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3.1 midterms > cns infections > Flashcards

cns infections Flashcards

1
Q

lumbar puncture indications [3]

A
  • cns infection
  • thunderclap headache: rule out SAH when CT/MRI is normal
  • evaluate for normal pressure hydrocephalus
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2
Q

lumbar puncture contraindications [3]

A
  • infection near puncture site
  • presence of space occupying lesion
  • PLT <80, INR >1.4
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3
Q

opening pressure for lumbar puncture

A

10-18 cm H20

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4
Q

elevated opening pressure for lumbar puncture indicates:
[3]

A

infective: bacteria, TB, fungal
hydrocephalus
benign intracranial hypertension

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5
Q

low opening pressure for lumbar puncture indicates [2]

A

blockage (spinal block but high ICP)
intracranial hypotension

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6
Q

yellow CSF indicates [3]

A

blood breakdown products
hyperbilirubinemia
high proteins/RBC

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7
Q

orange CSF indicates [2]

A

blood breakdown products
high carotenoid ingestion

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8
Q

pink CSF indicates

A

blood breakdown products

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9
Q

green CSF indicates

A

purulent CSF
hyperbilirubinemia

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10
Q

CSF characteristics for bacterial meningitis

A

opening pressure: elevated
WBC: > 1,000
cell differential: neutrophils, eosinophils, basophils
protein: mild to marked elevation
glucose: normal to marked decrease

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11
Q

CSF characteristics for viral meningitis

A

opening pressure: normal
WBC: <1,000
cell: LYMPHOCYTE
protein: normal to elevated
glucose: normal

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12
Q

CSF characteristics for fungal meningitis

A

opening pressure: variable
WBC: variable
cell: LYMPHOCYTE
protein: ELEVATED
glucose: low

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13
Q

CSF characteristics for tubercular meningitis

A

opening pressure: variable
WBC: variable
cell: LYMPHOCYTE
protein: ELEVATED
glucose: low

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14
Q

brain abscess treatment

A

drainage/excision
IV abx

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15
Q

types of encephalitis [4]

A
  • herpes simplex
  • varicella zoster
  • cytomegalovirus
  • japanese encephalitis virus
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16
Q

herpes simplex encephalitis symptoms [3]

A

fever
chills
signs of increased ICP

17
Q

pathology of herpes simplex encephalitis

A

oedema > haemorrhage > necrosis of TEMPORAL lobe

18
Q

herpes simplex encephalitis symptoms [4]

A
  • behaviour & personality change
  • focal neurological signs (aphasia, hemiplegia)
  • seizures
  • drowsiness & coma
19
Q

japanese encephalitis risk factors [2]

A

rural residents in padi fields

rural area during transmission period

20
Q

is vaccine available for japanese encephalitis

21
Q

dx investigations for encephalitis [3]

A

CT: exclude mass lesion, localise site of lesion

lumbar puncture

EEG (slow waves for HSV)

22
Q

encephalitis treatment [3]

A

anticonvulsants

decrease ICP > mannitol/dexamethasone

antivirals

23
Q

encephalitis prognosis

A

poor prognosis
- residual epilepsy / cogimpairment
- 10-30% mortality

24
Q

meningitis definition

A

inflammation of meninges around brain & spinal cord, irritation of nerves passing through meninges

25
s&s meningitis [9]
- fever - headache - irritability - delirium - LOC - purpura - neck stiffnes - kernig's sign - brudzinski's sign
26
what is kernig's sign
trying to extend flexed knee with hips flexed --> hamstring spasm
27
what is brudzinski's sign
severe neck stiffness --> hips & knees flex when neck is flexed
28
meningitis causative bacteria [3]
strep pneumoniae haemophilus influenzae meningococcus
29
meningitis features [5]
purulent exudates, thrombosed veins on surface & base of brain haemorrhagic infarction of penetrating vessels neutrophils in subarachnoid space haemorrhages throughout body adrenal haemorrhagic necrosis
30
tuberculosis meningitis features (2)
- small yellow nodules (tubers) on brain surface - lymphocytes, langhan's giant cells on histology
31
viral meningitis causative organisms [3]
mumps measles echoviruses
32
viral meningitis features
dense lymphocytic infiltration csf shows lymphocytes
33
lymphocytes in csf indicate what kind of meningitis
viral meningitis
34
langhan's giant cells on histology indicate what kind of meningitis
TB meningitis
35
encephalitis vs meningitis
encephalitis is usually caused by viruses. encephalitis: inflammation of brain meningitis: inflammation of meninges & spinal cord
36
dx investigations for meningitis [3]
CT lumbar puncture blood culture
37
meningitis treatment [4]
IV abx supportive meaures contact tracing (meningococcal > rifampicin prophylaxis) vaccination
38
meningitis complications [3]
cerebral nerve palsies d/t fibrosis hydrocephalus (block aqueduct) cortical atrophy (vessel thrombosis > increase ICP) - mental retardation, blindness, deafness, paralysis
39

3.1 midterms (7 decks)

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