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CNS Infections Flashcards

1
Q

Classic meningitis triad

A

Fever
Headache
Neck stiffness
(photophobia …?)

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2
Q

What is encephalomyelitis

A

Inflammation of the brain and the spinal cord

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3
Q

Diagnosis of viral meningitis

A

Viral stool culture
Throat swab
CSF PCR

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4
Q

Treatment for herpes simplex encephalitis

A

Aciclovir (IV high dose !!)

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5
Q

How quickly do you need to diagnose herpes simplex encephalitis?

A

RAPIDLY within 6 hours !!

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6
Q

Diagnosis of encephalitis:

A

Lumbar puncture
EEG
MRI

If delay, start pre-emptive treatment with aciclovir!!!!! prevents death

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7
Q

Bacteria most likely to cause meningitis in children?

A

H. influenza

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8
Q

Bacteria most likely to cause meningitis in ppl aged 10-21

A

Meningococcal

above 21 = pneumococcal

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9
Q

Listeria, group B strep and E. coli are most likely to cause meningitis in which age group?

A

Neonates

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10
Q

Bacteria most likely to cause meningitis in immunocompromised?

A

LISTERIA !!!

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11
Q

Satphylococcus / gram negative rods most likely to cause meningitis in which group of people?

A

Ppl who have had neurosurgery / open head trauma

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12
Q

WHAT ORGANISM CAUSES MENINGITIS IN PEOPLE WITH CRIBRIFORM FRACTURE ?!

A

Pneumococcal

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13
Q

Organism causing meningitis in patient with CSF shunt?

A

Staph epidermidis

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14
Q

Which bacteria causes meningococcal meningitis?

A

Neisseria meningitidis

-this occurs most often in young children

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15
Q

Where is neisseria meningitidis found?

A

Throats of healthy carriers

-H. influenza also found in the throat

Step. pneumonia is found in the nose !!!

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16
Q

Which meningitis causing bacteria can be found in leukocytes in the CNS? and what are the symptoms due to?

A

N. meningitidis

-symptoms are due to endotoxin

17
Q

Vaccination with purified capsular polysaccharide prevents against which meningitis?

A

Meningococcal meningitis

N. meningitidis

18
Q

What does H. influenzae require for growth?

A

Blood factors

19
Q

Most common type of H. influenzae in children under 4?

A

H. influenza type b

20
Q

What type of vaccine is available against haemophilus influenza?

A

A coonjugate vaccine against the polysaccharide antigen

21
Q

Which bacteria is found in the nose?

22
Q

Some evidence that this bacteria is related to CNS implants like cochlear implants

23
Q

Hospitalized patients, patients with CSF skull fractures, diabetics/ alcoholics and young children are most susceptible to which bacteria meningitis?

A

Penumococcal!!! (caused by strep. pneumoniae)

24
Q

This type of meningitis is caused by gram positive bacilli?

25
Q

Bacteria most likely to cause meningitis in malignancy? (a.k.a immunocompromised)

26
Q

Antibiotics for listeria

A

IV ampicillin/amoxicillin

ceftriaxone no value as intrinsically resistant

27
Q

GRAM POSITIVE ROD

A

Listeria (LEARN THIS)

28
Q

Treatment for tb meningitis?

A

Rifampicine and isoniazid (add pyrazinamide and ethambutol)

29
Q

Organism seen in HIV meningitis

A

Cryptotoccus

this is a FUNGUS !!

30
Q

Treatment for cryptococcus meningitis?

A
  • IV amphotericin b / flucytosine

- fluconazole

31
Q

This organism gives an aseptic picture on CSF

A

Cryptococcal meningitis

32
Q

Other causes of raised neutrophils and low CSF glucose (i.e. causes which aren’t bacterial meningitis)

A
  • viral meningitis in early phase
  • leakage of brain abscess
  • chemical-meningitis (contrast)
  • Behcet syndrom
  • Drug induced (NASIDS etc)
33
Q

What is aseptic meningitis?

A

Non-pyogenic meningitis

low WBC, protein minimally elevated, normal glucose

34
Q

Admission to hospital: what type of swab should you take?

A

Throat swab and swab from any petechial/purpuric lesions

35
Q

Antibiotics for meningitis (acute admission)

A

CEFOTAXIME/ CEFTRIAXONE

add ampicillin/amoxicillin if listeria suspected

Penicillin allergy = chloramphenicol with vancomycin

If listeria suspected and penicillin allergy, co-trimoxazole

36
Q

WHAT DO YOU GIVE WITH ABX FOR SUSPECTED BACTERIAL MENINGITIS?

A

STEROIDS !!!!

-before or with first dose

37
Q

When would you not give steroids in meningitis?

A
  • post-surgical meningitis
  • severe immunocompromised
  • meningococcal or septic shock
38
Q

Abx used for contact prophylaxis for meningitis

A

Rifampicin (over 12)
Ciprofloxacin (not licensed but widely used)
Ceftriaxone

Rifampicin - warn of reduced efficacy of OCP, red coloration of urine, staining of contact lenses

39
Q

Neisseria meningitidis vaccine:

  • which serogroups does it vaccinate against?
  • who commonly receives it?
A
  • Serogroups A and C

- Commonly used in travel vaccination

Neurology (56 decks)

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