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Microbiology > CNS infections > Flashcards

CNS infections Flashcards

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1
Q

_ limit access to CSF and brain tissue

A

capillaries

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2
Q

_ meningitis: normally associated with viral and fungal infections, adverse drug reactions, autoimmune disorders, cancer; essentially non bacterial cases; symptoms last longer than 2 weeks (variability)

A

Aseptic

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3
Q

_ : inflammation of the blood vessels

A

vasculitis

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4
Q

The leading cause of meningitis in Canada is _ (gram_) pneumonia we call it pneumococcal meningitis

A

streptococcus ; positive

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5
Q

If we see a rash present we know that the infection was caused by gram
_ bacteria due to the endotoxins such as meningococcal meningitis

A

negative

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6
Q

Fever, myalgia and rash are signs of what infection?

A

systemic infection

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7
Q

_ is seen as neck stiffness, Brudzinski’s sign, Kernig’s sign, jolt accentuation of headache

A

meningeal inflammation

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8
Q

Cerebral _ causes seizures

A

vasculitis

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9
Q

Clinical findings of headache, N&V, change in mental status, neurologic symptoms and seizures are indicative of _

A

elevated intracranial pressure

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10
Q

_: chills, neck stiffness, headache, altered mental state, focal neurological deficits, seizure, photophobia, N&V

A

meningitis

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11
Q

_: fever, nuchal rigidity, Brudzinski & Kernig signs, jolt accentuation of headache, GCS, rash

A

meningitis

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12
Q

What are expected glucose CSF glucose levels in patient with bacterial meningitis?

A

low CSF glucose levels (2.5 mmol/L or <40% of serum glucose)

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13
Q

Expected CSF protein level in patient with bacterial meningitis

A

High CSF protein levels (> 0.45 g/L)

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14
Q

What range would you expect the WBC to be at in a patient with bacterial meningitis

A

anywhere between 500-20000 WBC/mm3 and >80% neutrophils

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15
Q

In a patient who has viral meningitis you would expect to see _ CSF glucose levels

A

normal

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16
Q

_ to mildy _ CSF protein levels in a patient with viral meningitis

A

normal ; mildly; increased

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17
Q

What is the expected WBC range in a patient with viral meningitis?

A

10-1000 WBC/mm3

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18
Q

_ pneumoniae is gram _ ( bacterial pathogen of meningitis)

A

streptococcus ; positive

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19
Q

_ meningitidis is gram _ (bacterial pathogen of meningitis)

A

neisseria ; negative

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20
Q

80% of adult cases of meningitis are caused by _ and _

A

streptococcus pneumoniae ; neisseria meningitidis

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21
Q

_ monocytogenes are seen with eating, it gets in through the GI tract, only affects newborns, elderly, pregnant women

A

Listeria

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22
Q

Which bacterial pathogen only effects neonates?

A

Group B streptococcus

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23
Q

_ meningitis is responsible for ~50% of all cases of bacterial meningitis

A

pneumococcal

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24
Q

Infectious period of pneumococcal meningitis _ days prior to onset of clinical symptoms until pathogen is no longer present in _ and _ discharge (24 hours post targeted antibiotic therapy)

A

1-3 ; nasal ; oral

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25
Q

T/F: No droplet precautions necessary when treating a patient with streptococcus pneumonia

A

True

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26
Q

T/F: chemoprophylaxis is required for people in close contact with patient who has streptococcus pneumoniae

A

False

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27
Q

Neisseria meningitidis is gram _

A

negative

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28
Q

_ meningitis affects mainly children, adolescents and young adults

A

meningococcal

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29
Q

_ meningitis is responsible for about 25% of all cases of bacterial meningitis

A

meningococcal

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30
Q

~20% of people are colonized with _ in the nasopharynx

A

N. meningitidis

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31
Q

Chills, fever, weakness, generalized aches, petechial rash, _ shock and disseminated intravascular coagulation are signs and symptoms of _ meningitis due to the endotoxin production (gram_)

A

endotoxin ; meningococcal meningitis ; negative

32
Q

The infectious period of _ meningitis: 7 days prior to onset of symptoms until pathogen no longer present in nasal or oral discharge (24 hours post targeted antibiotic therapy)

A

meningococcal meningitis

33
Q

~20% of survivors of _ meningitis exhibit permanent neurological or physical deficit

A

Neisseria meningitidis

34
Q

meningococcal meningitis = _ meningitidis

A

Neisseria

35
Q

All suspected or possible cases of _ meningitis should be placed in droplet precautions for 24 hours post targeted antibiotic therapy

A

meningococcal meningitis

36
Q

T/F: people who have come into close contact with someone with meningococcal meningitis need special attention

A

True

37
Q

Vaccination recommended to control outbreaks, for patients with increased susceptibility to _ disease, and for travelers

