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CNS Infections Flashcards

1
Q

meningitis should always be treated like __________

A

an emergency

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2
Q

what is more acute, bacterial or viral meningitis?

A

bacterial

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3
Q

what is meningitis?

A

infection/inflammation of meninges

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4
Q

what are the common clinical symptoms of meningitis?

A

nuchal rigidity
headache
confusion
drowsiness

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5
Q

how is meningitis diagnosed?

A

lumbar puncture

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6
Q

what are the requirements for collecting a lumbar puncture sample?

A

4 mL CSF
1st tube goes to chemistry
2nd + 3rd tubes go to micro

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7
Q

why can’t the first LP tube go to micro for meningitis diagnosis?

A

1st tube is a skin puncture
will just be normal flora

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8
Q

what is the problem with gram stains for meningitis?

A

poor sensitivity

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9
Q

what are the 2 inflammatory condition of the CNS?

A
  1. encephalitis
  2. meningoencephalitis
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10
Q

what is encephalitis?

A

inflammation of brain tissue

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11
Q

encephalitis is most often caused by _________ infections

A

viral

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12
Q

is encephalitis the same as meningitis?

A

no

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13
Q

what I meningoencephalitis?

A

inflammation of meninges + brain tissue

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14
Q

what are the 2 ways of acquiring meningitis?

A
  1. seeding of meninges
  2. direct inoculation (trauma, surgery)
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15
Q

how are the meninges “seeded”?

A

from bloodstream secondary to bacteremia or viremia

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16
Q

why is oral health important for preventing meningitis?

A

organism from the mouth and oropharynx seed into brain

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17
Q

what happens to the BBB with inflammation?

A

increased permeability allows for more seeding

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18
Q

who is at highest risk for bacterial meningitis? why?

A

neonates

immature immune system

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19
Q

how do neonates acquire bacterial meningitis?

A

birth canal

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20
Q

what are the top 3 organisms that cause bacterial meningitis in neonates?

A
  1. GBS
  2. E. coli
  3. listeria monocytogenes
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21
Q

how do we prevent GBS and bacterial meningitis in neonates?

A

screening pregnant women at 35 week

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22
Q

why is bacterial meningitis difficult to diagnose in neonates?

A

general signs and symptoms are difficult to interpret

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23
Q

how is the baby exposed to listeria monocytogenes?

A

if mom eats soft cheeses and deli meats –> placenta –> baby

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24
Q

what are the complications of bacterial meningitis in neonates?

A

blindess
hearing loss
developmental delays

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25
what are the top 3 organisms that cause bacterial meningitis in children? what do these have in common?
1. S. pneumoniae 2. H. influenzai 3. N. meningitides all colonize RT
26
S. pneumoniae haș very high colonization in ________________
the respiratory tract
27
what is the earliest vaccine we give?
H. influenzae
28
GBS causes _____________ in infants, but not in _____________
causes meningitis, pneumonia and bacteremia not in adults
29
what do you do if a non-pregnant woman tests positive for GBS? why?
nothing normal colonizer of genital tract
30
what do you do if E. coli is in the GI tract?
nothing if asymptomatic
31
what do you do if S. pneumonia is found in the respiratory tract?
nothing
32
what is the reason for N. meningitidis outbreaks?
quadrivalent vaccine only covers 4x strains doesn't cover the B strain which causes outbreak
33
________________ is almost never seen as meningitis
H. influenzae
34
all 3 causes of bacterial meningitis in children are ___________ preventable
vaccine
35
what are the top 2 organisms that cause bacterial meningitis in adults?
1. S. pneumoniae 2. N. meningitidis
36
what is a less common cause of bacterial meningitis in adults?
listeria monocytogenes
37
many healthy, non-pregnant woman have vaginal _____________ of ________________
vaginl carriage of GBSS
38
full term babies that become carriers of GBS can develop ________
meningitis
39
what babies are at high risk for E. coli meningitis?
preterm LBW
40
what type of bacteria is listeria monocytogenes?
gram positive bacillus
41
what are the 2 ways of transmitting listeria monocytogenes to infants?
1. oral ingestion --> intestinal penetration --> circulation 2. lateral bacteremia --> transplacental
42
listeria monocytogenes is incredible rare, except for which populations?
immunocompromised elderly
43
why is S. pneumoniae so pathogenic?
capsule helps it evade immune system
44
where is S. pneumoniae carriage?
nose and throat
45
where is N. meningitidis carriage?
nose and throat
46
what is the #1 cause of bacterial meningitis in teens ad adults?
N. meningitidis
47
what are the 3 vaccines for . meningitidis?
1. quadrivalent 2. meningococcal group C 3. meningococcal group B
48
how long does it take to grow bacteria for meningitis diagnosis? what should be done in the meantime?
24-24 hours? broad spectrum antibiotics
49
what 3 host factors should be assessed in CSF for meningitis?
1. glucose 2. protein 3. WBCs
50
bacterial meningitis - glucose
low
51
viral meningitis - glucose
normal
52
fungal meningitis - glucose
low
53
bacterial meningitis - protein
high
54
viral meningitis - protein
low
55
fungal meningitis - protein
moderate
56
bacterial meningitis - WBCs
high
57
viral meningitis - WBCs
moderate
58
fungal meningitis - WBCs
moderate
59
how is bacterial meningitis diagnosed?
#1 PCR
60
what causes fungal meningitis?
cryptococcus neoformans
61
what is cryptococcus neoformans?
yeast with a large capsule
62
where is cryptococcus neoformans found?
environmental bird poop
63
cryptococcus neoformans meningiti is more common in what populations?
T cell immunocompromised - lymphoma - AIDs - steroids
64
if a patient in the ICU is being treated with dexamethasone (steroids) and becomes infected with cryptococcus neoformans, this is an ______________ infection
opportunistic
65
how is C. neoformans meningitis diagnosed?
culture latex agglutination
66
what is latex agglutination?
rapid antigen test latex beads with specific C. neoformans antibody added to CSF C. neoformans will bind latex beads
67
viral meningitis is self-limiting, unless caused by what?
HSV-1 HSV-2 VZV
68
what is more common, bacterial or viral meningitis?
viral
69
most cases of viral meningitis are ______________
self limiting
70
most viral meningitis cases are caused by _______________
enterovirus

MICR 121 (16 decks)

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