Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CABS - Neuro > CNS infections (cabs and clin med) > Flashcards

CNS infections (cabs and clin med) Flashcards

1
Q

what is the leptomeninges

A

the pia and arachnoid mater together

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

What is the dense outer layer

A

dura mater

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

what is the middle - web like layer

A

arachnoid mater
lies over the subarachnoid space which houses CSF

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

what is the Falx cerebri

A

folds into the longitudinal cerrebral fissue seperating the hemistpheres

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

what is the inner layer that is adhered to the brain parenchyma

A

pia matter
supports vasculature and creates the choroid plexus

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

Where is CSF made

A

within the choroid plexus of the ventricles in the pia matter

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

what is an inflammatory disease affecting the leptomeninges

A

Bacterial meningitis
MEDICAL EMERGENCY - DO NOT MISS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what prevents free flow of ions, cells and molecules from getting into the NS

A

BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the flow of CSF

A

secreted by choroid plexus within lateral ventricles
flows to third ventricle -> fourth ventricles -> flows outside of the brainstem into subarachnoid space (btwn pia and arachnoid), exits via arachnoid villi within the superior sagital sinus

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

What is rapidly fatal with mortality rate of 20-25% even with appropriate treatment

A

bacterial meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what condition is fatal 70-100% of the time without treatment

A

bacterial meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the predisposing factors of bacterial meningitis

A

prior viral infection
household crowding (college kids)
active and passive smoking
occupation risk (use and microbioligists)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the most common bacteria causing bacterial meningitis

A

S. pneumoniae
N. meningitidis
L. monocytogenese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what population is group B strep the cause of bacterial meningitis

A

Newborns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how can bacterial meningitis be spread

A

via droplet or secretions from colonized persons
bacterial entry into blood stream and enter CNS through BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

where does bacteria cross the blood brain barrier

A

choroid plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what occurs when there is an inflammatory response with bacteria crossing the BBB

A

vasculitis and cerebral edema and increased ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what type of bacteria is Neisseria meningitidis

A

aerobic and gram negative diplococcus
outer membrane covered in polysaccharide which helps to resist phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is important about blood cultures

A

need to be extremely sterile and from two bodily sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the drug of choice for N. meningitides

A

ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what type of bacteria is Streptococcus pneumoniae

A

lancet-shaped, gram positive, facultative anaerobic bacteria. typically diplococci.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the drug of choice against S. pneumoniae

A

Vancomycin plus ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what type of bacteria is listeria monocytogenes

A

gram positive facultative anaerobic bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the likely presentation of listeria monocytogenesis in bacterial meningitis

