CNS infections

Question 1

Meningitis

Answer 1

Inflammation of the leptomeninges (bacterial usually)

Question 2

Encephalitis

Answer 2

Inflammation of the brain itself (viral usually)

Question 3

Myelitis

Answer 3

Inflammation of the spinal cord

Question 4

Acute bacterial meningitis, CSF guidelines

Answer 4

Fever, neck flexion, medical emergency.

CSF: elevated opening pressure, low glucose (.6 of peripheral), elevated protein, Poly predominance.

MRI, but don’t wait to scan to treat. Give steroids to treat vasculitis)

Question 5

Most common cause of bacterial meningitis

Answer 5

S. pneumo (60%)

N. meningitidis (20%) – there is a vaccine

Question 6

How does acute meningitis cause stroke?

Answer 6

Causes vasculitis!

Question 7

Meningococcal septicemia

Answer 7

Petechial non-blanching rash. DIC

Question 8

Waterhouse friederichsen syndrome

Answer 8

Adrenal failure secondary to N meningitides

Question 9

Viral meningitis

Answer 9

Coxsackie B, echovirus, HIV, HSV-2

CSF: Lymphos predominate, glucose and protein more normal

Question 10

Neuro tuberculosis

Answer 10

Secondary to lung tuberculosis, Can cause tuberculous meningitis or tuberculoma

Question 11

Brain abscess

Answer 11

Starts as cerebritis then forms capsule. Can cause herniation

Question 12

Subdural empyema

Answer 12

Looks like subdural hemorrhage. Sinusitis with fever, headache.

Question 13

Neurosyphilis

Answer 13

Gummas (granulomas), chancres, noninfection rash on soles, argyll robinson pupils, tabes dorsalis (shooting pains in legs)

Question 14

CSF for neurosyphilis

Answer 14

Positive VDRL means patient has syphilis, but negative doesn’t rule it out. Negative CSF FTA rules it out, but positive CSF doesn’t rule it in.

Question 15

Fungi

Answer 15

Lots of them.

Question 16

Mucor

Answer 16

bad with diabetes (ketoacidosis)

Question 17

Herpes simplex encephalitis

Answer 17

Hemorrhagic temporal lobe lesion – RBC’s in CSF.

Question 18

Characteristic rabies pathology

Answer 18

Negri bodies