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D&T2 Exam 1 > CNS infections - Pino > Flashcards

CNS infections - Pino Flashcards

1
Q

most common cause of fever is associated with signs and symptoms of what disease

A

CNS disease

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2
Q

what is the most common agent to cause CNS disease

A

viral

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3
Q

nuchal rigidity

A

inability to flex neck forward

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4
Q

obtundation

A

less than full alertness

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5
Q

stupor

A

a state of near-unconsciousness or insensibility

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6
Q

what brain structure are involved for meningitis

A

meninges

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7
Q

what brain structure is involved for encephalitis

A

parenchyma

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8
Q

what is Meningoenceohpalitis

A

both meningitis and encephalitis

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9
Q

DIAGNOSIS OF DIFFUSE CNS INFECTIONS DEPENDS ON WHAT

A

EXAMINATION OF CNS

LUMBAR PUNCTURE

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10
Q

what are 3 bacteria that cause neonate bacterial meningitis

A

group B step
E. coli
Listeria

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11
Q

what are 3 bacteria that cause 2mos - 12 yr bacterial meningitis

A

strep pneumo
Neisseria meningitidis
H. flu b

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12
Q

what are 3 bacteria that cause immunosuppressed bacterial meningitis

A

pseudomonas
staph
salmonella
listeria

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13
Q

what happens to the brain in bacterial meningitis

A

meningeal purulent exudate
ventriculitis
cerebral infarction
increased intracranial pressure

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14
Q

what is the CSF fluid for bacterial meningitis

A

increased protein
decreased glucose
increase white count ( neutrophils)

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15
Q

how can bacteria enter CNS

A

bacteremia

choroid plexus

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16
Q

what are sudden clinical manifestations for bacterial menigitis

A

shock

purpura

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17
Q

what are insidious clinical manifestations for bacterial menigitis

A

fever
URI, GI
irritability

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18
Q

what are PE tests that can be done

A

Nuchal rigidity
back pain
Kernig
Brudzinski

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19
Q

Nuchal rigidity

A

inability to flex the neck forward

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20
Q

Kernig

A

Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.

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21
Q

Brudzinski

A

Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed.

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22
Q

when a child has open fontelle, what PE will not work, which ones will

A

not work: Kernig and Brudzinski

work: Nuchal ridgitiy

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23
Q

what do neonates have in their spinal tap that is not present in normal adults

A

elevated white count

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24
Q

when should someone not do a spinal tap? how do you determine if they have this condition?

A 
evidence of increased intracranial pressure
- 3rd or 6th cranial nerve palsy 
- Cushing's triad
cardiorespiratory compromise
skin infection of LP site
25
Q

Cushing’s triad

A

hypertension
bradycardia
irregular respiratory

26
Q

can you do a spinal tap on a child with bulging fontanel

A

yes

27
Q

how do you treat a neonate bacterial meningitis

A

Ampicillin + aminoglycoside

ampicillin + 3rd generation cephalosporin ( Cefotaxime)

28
Q

treatment for strep pneumo menintigits

A

vancomycin + 3rd generation cephalosporin

29
Q

treament for Neisseria menintigits

A

cefotaxime/ceftriaxone

30
Q

treatment for H. flu B

A

cefotaxime/ceftriaxone

31
Q

treatment for immunocompromised

A

ceftazidime + aminoglycosides

32
Q

SHOULD YOU DELAY THERAPY WHILE WAITING FOR AN LP

A

NO

33
Q

when should corticosteroids be used for treatment

A

H. flu B meningitis

34
Q

what are some complications for treating bacterial meningitis

A

seizures
increased ICP
stroke

35
Q

what type of bacterial meningitis has the highest mortality

A

pneumococcal meningitis

36
Q

when is prognosis worse for patient for bacterial meningitis

A

less then 6 months

- high concentration bacteria in CSF

37
Q

what is the most common sequela with bacterial meningitis

A

sensorinerual hearing loss

38
Q

what are 2 methods to prevent bacterial meningitis

A

vaccination

anit-biotic prophylaxis

39
Q

what bacteria do you give antibiotic prophylaxis for? and what antibiotic is given

A

Neisseria
H. flu B
rifampin

40
Q

what defines close contact with Neisseria and H. flu B

A

Neisseria: close contact

H. flu b: 4H/day for 5/7 days

41
Q

what is the most commone viral meningoencephalitis

A

enterovirus

42
Q

What time of the year and from what can someone get arbovirus viral meningoencephalitis

A

summer
mosquitoes, ticks vectors
west nile

43
Q

what are clinical symptoms of viral Meningoencephalitis

A

hallucinations

bizarre movements

44
Q

how do you differentiate between bacterial and viral meningitis with spinal tap

A

viral: PCR
bacterial: culture

45
Q

what appears in spinal tap for viral Meningoencephalitis

A

mononuclears
normal to slightly elevated proteins
glucose normal

46
Q

how do you test west nile virus

A

CSF serology

47
Q

ANY FINDINGS SUGGESTIVE OF TEMPEROAL LOBE INVOLVMENT SHOUDL AROUSE WHAT SUSPICION

A

HSV

48
Q

what is the treatment for viral Meningoencephalitis

A

supportive

Acyclovir

49
Q

prognosis for viral Meningoencephalitis

A

most complete recovery

50
Q

for viral Meningoencephalitis what follow ups should be done

A

eye and ear

51
Q

what makes CSF fluid

A

choroid plexus

- lateral 3rd and 4th ventricles

52
Q

what takes up CSF fluid

A

arachnoid vili

-superior sagittal sinus

53
Q

why would someone get a spinal tap

A

CNS infection

deliver medications

54
Q

when would you not give spinal tap

A

local skin infection
increased ICP
hemodynamic instability

55
Q

what is the most common complication with spinal taps

A

headache

56
Q

what position should the patient be sitting in for spinal taps

A

laying or sitting

57
Q

what is the name of the needle

A

Regular Bevel

58
Q

between what vertebrae can spinal tap occur

A

3rd and 4th vertebra

59
Q

what space in the vertebra does the need go into

A

subarachnoid space

D&T2 Exam 1 (22 decks)

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