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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

A

yes

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
Q

s&s meningitis [9]

A
  • fever
  • headache
  • irritability
  • delirium
  • LOC
  • purpura
  • neck stiffnes
  • kernig’s sign
  • brudzinski’s sign
26
Q

what is kernig’s sign

A

trying to extend flexed knee with hips flexed –> hamstring spasm

27
Q

what is brudzinski’s sign

A

severe neck stiffness –> hips & knees flex when neck is flexed

28
Q

meningitis causative bacteria [3]

A

strep pneumoniae
haemophilus influenzae
meningococcus

29
Q

meningitis features [5]

A

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
Q

tuberculosis meningitis features (2)

A
  • small yellow nodules (tubers) on brain surface
  • lymphocytes, langhan’s giant cells on histology
31
Q

viral meningitis causative organisms [3]

A

mumps
measles
echoviruses

32
Q

viral meningitis features

A

dense lymphocytic infiltration
csf shows lymphocytes

33
Q

lymphocytes in csf indicate what kind of meningitis

A

viral meningitis

34
Q

langhan’s giant cells on histology indicate what kind of meningitis

A

TB meningitis

35
Q

encephalitis vs meningitis

A

encephalitis is usually caused by viruses. encephalitis: inflammation of brain

meningitis: inflammation of meninges & spinal cord

36
Q

dx investigations for meningitis [3]

A

CT
lumbar puncture
blood culture

37
Q

meningitis treatment [4]

A

IV abx
supportive meaures
contact tracing (meningococcal > rifampicin prophylaxis)
vaccination

38
Q

meningitis complications [3]

A

cerebral nerve palsies d/t fibrosis

hydrocephalus (block aqueduct)

cortical atrophy (vessel thrombosis > increase ICP)
- mental retardation, blindness, deafness, paralysis

39
Q
A

3.1 midterms (7 decks)

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