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Step 2 CK > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

Most likely diagnosis:

  • stiff neck
  • photophobia
  • meningismus
A

Meningitis

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2
Q

Most likely diagnosis:

  • fever
  • headache
  • confusion
A

Encephalitis

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3
Q

MCC meningitis in elderly, neonates, and IC pts?

A

Listeria

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4
Q

Cause of meningitis after recent neurosurgery?

A

Staphylococcus

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5
Q

Cause of meningitis in AIDS pt w/ CD4

A

Cryptococcus

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6
Q

Cause of meningitis in camper with rash shaped like a target, joint pain, and facial palsy?

A

Lyme disease

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7
Q

Cause of meningitis in camper, rash moving from risks to trunk

A

RMSF

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8
Q

Cause of meningitis in pulmonary TB pt?

A

TB

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9
Q

Cause of meningitis in pt with no specific presentation?

A

viral

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10
Q

Cause of meningitis in adolescent w/ petechial rash?

A

Neisseria

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11
Q

Best initial test/most accurate test for meningitis?

A

LP

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12
Q

Characteristics of CSF of pt with bacterial meningitis?

A

HIGH neutrophils/cell count
ELEVATED protein level
DECREASED glucose level
Sometimes positive stain and culture

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13
Q

Characteristics of CSF of pt with viral meningitis?

A

LOW cell count
NORMAL protein level
NORMAL glucose level
Negative stain and culture

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14
Q

Characteristics of CSF of pt with Cryptococcus, Lyme, or Rickettsia meningitis?

A

LOW cell count
possibly elevated protein level
possibly decreased glucose level
Negative stain and culture

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15
Q

Characteristics of CSF of pt with TB meningitis?

A

LOW cell count
MARKEDLY ELEVATED protein level
Possibly decreased glucose level
Negative stain and culture

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16
Q

What is a specific characteristic in CSF of TB meningitis?

A

Markedly elevated protein level in CSF

17
Q

If pt has focal findings, seizures, papilledema, or confusion with diagnosis of meningitis, what is the first initial test?

A

Head CT

18
Q

If Listeria is possible cause of meningitis, what is added to treatment regimen?

A

Ampicillin

19
Q

All close contacts of a patient treated for N. meningitis meningitis are treated with what abx?

A

rifampin, cipro, or ceftriaxone

20
Q

MC neuro deficit of untreated meningitis

A

8th CN deficit or deafness

21
Q

MCC of encephalitis

A

HSV

22
Q

Most accurate test for HSV encephalitis

A

PCR of CSF

23
Q

1st line Tx for HSV encephalitis

A

acyclovir

24
Q

1st line Tx for Acyclovir-resistant encephalitis?

A

Foscarnet

25
Q

What is a major side effect of acyclovir?

A

renal toxicity

26
Q

What is the most accurate diagnostic test for TB meningitis?

A

acid-fast stain and culture on 3 high-volume lumbar punctures

27
Q

What is the most accurate diagnostic test for Lyme and Rickettsia meningitis?

A

specific serology testing, ELISA, Western blot, and PCR

28
Q

What is the most accurate diagnostic test for Cryptococcus meningitis?

A 
India ink (60-70% sensitivity)
Cryptococcal Ag (>95% sensitive and specific)
29
Q

What is the most accurate diagnostic test for viral meningitis?

A

diagnosis of exclusion

Step 2 CK (7 decks)

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