A

seizures, focal deficits early in disease and ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the drug of choice for listeria monocytogenes
ampicillin or penicillin (if allergic, Bactrim)
26
what type of bacteria is Haemorphilus influenzae
pleomorphic gram negative rods
27
where is haemorphilus influenze located
respiratory tract
28
what population is usually affected by haemorphilus influenzae
affects children most commonly
29
what is the drug of choice for Haemophilus influenzae
ceftriaxone
30
what is neucal regidity
neck stiffness
31
what is the presentation of bacterial meningitis
typically present < 24 hours after onset of symptoms classic triad: fever, stiff neck, AMS fever severe headache N/V possible seizure, coma, CN palsy petechiae and palable purpura
32
what are specific baby presentations of bacterial meninititis
poor feeding irritable particularly when handles high pitched or moaning cry abnormal tone vacant staring poorly responsive or lethargic tense fontanelle cyanosis
33
what is the difference between sepsis and meninigitis
sepsis = death from cardiovascular failure meningitis = death from raised ICP
34
what test has spontaneous flexion of hips with passive flexion or neck
Brudzinski sign
35
what test is when there is an inability for full extension of the knee with hip flexion
Kernig
36
what is the workup for bacterial meningitis
CBC Coagulation studies CMP 2 sets of blood cultures head CT LP MRI
37
what is a left shift of leukocytosis
immature WBCs
38
what is seen on CBC for bacterial meningitis
leukocytosis with left shift and may have. thrombocytopenia
39
what is the lumbar cistern
the pool of CSF in the lumbar spine
40
when are LP contraindicated
anti-coagulated patients if concern for herniation - elevated ICP (mass?) if platelets < 50,000
41
what is normal glucose levels on LP
45-85
42
what is a LP for bacterial meninigitis positive for
> 200 mm H20 opening pressure >1,000 WBCs Neutrophils present >200 protein <40 glucose positive gram stain and culture
43
what is a LP for viral meningitis positive for
normal or slightly high opening pressure 100-1,000 WBCs lymphocytes present protein normal normal glucose negative gran stain and culture
44
what is the plan for patient with concern for meningitis
ABC VS hx, exam 2 large bore IV LABS: CBC, CMP, PT/PTT, culture, lactate fluids treat shock dexamethasone antibiotics antivirals head CT LP exposure prophylaxis
45
what is the treatment of bacterial meningitis
dexamethasone (prior to ABX) Broad spectrum ABX REAASSESS FREQUENTLY
46
what is the classic antibiotic regimen for bacterial meningitis
cetriaxone, vancoymcin, ampicillin if penicillin allergy: vancomycin and Bactrim
47
what is used for prevention in people in close contact to known meningitis person
Chemoprophylaxis- ceftriaxone, rifampin or ciprofloxacin
48
what is aseptic meningitis
negative bacterial cultures - but otherwise suggestive of bacterial meningitis usually associated with enteroviruses
49
what is the epidemoplogy of viral meningitis
infants <1yo or >5yo most commonly in summer and fall
50
what is the pathophysioloyg of viral meningitis
virus invades respiratory or GI track typically 3-6 days after exposure Enterovirus - peak in summer and fall Herpes virus - HSV-1
51
what is the presentation of viral meningitis
febrile no neurologic dysfunction headache stiff neck maculopapular rash muscle aches N/V pharyngitis fatigue
52
what is the workup of viral meningitis
same as bacterial negative gram stain and cultures for CSF CSF shows lymphocytes Send out CSF for viral detection assay imaging: may see enhancement of the meninges on MRI
53
what is the treatment of viral meningitis
typically supportive depends on virus: acylovir IV dark and quiet room Tylenol for HA, fever, pain
54
what is the difference between meningitis and encephalitis
mental status with menigitis is baseline but lethargic or distracted mental status with encephalitis will be altered ALWAYS ASSUME THE WROSE - IF QUESTION - START ABX
55
what is encephalitis
inflammation of the brain parenchyma
56
what are the common causes of encephalitis
unknown in half of the cases 20-50% viral etiology: HSV or VZV) Genetic predisposition
57
what is damaged with encephalitis
damage neurons can produce hemorrhagic necrosis
58
what is the pathophysiology of encephalitis
viral other infectious source drug induced autoimmune
59
what are the 6 V's of encephalitis
Vacation Vaccination Vectors Viruses Veterinary source Vital statistics (people around you that have it)
60
what is the presentation of encephalitis
AMS fever HA N/V Seizures focal neurologic abnormalities meningeal irritation if meningoencephalitis disease specific findings
61
what is the diagnostic criteria of encephalitis
Major: AMS lasting longer than or equal to 24 hours Minor (2+): documented fever wtihin 72 hours seizure new onset focal neuro findings CSF pleocytosis abnormality of parenchyma on imaging EEG abnormality consistent with encephalitis
62
what is the workup of encephlitis
LP with same testing as before plus PCR and RT- PCR include HSV1,2, VZV, enteroviruses, parechoviruses can consider influenca, mumps, rabies fresh water ameba Imaging: MRI or CT
63
what is a fresh water ameba that can cause encephalitis
naegleria fowleri
64
what is the treatment of encephalitis
ABCs Acyclovir for HSV and VZV encephalitis
65
what is a focal collection of infection in the brain parenchyma
brain abscess
66
who are brain abscesses more common in?
men
67
what is the cause of brain abscess
direct spread from infection - otitis media, mastoiditis, dental infection foreign body post op infection
68
what is the typical presentation of Brain abscess
headache fever neck stiffness focal neurologic deficit seizures and CN VI palsy secondary to elevated ICP
69
what is the presentation triad of brain abscess
headache, fever and focal neurologic deficit
70
what type of imaging is necessary with concern for brain abscess
MRI WITH CONTRAST
71
what is the initial treatment of brain abscesses
broad IV coverage abx (vanco, metronidazole, ceftriaxone) for 4-8 weeks with repeat imaging to guide and ensure clearance
72
what is used if mass effect in brain abscesses is noted
steroids
73
where is the most common sites of brain abscesses
frontal or temporal lobes
74
when is excision considered for brain abscesses
if secondary to TBI and material in the abscess fungal abscess loculated no improvement >1week of treatment elevated ICP increased size AMS after initial drainage and treatment

CABS - Neuro (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions