

A

Yes

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6
Q

Peaks of viral meningitis age?

A

neonate and age 5

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7
Q

Most common viral cause?

A

Enteroviruses - coxsackie, echovirus

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8
Q

Herpes virus 1 or 2 causing meningitis more?

A

2 and this causes genital herpes

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9
Q

Unknown cause of viral meningitis %

A

35%

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10
Q

Viral symptoms usually due to what?

A

Bodies response

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11
Q

What is meningism?

A

Nick stiffness, headache, photophobia

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12
Q

Presentation of meningitis in kids?

A

absent often, rigid neck, and bulging ant fontanelle

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13
Q

What is kernigs sign?

A

hip and knee flexed at 90degree knee cant be extended due to neck pain/stiffness

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14
Q

Flexing of neck causes the hips and knees to flex is what sign?

A

Brudzinskis

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15
Q

When to do a ct in suspected meningitis?

A

Not very often on if sub arach or raised icp suspected or focal signs

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16
Q

When to do lumbar punctures?

A
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17
Q

should always measure what when you do a lumbar puncture?

A

Blood glucose too!

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18
Q

Viral csf profile?

A

Lymphocytic usually

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19
Q

Opening pressure in viral vs bacterial meningitis?

A

Viral low bac high

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20
Q

Bacterial meningitis protein?

A

High

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21
Q

Glucose ratio in bacterial meningitis?

A

Low

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22
Q

ABX of choice with suspected meningitis?

A

Cefotaxime

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23
Q

Classic time for enteroviral meningitis?

A

summer/aurumn

24
Q

Any evidence to suggest use of aciclovir?

A

Not really

25
Q

Viral encephalitis cause in >90%?

A

HSV1

26
Q

Important difference with encephalitis is what?

A

Altered mental state and seizures

27
Q

What may EEG show in 75% of patients with encephalitis ?

A

Abnormal temporall lobe activity

28
Q

Treatment of viral enceph?

A

High dose aciclovir 10mg/kg tds for 2-3 weeks do not wait

29
Q

Mortality of untreated enceph?

A

70%

30
Q

ADEM stands for what in neuro?

A

Acute disseminated encephalomyelopathy

31
Q

PCR is clear on csf could be?

A

ADEM

32
Q

Neisseria meningitidis

bacteria type?

A

Gram +ve diplococci

33
Q

what does Neisseria meningitidis need to grow?

A

Choclate agar (blood)

34
Q

Antibiotics for close contacts of meninigitis victim?

A

ciprofloxacin/rifampicin

35
Q

Other causative bacteria for meningitis other than meningitidis?

A

Strep pneumoniae and haemophillus

36
Q

optochin test for which bacteria?

A

Strep pneumoniae

37
Q

What adjunct is indicated for adult bacterial meningitis? Which strain?

A

Dexamethasone with first dose of abx strep pneumo only not meningococcal

38
Q

Neonatal meningitis suspect organisms?

A

Group b strep, listeria and e-coli

39
Q

Early neonatal infection likely to be what (neuro)?

A

Septicaemia

40
Q

Late infection of neonate >5 days neuro signs =?

A

meningitis

41
Q

Cryptococcal meningitis in who?

A

Late HIV

42
Q

Cryptococcal (yeast)meningitis treatment?

A

amphotericin, fluconazole and flucytosine

43
Q

Bacteria forming a drumstick appearance?

A

C.tetani

44
Q

Where is c.tetani found naturally?

A

Soil

45
Q

Most common entry site for tetanus infection?

A

foot

46
Q

C.tetani treatment?

A

Antitoxin (horse or human) penicillin metronidazole)

47
Q

Most common bacterium in brain abscess?

A

Strep milleri 60-70%

48
Q

Atypical bacteria causing brain abscess?

A

TB, toxplasma, nocardia, actinomyces

49
Q

Persistent infection can lead to brain abscess, which infection?

A

Endocarditis

50
Q

Most common presentation of brain abscess?

A

Headache and focal neurological defect

51
Q

Which symptom often missing in brain abscesses?

A

Fever can be severe infection too

52
Q

Principle of abscess drainage?

A

Drainage unless very small, confirm bacteria and avoid spread to ventricles!

53
Q

ABX that penetrate well into pus?

A

ampicillin, penicillin g, cefotax, ceftaz(anti pseudo) and metro

54
Q

Subdural empyema is what?

A

Infection between dura and arachnoid

55
Q

Subdural empyema often spreads from where?

A

Sinus and middle ear

56
Q

Focal defects likely in which infection brain?

A

Subdural empyema

57
Q

Most common cause of vp shunt infection?

A

Coagulase negative staph

Sam Clin Path (9 decks)

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