Delirium Peer Learning Small Group Flashcards
A 4-month old infant is brought to urgent care by his mother. Last night he was very fussy and crying. This morning he developed a 103F fever. The infant appears lethargic, barely withdrawing during a blood draw. LP shows elevated opening pressure, elevated protein, decreased glucose, and abundant neutrophils. What is the infectious agent?
A. Cryptococcus neoformans
B. Cytomegalovirus
C. Enterovirus
D. Escherichia coli
E. Haemophilus influenzae
F. Neisseria meningitidis
D. Escherichia coli
The LP is classic for a bacterial meningitis. Those which affect infants aged 0-6mo are E. Coli, Group B Strep, and Listeria.
Your classmate is studying for Step 1 when she develops a severe headache and dies. On autopsy the pathologist removes the calvarium with dura attached. There is blood adhering to the surface of the brain. What type of hemorrhage is this?
A. Epidural hemorrhage
B. Intradural hemorrhage
C. Intraparenchymal hemorrhage
D. Subarachnoid hemorrhage
E. USMLE horror hemorrhage
D. Subarachnoid hemorrhage
The bleed was not epidural and there was no history of trauma. Intradural hemorrhage isn’t a real thing, and intraparenchymal hemorrhages are seen in deeper structures.
A 43yo male with AIDS presents with a 2 day history of vision problems. His speech is impaired as well as his memory, and he is uncoordinated on the neuro exam. He is admitted to the hospital but progressively deteriorates and dies a few weeks later. What was the most likely cause?
A. Cryptococcus neoformans
B. Herpes simplex virus
C. JC virus
D. Pneumocystis jirovecii
E. Toxoplasma gondii
C. JC Virus
All of these are afflictions that affect AIDS patients, but there is no meningitis to support cryptococcus, no personality changes to support HSV, no pneumonia to support PCP, and no seizures or radiology to support Toxoplasma.
