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Neurology > CNS Infxn > Flashcards

CNS Infxn Flashcards

1
Q

Who are at risk for CNS infxn?

A

immunocompromised
young
old

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2
Q

How is the brain protected?

A

skull
dura
BBB

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3
Q

Who is at HIGHEST risk for CNS infxn?

A

infants b/c they do not have a fully developed BBB

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4
Q

How can bacteria be spread?

A

hematogenously
thin bone (sinus)
veins (facial infxn)

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5
Q

What is baceterial meningitis?

A

bacterial infxn of the arachnoid, subarachnoid, CSF

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6
Q

Bacterial meningitis - sx?

A

stiff neck
headache
fever

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7
Q

Bacterial meningitis - PE?

A

Kernigs
Burdzinski
*anything that stretches the dura

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8
Q

Why is there a stiff neck with bacterial meningitis?

A

they cannot move the neck b/c of dura inflammed

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9
Q

Who is at risk of getting bacterial meningitis?

A

YA who live in close areas (colleges students dorming)

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10
Q

Vacciniation for bacterial meningitis?

A

Neisseria menigitidis

H influ

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11
Q

Bacterial meningitis - dx?

A

CSF!!

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12
Q

Bacterial meningitis - CSF labs?

A 
\+ neutrophils
high CSF protein
low glucose 
*bacteria eats glucose, poops proteins
CSF culture
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13
Q

Bacterial meningitis - CSF culture? infants, children, adults?

A

infants- E coli, B strep

Children and adults: s. pneumonia, neisseria meningitisis, H influ (vaccine)

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14
Q

Bacterial meningitis - tx?

A

ASAP W/ BROAD ABX!!

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15
Q

Epidural abscess - cx?

A

surgical procedure

infxn from neighboring areas

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16
Q

Epidural abscess - leads to?

A

osteomyelitis

TCB of vertebral column

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17
Q

Subdural abscess/subdural empyema - cx?

A

spread of bacterial infxn from sinuses/middle ear

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18
Q

Spinal empymea - leads to?

A

compression of spinal cord - permenant damage

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19
Q

Intracranial subdural/epidural empyema - leads to?

A

increase in ICP

vomiting, diplopia, papilledema

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20
Q

Subdural abscess/empyema- tx?

A

1) surgical 2) abx IV

* b/c of compression, there is low blood circulation, so abx cannot get there

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21
Q

Brain abscess - cx?

A

bacterial spread from sinus/middle ear infxn

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22
Q

Brain abscess - sx?

A

headache
increased ICP - vomit, nausea, papilledema
seizures
mental status changes

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23
Q

Brain abscess - dx?

A

CT/MRI - DO NOT DO LP!! (CAN CX HEMORRHAGE)

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24
Q

Brain abscess - tx?

A

1) surgical 2) IV abx

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25
Q

CNS spirochete infection?

A

syphillis

lyme dz

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26
Q

CNS spirochete infxn - syphilis result?

A

Tabes dorsalis

27
Q

CNS spirochete infxn -syphilis sx?

A

General paresis of the insane

tabes dorsalis

28
Q

Tabes dorsalis?

A

result of untreated syphilis
infects the posterior dorsal column - affects vibration and propioception
pain of the sensory

29
Q

General paresis of the insane?

A

behavior mood changes in syphilis infxted pts

encepahlitis

30
Q

Lyme dz - bug?

A

tick borne illness d/t borrelia burgodferi

31
Q

Lyme dz - leads to?

A

neurologic manifestions (neuropathy, meningitis)

32
Q

How to tx syphilis?

A

PCN

33
Q

CNS viral - cx?

A

vectors
GI tract
respiratory tract
animal bites

34
Q

CNS viral pathophys?

A

immune response to viral infxn can lead to tissue damage

more damage from T cell and potent cytokines

35
Q

Aseptic meningitis - sx?

A

HA

stiff neck

36
Q

Aseptic meningitis - cx?

A

unknown

maybe theratpuetic drug

37
Q

Aseptic meningitis vs bacterial meningitis - CSF labs?

A

CSF culture: negative

CSF: incr WBC/pleocytosis (same), elevated protein (same) but normal glucose

38
Q

Encephalitis?

A

infxn of CNS neurons and glial cells

39
Q

Viral encephalitis - cx?

A

secondary (common): viral infxn (pneumonia, enteritis)

primary (rare): rabies

40
Q

Viral encephalitis - results?

A

confusion –> stupor –> seizures –> focal neurological defects –> coma –> death

41
Q

Herpes simplex encephalitis - cx?

A 
HSV I (cold sores)
HSV II (herpes)
primary infxn or viral reactivation in trigeminal ganglion that travels to the brain
42
Q

Herpes simplex encephalitis - most common cx?

A

HSV I

43
Q

Herpes simplex encephalitis - sx?

A

fever
confusion
seizures
coma

44
Q

Herpes simplex encephalitis - what lobe is affected, role in sx?

A

frontal: personality changes, dementia, hallucination

temporal lobe

45
Q

Herpes simplex encephalitis - cx in infants?

A

HSV II

to avoid: C section instead of vaginal birth (infants can get it easier b/c no BBB)

46
Q

Herpes simplex encephalitis - CSF?

A

pleocytosis

increase protein

47
Q

Herpes simplex encephalitis - dx?

A

PCR

48
Q

CMV encephalitis?

A

rare in adults

49
Q

CMV encephalitis - population?

A

immunocompromised (HIV pts)

50
Q

HIV?

A

directly infects the CNS

51
Q

CNS arthropod borne virus?

A

vectors

52
Q

Prion dz?

A

abnormal form of neuron glycoprotein –> amyloid (neuron degeneration)
confined to gray matter –> spongiform encephalopathy

53
Q

Prion dz - sx?

A 
prominent personality changes
dementia
hallucination
gait abnormalities
seizures
54
Q

Prion dz types?

A

Creutzfeldt Jakob (CJD)
Kuru
Bonvein Spoinform encephalopathy (mad cow)

55
Q

Prion dz - dx?

A

brain bx postmortem - r/o other dz

56
Q

CNS fungal infxn - popuatoin?

A

immunocomporomied
AIDs (loss of normla T cells)
low WBC

57
Q

CNS fungal infxn - bugs?

A

candid
aspergillus mucormycosis
cryptococcus

58
Q

Mycobacterial infxn?

A

TB meningitis

59
Q

Mycobacterial infxn - sx?

A

HA
confusion
CN defects

60
Q

Primary ameobic meningoencephalitis infxn?

A

rare

HIGH MORTALITY RATE

61
Q

PAM - cx?

A

free-living ameoba (naegleria flowerir) - lives in freshwater and hot springs

62
Q

PAM - population?

A

young men playing in American SW waters

63
Q

CSF testing includes?

A

CBC and diff
protein
glucose
gram stain, C&S

Neurology (13 decks)

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