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ID > CNS infections > Flashcards

CNS infections Flashcards

1
Q

yellowish supernatant of CSF that is a result of RBC lysis

A

xanthochromia

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2
Q

xanthochromia indicates the presence of?

A

oxyhemoglobin, methehemoglobin, bilirubin

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3
Q

seizures can do what to CSF?

A

transient CSF pleocytosis with counts under 80, and all other normal values

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4
Q

white counts are usually the highest with _______

A

bacterial meningitis

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5
Q

bacterial meningitis presents with _____whites counts, ____glu, differential with _____, _____protein

A

high white counts, low glu, differential with neutrophils, high protein

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6
Q

cryptococcal meningitis presents with ____WBC, ____glu, differential wit____

A

moderately elevted WBC, low glu, differential with mononuclear cells

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7
Q

viral meningitis presents with WBC under _____, ___glu, protein____

A

WBC under 500, elevated glu, protein under 200

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8
Q

normal CSF: serum glu ratio

A

0.6

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9
Q

CSF hypoglycorrhachia

A

low CSF glu

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10
Q

csf protein concentrations over _____is abnormal

A

50

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11
Q

entry of agents into CSF is enhanced by ___MW, ___degree of ionization, ____lipid solubility, ____degree of protein binding

A

low MW, low degree of ionization, high lipid solubility, low degree of protein binding

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12
Q

_____and ______ are responsible for 80% of acute bacterial meningitis cases in adults

A

Strept pneumo and neisseria are responsible for 80% of acute bacterial meningitis cases in adults

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13
Q

bacteria that can cause acute, subacute, or chronic meningitis (3)

A
  1. M TB
  2. treponema pallidum
  3. borrelia burgdorferi
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14
Q

how to empircally tx acute bacterial meningitis

A

IV vancomycin + 3rd gen cephalosporin

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15
Q

what to use to tx listeria as causative agent of acute bacterial meningtiis?

A

ampicillin

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16
Q

what is the triad for meningitis

A

HA, fever, meningismus

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17
Q

in someone who has had neurosurgery & now acute bacterial meningitis, what bug to suspect

A

coagulase negative staphy species

18
Q

how to tx acute bacterial meningitis in someone with neurosurg

A

vancomycin + ceftazidime or cefepime or meropenem

19
Q

what commonly used drug can you NOT use to tx acute bacterial meningtis?

A

extended PCN

20
Q

The only pathogen that has been studied and had positive results with steroid admin is ______

A

strept pneumo

21
Q

listeria acute meningitis should be tx’d for a minimum of _____

A

3 weeks

22
Q

Neisseria & H influenzase acute meningitis should be tx’d for how long

A

7 days

23
Q

tx S pneumoniae acute meningitis for how long

A

10-14 days

24
Q

tx GBS acute meningitis for how long

A

14-21 days

25
Q

which stage of lyme disease: erythema migrans, flu-like sx

A

stage 1: localized infxn

26
Q

which stage of lyme disease: neuroborreliosis with meningitis, cranial neuopathy, motor or sensory radiculopathy

A

stage 2: early disseminated ifnxn

27
Q

which stage of lyme disease: arthritis, encephalopathy

A

stage 3: late persistent infxn

28
Q

tx of early lyme disease

A

doxycycline or amoxicillin

29
Q

how long is tx of early lyme disease

A

14-21 days

30
Q

tx of neuroborreliosis

A

2-4 weeks of 3rd gen cephalosporin IV

31
Q

how long to tx lyme disease when there is heart involvement

A

4 weeks

32
Q

how long to tx lyme disease when there is joint involvement

A

4-8 weeks

33
Q

how to dx cryptococcal meningitis

A

cryptococcal Ag test

34
Q

tx of cryptococcal meninogoencephalitis

A

amphotercin B or fluconazole

35
Q

most common fungal causes of chronic meningitis

A
  1. cryptococcus

2. histo

36
Q

most common bacterial causes of chronic meningitis

A
  1. M TB

2. syphilis

37
Q

does HSV encephalitis or meningitis require immediate tx?

A

HSV encephalitis

38
Q

normal opening pressure

A

50-195

39
Q

in a patient with left temporal lobe enhancement, do not miss what?

A

herpes

40
Q

what is the most sensitive neuroimaging to evaluate encephalitis

A

MRI

41
Q

what should be performed on all CSF in patients with encephalitis?

A

HSV PCR

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