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neurology > CNS infections > Flashcards

CNS infections Flashcards

1
Q

what does pyogenic meningitis show

A

a thick layer of suppurative exudate which covers the leptomeninges over the surface of the brain

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2
Q

where do you see the exudate in pyogenic meningitis

A

in basal and convexity surface

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3
Q

what do you see microscopically in pyogenic meningitis

A

neutrophils in the subarachnoid space

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4
Q

what is acute encephalitis

A

an infection of the brain parenchyma

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5
Q

what time of year is viral meningitis most common

A

late summer/autumn

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6
Q

what viruses can cause viral meningitis

A

enteroviruses eg ECHO virus

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7
Q

how is viral meningitis diagnosed

A

viral stool culture, throat swab, CSF PCR

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8
Q

what are the clinical features of encephalitis

A 
insidious onset-sometimes sudden 
meningismus 
stupor, coma 
seizures, partial paralysis 
confusion, psychosis 
speech, memory symptoms
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9
Q

what drug would you give for suspected encephalitis

A

acyclovir

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10
Q

what type of organisms tend to cause neonatal community acquired bacterial meningitis

A

listeria, group B streptococci, E COLI

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11
Q

organisms in children bacterial meningitis

A

h. influenza

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12
Q

organisms in over 21

A

strep pneumonia > Neisseria meningitides

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13
Q

10-21 bacterial meningitis

A

Neisseria meningitis

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14
Q

over 65

A

step pneumonia > listeria

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15
Q

what are the risk factors for bacterial meningitis

A

decreased cell mediated immunity-listeria monocytogenes
neurosurgery-staphylococcus, gram negative bacilli
fracture of the cribriform plate-step pneumonia

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16
Q

what is the pathogenesis of bacterial meningitis

A
  1. nasopharyngeal colonization
  2. direct extension of bacteria-sinusitis, mastoiditis, or brain abscess
  3. from remote foci of infection-endocarditis, pneumonia, UTI
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17
Q

which organism causes meningococcal meningitis

A

Neisseria meningitis

18
Q

where is n. meningitis found

A

in the throats of healthy carriers

19
Q

what causes the symptoms of n. meningitis

A

endotoxin (bacteria may be found in leukocytes in CSF)

20
Q

in which cell is the n. meningitis bacteria found

A

leukocytes

21
Q

n.meningitiis occurs in which demographic

A

young children

22
Q

how are military vaccinated against n. meningitis

A

purifies capsular polysaccharide

23
Q

where is h. influenza found

A

in the throat microbiota

24
Q

what does h. influenza require for growth

A

blood factors

25
Q

what type of vaccine is available for h. influenza

A

conjugated vaccine directed against the capsular polysaccharide antigen

26
Q

who are most susceptible to s. pneumoniae meningitis

A

hospitalised patients, patients with CSF skull fractures, diabetics, alcoholics and young children

27
Q

where is s. pneumonia found

A

in the nasopharynx

28
Q

what vaccine is for s, pneumonia

A

new conjugate vaccine for pneumococcal pneumonia also provides protection against pneumococcal meningitis in children

29
Q

what type of bacteria are listeria monocytogenes

A

gram positive bacilli

30
Q

what is listeria resistant to

A

ceftriaxone

31
Q

what is the antibiotic of choice for listeria

A

IV ampicillin/amoxicillin

32
Q

how is tuberculous meningitis diagnosed

A

reactivation in the elderly
high index of suspicion for diagnosis
previous TB on CXR
poor yield from CSF

33
Q

what type of organism produced cryptococcal meningitis

A

fungal infection

34
Q

what does cryptococcal meningitis look like on CSF

A

aseptic picture

35
Q

what type of infection does cryptococcal meninigitis produce

A

disseminated infection

36
Q

how do you treat cryptococcal meningitis

A

IV amphotericin B/flucytosine/fluconazole

37
Q

what are the most common symptoms of meningitis

A

fever, neck stiffness, changes in mental state, headache

38
Q

what do you need to be cautious of in lumbar puncture

A

if pt has ICP

39
Q

what are the main cells found in viral meningitis

A

lymphocytes

40
Q

what are the main cells in bacterial meningitis

A

polymorphs

41
Q

CSF is 99% predictive of bacterial meningitis if

A 
WBC>2000
Neutrophils >1180
Protein >220
Glucose <34
Glucose (csf/serum) <0.23

neurology (9 decks)

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