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NEUROLOGY REVIEW > CNS Infection > Flashcards

CNS Infection Flashcards

1
Q

Characteristic imaging triad of TB meningitis?

A

Hydrocephalus, Basal Enhancement and Infarcts

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2
Q

initial event in the neurosyphilitic infection which occurs in approx 25% of all cases of syphilis?

A

Meningitis

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3
Q

Most common form of neurosyphilis

A

Meningovascular syphilis

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4
Q

Tuberculomas may grow up to size of

range

A

2-12 mm

page 742

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5
Q

most frequent opportunistic fungal infection

A

Candidiasis

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6
Q

The following are true of Candidiasis, except:

a. antecedents include severe burns, use of TPN
b. with treatment of IV amphotericin B, the prognosis is good
c. Yeast can be seen on direct microscopy n half of the cases
d. no feature distinguishes candidiasis with other fungal infection

A

b. with treatment of IV amphotericin B, the prognosis is good
- even with treatment of IV amphotericin B, the prognosis is grave

page 753

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7
Q

Cerebral toxoplasmosis occurs in patients with HIV and CD4 counts below:

a. 400/ul
b. 200/ul
c. 100/ul
d. 50/ul

A

c. 100 /ul

page 755

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8
Q

Which of the following would be the first reaction to bacterial infection in the brain?

a. exudation of protein
b. migration of neutrophils into the pia and subarachnoid space
c. lymphocytes and histiocytes migrate into the area of infection
d. hyperemia of the meningeal venules and capillaries

A

d. hyperemia of the meningeal venules and capillaries

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9
Q

Signs and symptoms of headache, stiff neck, Kernig and Brudzinski signs would correlate with this pathological reaction:

a. pure pia-arachnoiditis
b. subpial encephalopathy
c. thrombosis of meningeal veins
d. inflammatory or vascular involvement of cranial nerves

A

a. pure pia-arachnoiditis

Table 31-1 page 721

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10
Q

Signs and symptoms of focal seizures, focal cerebral defects eg hemiparesis, aphasia would correlate with this pathological reaction:

a. pure pia-arachnoiditis
b. subpial encephalopathy
c. thrombosis of meningeal veins
d. inflammatory or vascular involvement of cranial nerves

A

c. thrombosis of meningeal veins

table 31-1

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11
Q

most sensitive and specific test for CSF rhinorrhea and otorrhea

A

B2 transferrin

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12
Q

household contacts of patients with meningococcal meningitis should be protected with antibiotic treatment. the following are recommended prophylactic treatment
,except:

a. rifampin 10 mg/kg q12 for 2 days in children
b. ciprofloxacin 500 mg once a day for 2 days
c. single dose of ciprofloxacin 500 mg
d. rifampin 600mg q12 hrs in adults for 2 days

A

except B

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13
Q

components of oslers triad

A

pneumococcal meningitis
pneumonia
endocarditis

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14
Q

which of the bacterial etiologies of encephalitis can cause GBS, cranial neuritis, acute myositis, aseptic meningitis, transverse myelitis, global encephalitis, seizures, cerebellitis? *

a. mycoplasma
b, legionella
c. bartonella
d. anthrax
e. listeria
A

a. mycoplasma

p 739

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15
Q

Which of the following bacterial etiologies of encephalitis can cause hemorrhagic and inflammatory CSF?

a. mycoplasma
b. legionella
c. bartonella
d. listeria
e. anthrax

A

e. anthrax

p 732

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16
Q

most common congenital heart defect associated with brain abscess

A

tetralogy of fallot

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17
Q

most frequent initial symptom of intracranial abscess?

a. seizure
b. focal neurologic deficit
c. headache
d. drowsiness

A

c. headache

p. 738

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18
Q

Most frequent initial symptom of intracranial abscess?

a. focal seizure
b. unilateral weakness
c. headache
d. drowsiness
e. confusion

A

c. headache

p. 738

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19
Q

which aspect of bacterial meningitis produces seizures

a. pia-arachnoiditis
b. subpial encephalopathy
c. hydrocephalus
d. inflammatory involvement of cranial nerve roots

A

b. subpial encephalopathy

table 31-1

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20
Q

Single most effective anti TB drug in treating tuberculous infections

a. Rifampin
b. Isoniazid
c. Pyrazinamide
d. Ethambutol

A

b. Isoniazid

21
Q

Which anti TB medication is associated with optic neuropathy?

a. Rifampin
b. Isoniazid
c. Pyrazinamide
d. Ethambutol

A

d. Ethambutol

22
Q

Which anti TB medication is associated with neuropathy and hepatitis?

a. Rifampin
b. Isoniazid
c. Pyrazinamide
d. Ethambutol

A

b. Isoniazid

23
Q

Which is not a presentation of syphilis?*

a. tabes dorsalis
b. meningovascular meningitis
c. weils syndrome
d. dementia paralytica
e. spinal syphilis

A

c. Wiels syndrome

- extreme form of leptospirosis

24
Q

inflammation and fibrosis of small arteries in meningovascular syphilis?

A

Heubner arteritis

25
Q

Medication given to counteract the antifolate action of pyrimethamine in cerebral toxoplasmosis

A

Leucovorin

dose:15-20 mg daily

26
Q

Infections of which of the following organisms does not cause seizures?*

a. entamoeba histolytica
b. schistosomiasis
c. toxoplasmosis
d. trichinella
e. taenia solium

A

d. trichinella

27
Q

Most common finding on lumbar tap of cerebral malaria?*

a. increased protein
b. low glucose
c. elevated opening pressure

A
28
Q

Treatment of CNS toxoplasmosis in HIV infected patients?*

A

Pyrimethamine + sulfadiazine

29
Q

Least helpful diagnostic test in the treatment of cryptococcal meningitis?*

A

positive Saboraud agar culture

30
Q

Characteristic CSF finding of Anthrax?*

A

hemorrhagic and inflammatory CSF

RBCs on CSF

31
Q

Transmission of :

  1. epidemic typhus -
  2. Murine (endemic) Typhus -
  3. Scrub typhus/Tsutsugamushi fever -
  4. Rocky mountain spotted fever -
A
  1. epidemic typhus - lice
  2. Murine (endemic) Typhus - fleas from rats
  3. Scrub typhus/Tsutsugamushi fever - mites from infected rodents
  4. Rocky mountain spotted fever - ticks
32
Q

The following viruses involves retrograde axoplasmic transport system, except?

a. rabies
b. poliovirus
c. HSV
d. VZV

A

b. poliovirus

33
Q

Which of the following would be the most common viral identifiable cause of aseptic meningitis?

a. enteroviruses
b. HSV-2
c. mumps
d. varicella
e. HIV

A

a. enteroviruses
eg. echoviruses and coxsackie virus

page 764

34
Q

Most common sporadic cause of viral encephalitis and has no seasonal or geographic predilection?

A

HSV

35
Q

Typical eeg finding of HSV encephalitis

A

lateralized periodic high-voltage sharp waves in the temporal regions
and slow wave complexes at regular 2-3s intervals

36
Q

Incubation period of rabies?

a. 7-14 days
b. 10-30 days
c. 20-60 days
d. 30-90 days

A

c. 20-60 days

37
Q

Most common site involved in Herpes Zoster?

A

Thoracic T5-T10

followed by craniocervical regions

38
Q

A characteristic cranial nerve syndrome consisting of facial palsy in combination with a herpetic eruption of the external auditory meatus, sometimes with tinnitus, vertigo and deafness

A

Ramsay Hunt Syndrome

39
Q

of the focal opportunistic infectious complications of HIV, this is the most frequent

A

cerebral toxoplasmosis

p. 781

40
Q

Progressive multifocal leukoencephalopathy occurs in patients with CD4+ counts of below:

A

50 cells/uL

41
Q

Among NON-focal opportunistic infectious neurologic complications of AIDS, these 2 are the most common

A

CMV and cryptococcal infections

42
Q

Shingles involving several contiguous dermatomes have known to occur in HIV with CD4 counts below

A

500

43
Q

cerebral disease characterized by rapid or subacutely progressive and profound dementia associated with diffuse myoclonic jerks and cerebellar neurologic disturbances

A

Creutzfeldt Jacob disease

44
Q

Most common variant of CJD (2 answers)

a. MM1
b. MV1
c. MM2
d. MV2

A

a and b
MM1 and MV1

MM > VV
type 1 > Type 2

page 791

45
Q

CSF findings in CJD

a. normal
b. elevated protein
c. elevated leukocytes
d. presence of RBCs

A

a. normal

page 791

46
Q

Which of the following is a recommended inactivating process for prion agent:

a. autoclaving at 132 degrees C at 15 lb/in2
b. immersion for 1 hour in 5 percent sodium hypochlorite (bleach)
c. boiling in water for 30 minute duration
d. A and B
e. B and C
f. all of the above

A

D. A and B are correct

boiling, treatment with formalin and alcohol and ultravoilet radiation are ineffective

p 793

47
Q

causative organism of Progressive Multifocal Leukoencephalopathy

A

JC virus

48
Q

Severe clinical worsening of PML that may occur during the initial treatment of HIV infection with antiretroviral drug
which is attributed to the emergence of acute inflammation surrounding the demyelinating lesions as a result of reconstitution of the immune system

A

Immune reconstitution inflammatory syndrome (IRIS)

NEUROLOGY REVIEW (24 decks)

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