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Y3 Neurology > CNS infections > Flashcards

CNS infections Flashcards

1
Q

What trio of clinical features suggest pyogenic bacterial meningitis

A

headache, fever, stiff neck

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2
Q

What additional features are sometimes present in meningitis

include what effect does meningitis have on blood pressure and HR

A 
non-blanching rash
papilloedema
photophobia
confusion
hypertension
bradycardia
lethargy
loss of consciousness
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3
Q

Which bacteria is associated with meningitis in those over 65yo

A

s. pneumoniae

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4
Q

Which bacteria is associated with meningitis in those aged 10-21

A

neisseria meningitides

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5
Q

What age ranges are associated with listeria monocytogenes meningits

A

neonates and over 55yo

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6
Q

Which organisms in meningitis are particularly associated with immunosuppressed patients

A

listeria and crytococcus

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7
Q

Which bacteria is associated with meningitis in military people / university freshers

A

neisseria meningitides

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8
Q

Which bacteria is associated with meningitis in cribriform plate fractures

A

s. pneumoniae

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9
Q

Which bacteria is associated with meningitis in alcoholic, diabetics and those with cochlear implants

A

s. pneumoniae

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10
Q

Neisseria is a gram +ve intercellular bacteria. True of false

A

false, gram -ve intracellular

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11
Q

Listeria is a gram +ve cocci. T or F

A

false, gram +ve bacilli

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12
Q

What is aseptic meningitis

A

no bacteria found

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13
Q

Which organisms known to cause meningitis have vaccines available

A

neisseria, Hib, others?

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14
Q

Which viruses can cause aseptic meningitis

A

syphilis, HSV

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15
Q

TB is known to cause bacterial meningitis. T or F

A

F, causes aseptic meningitis

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16
Q

What blood tests should be done when investigating meningitis

A 
FBC
CRP
clotting screen
U+Es
LFTs
BG
urea
creatinine
serology
17
Q

What microbiology specific tests should be done for meningitis

A

blood culture
throat swab + culture (for meningococcus/ enterovirus)
PCR (for meningococcus/ pneumococcus)

18
Q

What is seen in CSF after LP in bacterial meningitis

A

> WCC, >protein, lactate, >pressure, decreased glucose

19
Q

What imaging should be done for suspected bacterial meningitis

A

CT brain

20
Q

Empirical management of bacterial meningitis (incl allergy)

A

IV dexamethasone+ IV ceftriaxone

allergy: chloramphenicol

21
Q

What drug should be added to empirical management of bacterial meningitis in patients over 60 yrs

A

amox or co-trimoxazole

22
Q

What drug should be added to empirical management of bacterial meningitis in patients who have traveled to an amox resistant country in the last 6 months

A

vanco

23
Q

When are CCS contraindicated in the management of bacterial meningitis

A

immunocompromised, post-surgery, shock

24
Q

What are the contact prophylaxis options for bacterial meningitis in people over 12 years old

A 
rifampicin 
OR 
1X IV ciprofloxacin 
OR 
IM ceftriaxone
25
Q

What complication of bacterial meningitis occurs when the pia is invaded

A

brain abscess

26
Q

What virus is the commonest cause of viral meningitis

A

enterovirus eg. ECHO

27
Q

Investigations for viral meningitis

A

viral stool culture, throat swab, LP

28
Q

What abnormalities are seen in CSF in viral meningitis

A

none: protein/glucose normal

my other notes say raised proteins and lymphocytes?

29
Q

Management of viral meningitis

A

supportive

30
Q

What is stupor

A

decreased consciousness of cognitive function

31
Q

Commonest organism in encephalitis

A

HSV

32
Q

What structure is inflamed in encephalitis

A

brain parenchyma

33
Q

How does encephalitis present

A

decreased consciousness
focal sign hemiplegia, speech
psychosis
seizure

recent fever!

34
Q

Is encephalitis acute or insidious

A

sudden acute

35
Q

1st line investigation for encephalitis

A

LP (EEG also indicated)

36
Q

Investigation for encephalitis if LP contraindicated

A

CT (EEG also indicated)

37
Q

CSF abnormalities in encephalitis

A

mild >protein
>WCC lymphocytosis

OTHER ?

38
Q

Aetiology of brain abscesses

A

skull fracture
sinusitis
mastoiditis
bloodborne

39
Q

Presentation of brain abscess

A

> ICP + fever + underlying cause

Y3 Neurology (23 decks)

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