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MS 2 > ENCEPHALITIS > Flashcards

ENCEPHALITIS Flashcards

1
Q

Is an acute inflammatory process of the brain tissue

A

Encephalitis

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2
Q

Often involves the meninges-meningoencephalitis

A

Encephalitis

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3
Q

Etiology of Encephalitis

A

-Viral
-Tick-Borne
- Fungal

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4
Q

Epidemiology of Encephalitis

A

Japanese Encephalitis is the most common viral encephalitis outside US, occurring in Japan, SE Asia, and India

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5
Q

Herpes Simplex Encephalitis Causative Agent

A
  1. Herpes Simplex Virus Type-1 (HSV-1)
  2. Herpes Simplex Virus Type-2 (HSV-2)
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6
Q

Mode of Transmission of Herpes Simplex Virus Type-1 (HSV-1)

A

Direct contact with sores, saliva, or surfaces

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7
Q

Mode of Transmission of Herpes Simplex Virus Type-2 (HSV-2)

A

Sexual Contact

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8
Q

Initial Clinical Manifestations of Herpes Simplex Encephalitis

A

-Fever
- Headache
- Confusion
- Hallucinations

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9
Q

Focal Neurologic Manifestations of Herpes Simplex Encephalitis

A

-Behavioral Changes
- Focal seizures
- Dysphasia
- Hemiparesis
- Altered LOC

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10
Q

Diagnostics for Herpes Simplex Encephalitis

A

-CSF ANALYSIS
-Polymerase Chain Reaction (PCR)

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11
Q

CSF Analysis

A

-High opening pressure
- Glucose within normal
- High protein

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12
Q

Polymerase Chain Reaction (PCR)

A

-Standard test for early diagnosis of HSV encephalitis
- Identifies DNA bands of HSV-1 in the CSF
-Specimen: Blood or CSF
- High validity between 3rd and 10th day of symptom onset

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13
Q

What’s the specimen of Polymerase Chain Reaction

A

Blood or CSF

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14
Q

Standard test for early diagnosis of HSV encephalitis

A

Polymerase Chain Reaction

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15
Q

Medical Management of Herpes Simplex Encephalitis

A

Antiviral Therapy
*DOC: Acyclovir (Zovirax)
Ganciclovir (Cytovene)

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16
Q

Mechanisms of Action of Acyclovir and Ganciclovir

A

Inhibits viral DNA Replication

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17
Q

Nursing responsibilities of Antiviral drug

A

-Administer early in the course of disease
- Continue treatment up to 3 weeks to prevent relapse
- Administer via slow IV over 1 hour to prevent crystallization of medication in urine

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18
Q

Nursing Management of Herpes Simplex Encephalitis

A

-Provide comfort measures
*Dimming lights
* Limiting noise and visitor
* Clustering nursing care
* Administer analgesics, as ordered

-Promote injury prevention and safety (Seizure precautions)
-Monitor blood chemistries and urinary output

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19
Q

Leading cause of vaccine-preventable encephalitis in Asia and the western Pacific

A

Japanese Encephalitis

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20
Q

Causative Agent of Japanese Encephalitis

A

Japanese Encephalitis, a flavivirus

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21
Q

Vector of Japanese Encephalitis

A

mosquito-culex spp.

22
Q

Mode of Transmission of Japanese Encephalitis

A

vector-borne

23
Q

Incubation period of Japanese Encephalitis

A

5-15 days

24
Q

Prevalence of Japanese Encephalitis

A

*Rural agricultural areas-rice production and flooding irrigation
* Temperate- seasonal
* Subtropics and Tropics: year-round

25
Q

Initial Clinical Manifestations of Japanese Encephalitis

A

-Fever
- Headache
- Vomiting

26
Q

Late Clinical Manifestations of Japanese Encephalitis

A

-Mental Status changes
- neurologic symptoms
- Weakness
- Parkinsonian syndrome
- Seizure (esp. in children)

