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Y3 Neurology > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

what are the meninges?

A

the membranes covering the brain and spinal cord

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2
Q

name the three meninges

A

dura
arachnoid
pia

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3
Q

what can untreated CNS infection lead to?

A

brain herniation and death

cord compression and paralysis

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4
Q

what are the two main types of meningitis?

A

pyogenic/bacterial

aseptic/viral

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5
Q

what is acute encephalitis?

A

an infection of the brain parenchyma

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6
Q

what is seen on the surface of the brain in bacterial meningitis?

A

thick layer of suppurative exudate covering the meninges

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7
Q

what is seen microscopically in bacterial meningitis?

A

neutrophils in the subarachnoid space

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8
Q

name four possible causes of bacterial meningitis

A

strep pneumoniae
neisseria meningitidis
listeria monocytogenes
haemophilus influenza

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9
Q

what is the management of bacterial meningitis?

A

ceftriaxone IV 2g BD

dexamethasone IV 10mg

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10
Q

what is the management for bacterial meningitis in someone with a penicillin allergy?

A

chloramphenicol IV 25mg/kg

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11
Q

when should dexamethasone be given for bacterial meningitis?

A

with or just before the first dose of antibiotics

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12
Q

when should dexamethsone be continued in bacterial meningitis and for how long?

A

pneumococcal meningitis

for four days

any other cause = stop

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13
Q

what should be given if listeria cover is required in bacterial meningitis?

A

add amoxicillin IV 2g 4 hourly

or co-trimoxazole iV 4x a day

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14
Q

what should be added to the management of bacterial meningitis if recent travel to a country with high rates of penicillin resistant pneumococci?

A

vancomycin or rifampacin

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15
Q

what are the signs and symptoms of bacterial meningitis?

A 
headache 
vomiting 
pyrexia 
neck stiffness 
photophobia 
lethargy 
confusion 
rash
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16
Q

what bacteria cause bacterial meningitis in neonates?

A

listeria
group B strep
e coli

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17
Q

what bacteria causes bacterial meningitis in children?

A

h influenza

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18
Q

what bacteria cause bacterial meningitis in those aged 10-65?

A

neisseria meningitidis

strep pneumoniae

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19
Q

what bacteria cause bacterial meningitis in those >65?

A

strep pneumoniae

listeria

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20
Q

what bacteria are associated with bacterial meningitis in the immunocompromised?

A

listeria
strep pneumoniae
neisseria
pseudomonas

21
Q

what bacteria are associated with bacterial meningitis in those with head trauma?

A

staph

gram negative bacilli

22
Q

what bacteria is associated with bacterial meningitis after fracture of the cribriform plate?

A

strep pneumoniae

23
Q

name four possible complications of bacterial meningitis

A

purulence
invasion
cerebral oedema
hydrocephalus

24
Q

what causes meningococcal meningitis?

A

neisseria meningitidis

25
Q

what causes symptoms in meningococcal meningitis?

A

endotoxin production

26
Q

who is most commonly affected by meningococcal meningitis?

A

young children

27
Q

what type of h influenzae is the most common cause of meningitis in children <4?

A

type b

28
Q

what cause pneumococcal meningitis?

A

strep pneumoniae

29
Q

what can be given to provide protection against pneumococcal meningitis?

A

pneumococcal pneumonia vaccine

30
Q

what type of bacteria is listeria monocytogenes?

A

gram positive bacilli

31
Q

name three risk factors for meningitis due to listeria monocytogenes

A

neonate
>55
immunosuppression

32
Q

what antibiotics can be given for meningitis due to listeria monocytogenes?

A

IV ampicillin/amoxicilli n

33
Q

what causes tuberculous meningitis?

A

reactivation of TB

34
Q

who is more commonly affected by tuberculous meningitis?

A

the elderly

35
Q

what is given to treat tuberculous meningitis?

A

isoniazid and rifampicin

add on pyrazinamide and ethambutol
RI then RIPE

36
Q

what causes cryptococcal meningitis?

A

fungal infection

37
Q

who is most commonly affected by cryptococcal meningitis?

A

HIV positive patients

38
Q

how does cryptococcal meningitis present?

A

subtle neurological presentation

aseptic picture on CSF

39
Q

how is cryptococcal meningitis managed?

A

IV amphotericin/flucytosine

fluconazole

40
Q

when is viral meningitis usually seen?

A

late summer/autumn

41
Q

when is viral meningitis usually seen?

A

late summer/autumn

42
Q

what usually causes viral meningitis?

A

enteroviruses e.g. ECHO virus

43
Q

what investigations are done to diagnose viral meningitis?

A

viral stool culture
throat swab
CSF PCR

44
Q

how is viral meningitis managed?

A

supportive as it is self limiting

45
Q

how does encephalitis present?

A

mental state changes
confusion
behaviour/speech disturbances
seizures

46
Q

what investigations are done for encephalitis?

A

lumbar puncture
EEG
MRI

47
Q

what drug should be started if there is a delay to diagnosis or treatment in encephalitis?

A

aciclovir

48
Q

what drug is used to manage encephalitis?

A

aciclovir

49
Q

how does meningoencephalitis present?

A

headache
fever
neck stiffness
features of encephalitis

Y3 Neurology (31 decks)

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