A

meningococcal

38
Q

Prior to 1986, _ was the leading cause of bacterial meningitis

A

Haemophilus influenzae

39
Q

This type of infection is seen in people who choose not to vaccinate

A

Haemophilus influenzae

40
Q

Suspected or possible cases of _ meningitis; droplet precautions 24 hours post targeted antibiotic therapy ``

A

Haemophilus influenzae

41
Q

Haemophilus influenzae is gram _

A

negative ; rash is also seen in infected person

42
Q

_ is transmitted by ingestion of contaminated foods (soft cheeses, refrigerated unpasteurized foods, deli meats) and poor hand hygiene

A

Listeriosis

43
Q

_ is responsible for ~10% of all cases of meningitis; case fatality rate ~15%

A

Listeriosis

44
Q

40-70% will transmit _ during surgery

A

GBS

45
Q

What is the course of action if GBS was unable to be treated at the time of labour?

A

neonate blood cultures at 24 and 48 hours or antibiotic prophylaxis to prevent infection

46
Q

Because bacterial meningitis is life threatening we need to administer _ (corticosteroid) with _ therapy

A

dexamethasone ; antibiotic

47
Q

What are some supportive measures for treating a person with bacterial meningitis?

A

antipyretics, fluids and electrolytes, nutritional support

48
Q

_ is responsible for ~85% of viral meningitis cases in Cananda

A

enteroviruses

49
Q

_ is transmitted by direct contact nad fecal-oral route, most common in summer and fall

A

enteroviruses

50
Q

Patients with bacterial meningitis require close monitoring after treatment is initiated for signs of _ and _

A

deterioration or complication

51
Q

_: inflammatory process of the brain

A

encephalitis

52
Q

_ may occur as an overlapping syndrome in a patient with encephalitis

A

meningoencephalitis

53
Q

What is the most common type of encephalitis?

A

viral

54
Q

What is the classic clinical triad of encephalitis?

A
  • altered level of consciousness
  • headache
  • fever
55
Q

What are 3 common neurological symptoms of a patient with encephalitis?

A
  • disorientation
  • focal neurologic deficits
  • seizures
56
Q

A patient’s lab values of: increased proteins, increased lymphocytes, normal glucose are all indicative of what?

A

viral encephalitis

57
Q

_ is the most common cause of infection-related encephalitis (they have already been infected, latent, reactivation)

A

HSV

58
Q

Focal temporal lobe symptoms are most common with viral encephalitis_; visual field cut, hemiparesis, aphasia

A

HSV

59
Q

_ reduces overall mortality to 28% at 18 months post treatment of viral encephalitis -HSV

A

acyclovir

60
Q

_: pus containing cavity surrounded by inflamed tissue in the brain

A

Focal intracerebral infection (brain abcess)

61
Q

Clinical presentation of _ is nonspecific, largely based on location of _ within the brain and stage/progression of infection

A

brain abscess ; lesion

62
Q

T/F: when someone has a brain abscess they have some predisposing infection elsewhere, it moved from that primary site, entered the bloodstream and travelled to the brain

A

True

63
Q

_: antimicrobial therapy directed at suspected organisms

A

empiric therapy

64
Q

With _ we are able to culture the brain abscess and see what antibiotics will work

A

aspiration

65
Q

_ are warranted in cases of increased intracranial pressure or significant edema in a patient with a brain abscess

A

corticosteroids

66
Q

What is the best type of drug to use for CNS infections that can easily cross the BBB?

A

Non-polar, lipid soluble drugs

67
Q

When performing a lumbar puncture for the collection of CSF, how many tubes do you collect?

A

4; chemistry, microbiology, cytology

68
Q

What is tube 1 of collected CSF used for?

A

cell count

69
Q

What is tube 2 of collected CSF used for?

A

chemistry (glucose and protein)

70
Q

What is tube 3 of collected CSF used for?

A

microbiology (gram stain and culture)

71
Q

What is tube 4 of collected CSF used for?

A

cell count (or comparison to tube 1)

72
Q

What is the first-line therapy for the treatment of suspected or culture proven gram - meningeal infections?

A

third generation cephalosporins

73
Q

What is the gold standard for the definitive diagnosis of bacterial meningitis?

A

CSF culture

74
Q

What type of plate would you put CSF specimen on for the diagnosis of bacterial meningitis?

A

blood agar and chocolate agar plate

75
Q

What is the presumptive identification if there is growth on both CAP and BAP, and the gram stain is (-) diplococci?

A

Neisseria meningitidis

76
Q

What is the presumptive identification if there is growth on both CAP and BAP, and the gram stain is (+) diplococci?

A

Streptococcus pneumoniae

77
Q

What is the presumptive identification if there is only growth on the CAP, and the gram stain is (-) coccobacilli?

A

haemophilus influenzae

Microbiology (17 decks)

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