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CABS Neurology > CNS infections > Flashcards

CNS infections Flashcards

1
Q

who is bacterial meningitis most common in

A

Children under 2 months
-median age is 42

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2
Q

What are some predisposing factors of bacterial meningitis

A

Household browsing (dorms)
Occupation
Prior viral infection

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3
Q

What are the most common bacteria that cause bacterial meningitis

A

Neonates: Strep B
Newborns: S. Pneumoniae
Babies/children: N. Meningitidis
Older adults: L. Monocytogenes

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4
Q

Where does Nisseria meningitides generally enter the body

A

Nasopharynx

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5
Q

How does Strep pneumoniae generally enter the body

A

nasopharynx
skull fx
distant infection

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6
Q

What are some common sources that cause bacteremia and ultimately lead to bacterial meningitis

A

Otitis Media
Sinuses
Dental infection

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7
Q

What type of organism is Neisseria Meningitidis

A

Aerobic
gram negative
diplococcus

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8
Q

How does Neisseria meningitides generally present with

A

rash

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9
Q

What Vaccines can you get to prevent Meningitis

A

Meningococcal (2 rounds early in life)
MenB

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10
Q

What is the drug of choice against Neisseria meningitis

A

Ceftriaxone

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11
Q

What is a common symptoms with streptococcus pneumoniae meningitis

A

Neurologic sequelae

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12
Q

What vaccine is preventative for strep pneumoniae

A

PPSV23

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13
Q

What is the drug of choice to treat streptococcus pneumoniae diseases

A

Vanco and ceftriaxone

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14
Q

What does listeria monocytogenes cause once it enters the brain

A

ataxia
seizures
focal deficits
*seen early in disease

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15
Q

What bacteria is most likely to cause a brain abscess

A

Listeria monocytogenes

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16
Q

What is the drug of choice to treat listeria monocytogenes

A

ampicillin
*bactrim if allergic

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17
Q

What is the meningitis triad

A

Fever
stiff neck
petechiae/purpura

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18
Q

If a patient presented with confusion instead of lethargy, what would the concern be

A

encephalitis

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19
Q

How do you test a babies mental status

A

breast feeding

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20
Q

If someone becomes septic from H. influenza… what is their most likely cause of death

A

cardiac failure

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21
Q

If a patient gets meningitis from H influenza… what is their most likely cause of death

A

increased ICP

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22
Q

What is the drug of choice to treat H. Influenza

A

Cetriaxone

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23
Q

How fast does the clinical presentation of bacterial meningitis appear after the onset of symptoms

A

less than 24 hours

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24
Q

What are some signs babies can get from bacterial meningitis

A

Vacant staring
high pitched moan/cry
tense fontanelle
abnormal tone

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25
What is positive Kernigs or Burdinski a sign of
meningitis
26
What is an elevated anion gap indicative of
Increased PH and lactate
27
What is a normal glucose range in an LP
45-85
28
What will bacterial meningitis glucose level be
<40
29
What will glucose level be with viral meningitis
normal
30
What type of white blood cells are normally seen in an LP and what amount
<5 Monocytes
31
What amount and what type of WBC are seen in bacterial meningitis
>1000 Neutrophils
32
What type of WBC and what amount is seen in an LP with Viral meningitis
100-1000 Lymphocytes
33
What is normal opening pressure for an LP
70-180
34
What is opening pressure in someone with bacterial meningitis
>200
35
What will the CSF look like with bacterial meningitis
Turbid/cloudy
36
What are the biggest forms of treatment in the first hour in someone suspected to have bacterial meningitis
2 large bore IVs Labs (CBC,CMP,PT/PTT) Fluid resuscitation Dexamethasone (for inflammation)
37
When is dexamethasone given
prior to antibiotics
38
What type of antibiotics are you giving someone with suspected meningitis
Broad spectrum until the organism is knows
39
What is the classic antibiotic regimen with bacterial meningitis
ceftriaxone vanco ampicillin
40
When is chemoprophylaxis used with meningitis
for anyone who has had >8hours of contact, close defined as less than 3 feet or swapping spit
41
What are the most common causes of subacute chronic meningitis
TB Lyme Listeria VZV HIV SLE NSAIDs/IVIG
42
What is viral meningitis (aseptic) caused by
enterovirus -coxsackie -echo
43
Which form of meningitis is less likely to have seizures
viral *also less sick than bacterial
44
How do you treat viral meningitis
supportive care *if VZV or HSV-> acyclovir
45
What is the difference between encephalitis and meningitis
Encephalitis effects the brain meningitis effects the meninges
46
What is encephalitis
inflammation of the brain parenchyma
47
What is the usual cause of encephalitis
Generally viral -herpes
48
Where does the swelling generally occur with encephalitis
cerebrum -> cerebellum -> brainstem
49
What is pleocytosis
increase in cells
50
How long does someone need to have AMS to meet major criteria of encephalitis
>24 hours
51
Where does HSV generally affect in the brain with encephalitis
temporal lobe
52
What is the test of choice for encephalitis
MRI with contrast (CT may look normal)
53
How will post infectious encephalitis appear on imaging
Mutlifocal lesions of the surpatentorial white mater
54
How do you treat encephalitis
monitoring and supportive care
55
How do you treat encephalitis
PREVENTION *GET YOUR VACCINES
56
Which gender is at higher risk of getting a brain abscess
Men
57
How do brain abscesses occur
Generally a direct spread from other infection -otitis media -mastoiditis -dental infection
58
What is the classing presentation of a brain abscess
Headache fever focal neurological deficit
59
Which patients are LPs NOT preformed in the workup of a brain abscess
Neuro deficit focal symptoms papilledema risk of brainstem herniation
60
What is the initial treatment of a brain abscess
Metronidazole (has anaerobic coverage)
61
Where are brain abscesses most common
Frontal and temporal lobes

CABS Neurology (11 decks)

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