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Neurology > CNS infections + Hydrocephalus > Flashcards

CNS infections + Hydrocephalus Flashcards

1
Q

Investigations for ?meningitis

A

FBC, CRP, U+E, LFTs
Coagulation screen
Blood culture, glucose + gas
Lumbar puncture

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2
Q

Organisms causing meningitis

A

Meningitides = kids
Strep pneu
Haem influenza = neonatal

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3
Q

Management of meningitis

A

Dex
IV cefotaxime (empirical) + amoxicillin if <3mths or >50 y/o
Cloramphenicol if allergic
Rifampicin/ ciprofloxacin for family

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4
Q

Pathology of encephalitis

A

Acute inflammatory brain disease due to immune response

Inflammation of brain parenchyma

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5
Q

Causes of encephalitis

A

Viral (HSV, Polio, VZV, EBV, HIV)
Bacterial - listeria, syphilis
Autoimmune, NMDA receptor encepalitis

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6
Q

RF for encephalitis

A

Immunosuppression

Travel to low-income nations

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7
Q

Complications of encephalitis

A

Seizures
SIADH
Increased ICP
Coma

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8
Q

S+S of encephalitis

A

Fever, chills, malaise
Meningism (nuchal rigidity)
Parenchymal involvement - seizures, altered mental state

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9
Q

Investigations + results for ?encephalitis

A

Blood + CSF cultures
Serology
Tissue analysis (Tzanck smear)
Brain biopsy (definitive)

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10
Q

Complications of meningitis

A 
Cerebral oedema 
Cerebral herniation 
Deafness 
Epilepsy 
Hydrocephalus 
Cognitive deficits
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11
Q

Changes in CSF for bacterial meningitis

A 
Appears cloudy 
Increased pressure 
Neutrophils present 
High protein 
Low glucose 
Gram stain, culture for microbiology
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12
Q

Changes in CSF for viral meningitis

A 
Appears clear 
Normal pressure 
Lymphocytes present 
High protein 
Normal glucose 
PCR assay for microbiology
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13
Q

Changes in CSF for fungal meningitis

A 
Appears cloudy 
Normal pressure 
Mononuclear cells present 
Low glucose 
Acid fast bacillus stain, PCR for micro
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14
Q

Changes in CSF for TB meningitis

A 
Appears opaque
Increased pressure 
Neutrophils present 
High protein 
Low glucose 
Acid fast bacillus stain, PCR for microbiology
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15
Q

Changes in CSF for cryptococcal meningitis

A 
Appears clear
Increased pressure 
Lymphocutes present 
Low glucose 
India ink stain for microbiology
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16
Q

Pathology of normal pressure hydrocephalus

A

Enlarged ventricular size with normal opening pressures

17
Q

What is the triad of symptoms associated with normal pressure hydrocephalus?

A

Cognitive impairement, gait disturbance, urinary incontinence

18
Q

What is the common causes of secondary normal pressure hydrocephalus?

A

SAH + meningitis

19
Q

What investigations are used in normal pressure hydrocephalus?

A

MRI

Lumbar puncture

20
Q

Management of normal pressure hydrocephalus

A

Shunt

21
Q

S+S of raised ICP

A

CN V6 palsies
Papilloedema
Periorbital bruising
Bradycardia, resp depression + HTB (Cushings triad)

22
Q

What is Kernohans notch phenomenon?

A

Combinations of conrtalateral pupillary dilatation + ipsilateral weakness

Neurology (7 decks)

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