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Neurology > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

What is infected in meningitis?

A

Infection of pia mater and pus in subarachnoid space

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2
Q

What are the causes of meningitis in the elderly?

A

Listeria, TB and gram negatives

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3
Q

What are the causes of meningitis in neonates?

A

E-Coli
Beta Haemolytic Strep
Listeria

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4
Q

What are the viral causes of meningitis?

A

HIV
Mumps
Herpes
Coxsackie

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5
Q

What are non infectious causes of meningitis?

A 
Tumours
Cysts
NSAIDs
SLE
Vasculitis
Parameningeal infections
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6
Q

What is the presentation of meningitis?

A 
Meningismus
Headache
Fever
Kernigs sign
Bradzinki's sign
Photophobia
Rash?
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7
Q

What is Bradzinki’s sign?

A

Neck flexion causes knee flexion

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8
Q

What is Kernig’s sign?

A

Hip flexion and knee extension causes pain

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9
Q

How do you investigate meningitis?

A

CT then LP

CSF culture

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10
Q

What is CSF like in viral meningitis?

A

Clear
Raised lymphocytes
Raised protein
Normal Glucose

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11
Q

What is CSF like in TB meningitis?

A

Fibrin web
Raised WCC
Raised Protein
Low Glucose

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12
Q

What is CSF like in bacterial meningitis?

A

Turbid
Raised Neutrophils (& polymorphs)
Very raised protein
Low Glucose

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13
Q

How is meningitis treated?

A

ABCD
IV fluid
IV Ceftriaxone (Amoxicillin if pregnant or immunocompromised) & Isolate
Dexamethasone if pneumococcal

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14
Q

What prophylaxis do you give close contacts and what is your other responsibilty?

A

Notifiable disease

Rifampicin or Cipro and meningococcal vaccine

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15
Q

How do you treat meningitis in primary care or if the patient is in shock?

A

IV Benzylpenecillin

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16
Q

How do you treat aseptic or viral meningitis?

A

No treatment its self limiting

ABC & maintain fluids

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17
Q

Where do brain abscesses from direct invasion come from & what organisms?

A

Middle ear- S. pyogenes or S milleri
Sinus
Tooth

18
Q

Where do brain abscesses that occur after haematologous spread originate?

A

Endocarditis
Right to left Cardiac shunts
Bronchiectasis (anaerobes)

19
Q

What investigations do you do for a brain abscess?

A

CT
MRI
WCC
ESR

20
Q

What are the symptoms of a potential brain abscess?

A

Fever
Headache
Focal Neurological signs
Seizures

21
Q

What treatment options are there for brain abscesses?

A

Surgical excision/drainage
Ceftriaxone and Flucloxacillin and Metronidazole
Reduce ICP with dexamethasone

22
Q

What toxin mediated causes of CNS infection are there?

A

Tetanus

Botulinism

23
Q

Is Encephalitis usually viral or bacterial?

A

Viral

24
Q

What are the common causative agents in encephalitis?

A 
Enteroviruses
Mumps
HSV
VZV
HIV
Rabies
Japanese encephalitis
25
Q

Symptoms of encephalitis

A 
Headache
Fever
Altered consciousness
Hallucinations and delusions
Focal signs
Hemiparesis etc
26
Q

How do you diagnose encephalitis?

A 
High contrast CT
Blood culture
Viral ABs
EEG
LP
27
Q

How do you treat encephalitis?

A

High dose IV Acyclovir

28
Q

How is rabies spread?

A

Saliva

29
Q

How do you treat rabies in vaccinated and non vaccinated individuals?

A

5 IM vaccine shots and Ig to bite site if not vaccinated

Ditto, but 2 shots if vaccinated

30
Q

How is rabies diagnosed?

A

Nape of neck biospy

31
Q

How does rabies affect the brain?

A

Spreads up peripheral nerves and forms Negri bodies.

32
Q

Symptoms of rabies

A 
Fever
Heachache
Malaise
Hallucination and excitation with lucent periods
Salivation
33
Q

What symptoms are classic of Tetanus?

A

Trismus (lockjaw)
Sustained muscle contraction (bent back)
Facial muscle involvement and spasms

34
Q

How is tetanus diagnosed?

A

Wound culture

35
Q

How is Tetanus treated?

A

Benzlypenecillin and IVIg

36
Q

How does botulinism present?

A

Descending paralysis starting with cranial neuropathy

37
Q

How is Botulinism treated?

A

Antitoxin

38
Q

How is Polio spread?

A

Faeco Oral

39
Q

What kind of vaccine is the polio vaccine?

A

Live attenuated

40
Q

How do polioenteroviruses cause disease?

A

They cross the BBB and cause encephalitis with motor nuclei destruction in the anterior horn or brainstem and spinal cord causing paralytic poliomyelitis

Neurology (25 decks)

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