Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4: Infectious Disease > CNS Infections > Flashcards

CNS Infections Flashcards

1
Q

Name some anatomical infections of the CNS?

A
  • Myelitis
  • Abscess
  • Meningitis
  • Encephalitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 most important bacterial causes of CNS infections?

A
  • Listeria
  • Pneumococcus
  • Meningococcus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the most common viral causes of CNS infections?

A
  • HSV
  • VZV
  • Enterovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common fungal cause of CNS infections?

A

Cryptococcosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common protozoal cause of CNS infections?

A

Toxoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is meningitis?

What is diagnosis based on?

A

Inflammation of meninges +/- cerebrum (meningo-encephalitis)

Inflammation presence in the CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the types of meningitis and what causes them?

A
  • Acute
    • Bacterial/viral
  • Sub-acute
    • Bacterial (Listeria/TB)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the signs and symptoms of meningitis?

A
  • Most will have 2 of:
    • Fever
    • Headache
    • Neck stiffness
    • Reduced GCS
  • Rash
  • Kernigs sign
  • Brudzinskis sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What meningitis symptom is indicative of cerebritis/encephalitis?

A

Confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of rash is present in meningitis?

A
  • Purpuric +/
  • Petechial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  • What are each of the following?
    • Gram positive diplococci
    • Gram negative diplococci
    • Gram positive rods
A
  • Streptococcus pneumoniae
  • Neisseria meningitidis
  • Listeria monocytogenes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should be considered if someone who has meningitis has recently travelled?

A
  • May be resistant meningitis
    • South East Asia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the risk factors for a pneumococal meningitis?

A
  • Mostly caused by an underlying disorder
    • Alcohol
    • Head injury
    • Immunosuppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the risk factors for a listeria meningitis?

A
  • Pregnancy
  • Immunosuppression
  • Eating cheese and pate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name some signs which make meningitis more likely to have a pneumococcal cause?

A
  • Seizures
  • CN VIII palsy
  • Endocarditis
  • Focal neurological signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is pictured here?

A
  • Typical signs of meningococcal meningitis
    • Purpuric rashes
    • Digital vasculitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name 4 prognostic indicators of a adverse outcome in bacterial meningitis?

A
  • Reduced GCS
  • Pneumococcal cause
  • CN palsy (pneumococcal)
  • Bleeding (meningococcal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name some investigations for a suspected meningitis?

A
  • History/ exam
  • Throat culture
  • Blood cultures
  • Lumbar puncture
  • FBC, U&Es, LFTs, CRP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the use of a lumbar puncture as an investigation for a suspected meningitis?

A
  • Gram stain, Culture, PCR
  • Protein and Glucose
  • Viral PCR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What might you examine if there is a suspected meningitis?

A
  • Throat
  • Cervical lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When would you perform a CT scan for a suspected meningitis?

A
  • To exclude mass lesion and gross cerebral oedema
  • Give antibiotics pre-scan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can a CT not exclude?

A

Raised intracranial pressure

23
Q

When would you perform a CT before a lumbar puncture?

A
  • GCS <= 12
  • CNS signs
  • Papilloedema
  • Sezisures
  • Immunocompromised
24
Q

When is a LP contraindicated?

A
  • Brin shift
  • Severe sepsis
  • Coagulopathy
  • GCS deterioration
  • Infection at LP site
  • Rapidly evolving rash
25
Q

What would be the CSF findings from LP if there was a bacterial meningitis?

A
  • Raised protein
  • Glucose reduced <50%
  • Neutrophils / Lymphocytes
26
Q

What would be the CSF findings from LP if there was a TB meningitis?

A
  • Lymphocytes
  • Raised protein
  • Glucose reduced <50%
27
Q

What would be the CSF findings from LP if there was a viral meningitis?

A
  • Lymphocytes (neutrophils early)
  • Raised protein
  • Normal glucose
28
Q

What would be the CSF findings from LP if there was a fungal meningitis?

A
  • Lymphocytes
  • Raised protein
  • Glucose reduced <50%
29
Q

What investigations could be used to differentiate between a TB and a fungal cause of meningitis post-LP?

A
  • TB
    • Culture, PCR
  • Fungal
    • India ink, CrAG
30
Q

Describe the treatment of a suspected bacterial meningitis?

A
  • IV antibiotics
  • Treat for all possible causes
  • IF there is a high possibility of pneumo cause:
    • Add steroids
31
Q

What drug does everyone with a suspected bacterial meningitis get?

A
  • Ceftriaxone
    • Covers all possible causes
  • Add Amoxicillin if there is signs of Listeria cause
32
Q

What is the definitive antibiotic therapy for meningococcal bacterial meningitis?

A
  • IV Ceftriazone or Benzyl Penicillin
  • 5 days
33
Q

What is the definitive antibiotic therapy for pneumococcal bacterial meningitis?

A
  • IV Ceftriaxone or Benzyl Penicillin
  • 14 days
34
Q

What is the definitive antibiotic therapy for listerial bacterial meningitis?

A
  • IV Amoxicillin (stop Ceftriaxone)
  • 21 days
35
Q

Describe the use of secondary bacterial meningitis prevention?

A
  • Give close contacts of someone with BM prophylactic treatment
  • Ciprofloxacin or Rifampicin
36
Q

Look at the meningococcal vaccine schedule

A
37
Q

What are the special circumstances for bacterial meningitis vaccinations?

A
  • Asplenic patients
  • Cochlear implants
  • Complement deficiency
  • Travelling to Sub-Saharan Africa
38
Q

Describe Viral Meningitis?

A
  • Diagnosed only after bacterial exclusion
  • No confusion
  • Supportive treatment
  • Consider Aciclovir ONLY if immunocompromised
39
Q

When is Aciclovir only considered as a treatment of viral meningitis?

A
  • Immunocompromised
    • ?HIV
40
Q

Describe the signs of Viral Encephalitis and what causes it?

A
  • Confusion, Fever +/- Seizures
  • HSV
41
Q

What are the CSF signs of viral encephalitis?

A
  • Lymphocytes
  • Normal glucose
42
Q

What is the treatment of Viral Encephalitis?

A

IV Aciclovir for 3 weeks

43
Q

Describe intra-cerebral TB?

A
  • Sub-acute
  • Associated with TB in another site
  • CN lesions usual
  • CSF may be normal
44
Q

Describe the treatment for intra-cerebral TB?

A

‘RIPE’ + steroids

45
Q

Describe HIV brain disease?

A

Consequence of untreated infection and marked immunodeficiency

46
Q

What does PMLE stand for?

A

Progressive multifocal leucoencephalopathy

47
Q

Describe PMLE?

A
  • Progressive motor dysfunction
  • Immunocompromised
  • No specific treatment
48
Q

Describe Intra-cerebral toxoplasmosis?

A
  • Caused by Toxoplasma gondii
  • Immunocompromised
  • Headache, seizures, focal CNS signs
  • Multiple enhancing lesions
49
Q

Name a diagnostic sign of intra-cerebral toxoplasmosis?

A

IgG and IgM in the blood

50
Q

What is the treatment for intra-cerebral toxoplasmosis?

A
  • Sulphadiazine
  • Pyramethamime
51
Q

Describe Cryptococcal meningitis?

A
  • Caused by fungus cryptococcus neoformans
  • Immunodeficiency usually (HIV)
52
Q

How do you treat cryptococcal meningitis?

A
  • Amphotericin B + Flucytosine
  • Shunt if raised ICP
53
Q
A

Y4: Infectious Disease (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions