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NBB Test 2 > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

Focal, intracerebral infection that begins as a localized area of cerebritis and develops into collection of pus surrounded by a well vascularized capsule

A

Brain Abscess

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2
Q

One of most serious complications of head and neck infections

A

Brain Abscess

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3
Q

What is the most common location for sinusitis?

A

Frontla lobe

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4
Q

We also see sphenoid sinusitis in the

A

Temporal lobe or sella turcica

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5
Q

Otitis media infections can spread to the

A

Temporal lobe or cerebellum

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6
Q

Dental infections can spread to the

A

Frontal lobe

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7
Q

60-70% of brain abscesses are caused by

A

Streptococci

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8
Q

Make up around 20-40% of brain abscess infections?

A

Anaerobes

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9
Q

Enteric gram negatives account for

A

23-33% of brain abscesses

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10
Q

Clinical manifestations usually depend on size and location of space occupying lesion and virulence of organism

A

Brain abscesses

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11
Q

Brain abscesses can be classified as either

A

Indolent or Fulminant

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12
Q

The most common presenting symptom of a brian abscess is

A

Headache

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13
Q

Uncommon in cases of brain abscess

A

Nuchal Rigidity

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14
Q

The diagnostic procedure of choice for detecting a brain abscess is

A

MRI

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15
Q

Brain abscess shows as a hypodense center with peripheral ring enhancement after contrast, can be surrounded by edema (hypodense) in a

A

CT with contrast

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16
Q

Contraindicated in patients with a brain abscess

-Risk of Herniation

A

Lumbar Puncture

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17
Q

To manage a brain abscess, we need antibiotics with good

A

CNS penetration

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18
Q

The most common protozoal cause of brain abscess

A

Toxoplasma Gondii

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19
Q

Transmission mainly by ingestion of tissue cysts in contaminated meat or food or oocysts in food/water contaminated from cat feces

A

Toxoplasma gondii

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20
Q

Transmission mainly by ingestion of tissue cysts in contaminated meat or food or oocysts in food/water contaminated from cat feces

A

Toxoplasmosis

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21
Q

Toxoplasmosis has a prediliction for the

A

Basal ganglia or brainstem

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22
Q

Shows rounded isodense or hypodense lesions with ring enhancment-usually multiple lesions

A

Toxoplasmosis

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23
Q

Collection of pus between dura and arachanoid

A

Subdural Empyema

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24
Q

Localized collection of pus between dura and overlying skull or vertebral column

A

Epidural Abscess

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25
Q

Most common predisposing condition is ear and sinus infections for a

A

Cranial Subdural Empyema

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26
Q

Signs and symptoms secondary to increased intracranial pressure, meningeal irritation, or focal cortical inflammation

A

Cranial Subdural Empyema

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27
Q

The predominant complaint in a patient with a cranial subdural empyema is a

28
Q

Presents with focal neurologic signs (hemiparesis, hemiplegia, ocular palsies, dilated pupils, homonoymous hemaniopsia, cerebellar signs

A

Cranial Subdural Empyema

29
Q

Rare condition usually occurs secondary to metastatic infection from another site

A

Spinal Subdural Empyema

30
Q

Spinal Subdural Empyema is most frequently caused by

A

Staph areus

31
Q

Clinical presentation: radicular pain and symptoms of cord compression (can occur at multiple levels)

A

Spinal Subdural Empyema

32
Q

Can be difficult to distinguish from epidural abscess and can occur simultaneously

A

Spinal Subdural Empyema

33
Q

Signs and symptoms include headache, fever, seizures, focal neurologic signs, altered mental status but may be overshadowed by symptoms/signs from primary source of infection

-More indolent course

A

Cranial Epidural Abscess

34
Q

Initial focus usually sinuses, ear, mastoid infections but can occur after trauma or surgical procedures

A

Cranial Epidural Abscess

35
Q

Fever and headache are most common complaint with a cranial epidural abscess and patient may feel well until it progresses to

A

Subdural empyema, meningitis, or brain abscess

36
Q

Unlike a subdural abscess, can cross the midline

A

Epidural abscess

37
Q

Usually occurs secondary to hematogenous spread

-Blood cultures frequently positive-bacteremia

A

Spinal epidural abscess

38
Q

1/3 of spinal epidural abscess cases show

A

Contiguous foci

39
Q

Spinal epidural abscesses often occur with

A

Vertebral osteomyelitis

40
Q

Present in up to 50% of cases of spinal epidural abscess

41
Q

May develop within hours to days (after hematogenous seeding) or may be more chronic (weeks to months, usually with vertebral osteo or contigous focus), TB also more gradual

A

Spinal Epidural Abscess

42
Q

Pain is the most consistent symptom of a spinal epidural abscess, but there is a fever in

A

60-70% of patients

43
Q

With a spinal epidural abscess, empiric antibiotics should be given which include coverage for

A

S. aureus and gram negative bacilli

44
Q

Inflammatory process involving brain parenchyma with clinical or laboratory evidence of neurologic dysfunction

A

Encephalitis

45
Q

Differs from meningitis because of the region of inflammation and altered mental status (hallmark)

A

Encephalitis

46
Q

The hallmark of encephalitis is

A

Altered mental status

47
Q

In a CSF exam, the cell count is less than 500 in

A

90% of cases of encephalitis

48
Q

Usually lymphocytic predominance but can see more polys in Eastern equine or enterovirus or WNV

A

Encephalitis

49
Q

Consider an alternate diagnosis other than encephalitis if

A

Glucose is low

50
Q

Usually not useful for diagnosing encephalitis

A

Viral Culture

51
Q

Frequently abnormal in encephalitis patients, but does not not usually pinpoint cause of encephalitis

52
Q

Among most severe of all human viral infections of brain

  • > 70% mortality with no or ineffective therapy
A

Herpes Simplex Encephalitis

53
Q

Clinical features: Fever, personality change, dysphasia, autonomic dysfunction

-accounts for 10-20% of encephalitis viral infections

A

Herpes SImplex Encephalitis (HSE)

54
Q

Shows CSF findings of lymphocytic meningitis, presence of RBCs, and elevated protein

A

HS-Encephalitis

55
Q

In greater than 90% of HSE cases, MRI shows

A

Temporal lobe abnormalities

56
Q

Shows periodic lateralizing epileptiform discharges (PLEDs) on electroencephalography

57
Q

Treatment for HSE is high dose of

58
Q

Birds are the main reservoirs and has the mosquito vector culex pipens

A

West Nile Virus

59
Q

80% of patients show no clinical illness or symptoms with

A

West nile virus

60
Q

To diagnose with west nile virus, we can test

A

Serum IgM antibody (8-14 days after illness onset)

61
Q

CSF reveals lymphocytic pleocytosis and elevated protein; glucose is normal with

A

West Nile Virus

62
Q

Positive in greater than 90% of paitents with west nile virus

63
Q

Transmitted by bite of infected animal

-dogs are principal vector

64
Q

80% of rabies cases are an

A

Encephalitic (furious) form

65
Q

Immunofluorescent detection of viral antigens and RT-PCR in nuchal biopsy is diagnostic for

NBB Test 2 (33 decks)

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