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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
Viral encephalitis cause in >90%?
HSV1
26
Important difference with encephalitis is what?
Altered mental state and seizures
27
What may EEG show in 75% of patients with encephalitis ?
Abnormal temporall lobe activity
28
Treatment of viral enceph?
High dose aciclovir 10mg/kg tds for 2-3 weeks do not wait
29
Mortality of untreated enceph?
70%
30
ADEM stands for what in neuro?
Acute disseminated encephalomyelopathy
31
PCR is clear on csf could be?
ADEM
32
Neisseria meningitidis | bacteria type?
Gram +ve diplococci
33
what does Neisseria meningitidis need to grow?
Choclate agar (blood)
34
Antibiotics for close contacts of meninigitis victim?
ciprofloxacin/rifampicin
35
Other causative bacteria for meningitis other than meningitidis?
Strep pneumoniae and haemophillus
36
optochin test for which bacteria?
Strep pneumoniae
37
What adjunct is indicated for adult bacterial meningitis? Which strain?
Dexamethasone with first dose of abx strep pneumo only not meningococcal
38
Neonatal meningitis suspect organisms?
Group b strep, listeria and e-coli
39
Early neonatal infection likely to be what (neuro)?
Septicaemia
40
Late infection of neonate >5 days neuro signs =?
meningitis
41
Cryptococcal meningitis in who?
Late HIV
42
Cryptococcal (yeast)meningitis treatment?
amphotericin, fluconazole and flucytosine
43
Bacteria forming a drumstick appearance?
C.tetani
44
Where is c.tetani found naturally?
Soil
45
Most common entry site for tetanus infection?
foot
46
C.tetani treatment?
Antitoxin (horse or human) penicillin metronidazole)
47
Most common bacterium in brain abscess?
Strep milleri 60-70%
48
Atypical bacteria causing brain abscess?
TB, toxplasma, nocardia, actinomyces
49
Persistent infection can lead to brain abscess, which infection?
Endocarditis
50
Most common presentation of brain abscess?
Headache and focal neurological defect
51
Which symptom often missing in brain abscesses?
Fever can be severe infection too
52
Principle of abscess drainage?
Drainage unless very small, confirm bacteria and avoid spread to ventricles!
53
ABX that penetrate well into pus?
ampicillin, penicillin g, cefotax, ceftaz(anti pseudo) and metro
54
Subdural empyema is what?
Infection between dura and arachnoid
55
Subdural empyema often spreads from where?
Sinus and middle ear
56
Focal defects likely in which infection brain?
Subdural empyema
57
Most common cause of vp shunt infection?
Coagulase negative staph

Sam Clin Path (9 decks)

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