27
Q

Diagnostic Test for Japanese Encephalitis

A
  1. Virus-specific IgM antibodies
  2. Confirmatory neutralizing antibody testing
28
Q

Specimen for Virus-specific IgM antibodies

A

serum or CSF

29
Q

Virus-specific IgM antibodies

A

-Specimen: serum or CSF
- Detectable 3 to 8 days after onset of illness and persist for 30 to 90 days

30
Q

Confirmatory neutralizing antibody testing

A

-Performed on patients with (+) JE virus IgM antibodies
-Available on CDC and few specialized reference laboratories

31
Q

Medical Management of Japanese Encephalitis

A

-Close Observation
- Supportive Care
-Symptomatic Treatment
-Rest
- Fluids
-Analgesic, as ordered
- Antipyretics, as ordered

32
Q

Rarely seen among healthy individuals

A

Fungal Encephalitis

33
Q

Infections are related to geographical location or compromised immune system

A

Fungal Encephalitis

34
Q

Causative Agents of Fungal Encephalitis

A

-Cryptococcus neoformans- exposure to bird droppings

-Blastomyces dermatitidis
-Histoplasma capsulatum
-Aspergillus fumigatus
-Candida spp.
-Coccidioides immitis

35
Q

Pathophysiology of Fungal Encephalitis

A
  1. Spored enter via inhalation
  2. Once the spores enters via inhalation, it initially infects the lungs which leads to respiratory symptoms
  3. Fungi enters blood stream
  4. Once entered, it becomes fungemia
  5. Fungemia overwhelms immune system
  6. Fungus spreads to CNS
36
Q

Clinical Manifestations of Fungal Encephalitis

A

-Fever
- Malaise
- Headache
- Meningeal Signs
- Changes in LOC
- Increased ICP symptoms
- Seizures (common in H. capsulatum)
-C. Neoformans is involved with specific skin lesion

37
Q

Diagnostics of Fungal Encephalitis

A

-CSF Analysis
-Elevated WBC and protein levels
- Decreased glucose level

38
Q

C. Neoformans

A

Mostly involved with specific skin lesion

-Lesions are mostly found on head and neck
- First present as painless papules or pustules, which then become nodules that may ulcerate

39
Q

Medical Management of Fungal Encephalitis

A

-Anticonvulsants, if with seizure
-Repeated lumbar puncture or CSF shunting to prevent increase in ICP

40
Q

It allows excess CSF that has built-up inside the skull to drain out into another part of the body

A

Ventriculoperitoneal (VP) Shunt

41
Q

A piece of soft, flexible plastic tubing

A

Shunt

42
Q

Antifungal Therapy for Fungal Encephalitis

A

*Competent immune system- given for a specific period to cure infection

*Immunocompromised- given until infection is controlled, then shifted to maintenance dosing for an indefinite period

43
Q

Drugs for Fungal Encephalitis

A
  1. Amphotericin B
  2. Fluconazole (Diflucan) or Flucystosine (Ancobon)
44
Q

Amphotericin B

A

-Given via IV route
- Do not give concurrently with any other drug

45
Q

Side Effect of Amphotericin B

A

-Fever
- Nausea and Vomiting
- Anemia
- Uremia
- Electrolyte abnormalities (especially potassium and magnesium)

46
Q

Nursing Management for Amphotericin B

A

-Diphenhydramine (Benadryl) and Paracetamol (Biogesic), as ordered 30 minutes before administration may prevent flu-like symptoms

47
Q

Fluconazole (Diflucan) or Flucytosine (Ancobon)

A

-Given orally in conjuction with Amphotericin B as maintenance therapy

48
Q

Side Effects of Fluconazole and Flucytosine

A

-Nausea
- Vomiting
- Transient increase in liver enzymes

49
Q

For bone marrow depression

A

Flucytosine (Ancobon)

50
Q

Nursing Management of Fluconazole and Flucytosine

A

Monitor leukocyte and platelet count regularly for patients receiving Flucytosine (ancobon)

MS 2 (27 decks)

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