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MID Exam 3 > Exam 3 - CNS Infxn's > Flashcards

Exam 3 - CNS Infxn's Flashcards

1
Q

Acute meningitis

most common bacteria

A
  • S. Pneumoniae
  • H. influenzae (down since Hib vacc)
  • N. meningitidis
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2
Q

Acute meningitis

less common bacteria

A
  • Listeria
  • Strep B
  • Gram neg bacilli
  • Staph
  • Borrelia burgdorferi
  • Treponema Pallidum
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3
Q

Acute meningitis

viral causes

A
  • enteroviruses
  • arboviruses
  • HSV, CMV, VZV
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4
Q

Acute meningitis

bacterial path

A

-N. mening, H influenz fimbriae attah
to nasopharynx epithelium
-S. pneum, H. influenz, N. mening encapsulation
inhibits phagocytosis
-once in CSF, low complement and Ab levels

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5
Q

Acute meningitis

postpartum

A

-Strep B (agalact), Listeria, gram negs

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6
Q

Acute meningitis

1-3 mos

A

-Step B, Listeria, S. Pneum, H influenz,

N. mening

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7
Q

Acute meningitis

elderly, AIDS

A

-Listeria, gram negs

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8
Q

Acute meningitis

S. pneum

A
  • # 1 in US; also highest mortality

- ass’d w/ otitis, pneumonia

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9
Q

Acute meningitis

H. influenz

A

-ass’d w/ otisis, pharyngitis

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10
Q

Acute meningtis

N. mening

A
  • children, young adults
  • nasopharyngeal acquisition
  • chemoprophylaxis for close contacts
  • ass’d rash
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11
Q

Acute meningitis

Listeria

A
  • elderly, AIDS, neonates

- food-borne assoc’n

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12
Q

Acute meningitis

S. alagact

A
  • aka Strep B
  • neonates, chronic illness
  • high mortality rate
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13
Q

Acute meningitis

gram neg

A
  • E. coli, Klebsiella, Pseudomonas

- neonates, elderly, AIDS, nosocomial

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14
Q

Acute meningitis

bacterial clin/sx

A

-fever, headache, meningismus,
photophobia, confusion, CN palsy,
seizure

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15
Q

Acute meningitis

bacterial dx

A

-lumbar puncture, CSF analysis
-high intracranial pressure
-CSF leukocytosis (neutrophilic), high
protein, low glc
-gram stain, CSF culture

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16
Q

Acute meningitis

bacterial tx

A
  • abx ASAP while awaiting lab

- tx empirically

17
Q

Acute meningitis

bacterial prevention

A

-N. mening. vaccine
-however, this does not cover sero B (51%)
-rec’d for asplenics, complement deficiency,
travelers, military, children
-chemoprohpylaxis for close contacts

18
Q

Acute meningitis

viral path

A

-breaching mucocilliary app, alv macrophages,

IgA

19
Q

Acute meningitis

viral clin/sx

A

-fever, headache, meningismus, photophobia
-enteroviral may have rash, conjunctivitis
-HSV meningitis may have urinary retention,
paresthesias, weakness

20
Q

Acute meningitis

viral dx

A
  • lumbar puncture, CSF analysis
  • high intracranial pressure
  • CSF leukocytosis (lymphocytic)
  • less pronounced protein, glc changes
21
Q

Chronic meningitis

definition

A

sx persist at least 4 wks

22
Q

Chronic meningitis

causative agents

A

-M. tuberculosis
-fungal (Cryptococcus, Histoplasma)
-Spirochetes (treponema pallidum,
Borrelia burgdorferi

23
Q

Chronic meningitis

TB sx

A
  • fever, meningismus, headache

- bx change, CN palsy,

24
Q

Chronic meningitis

TB dx

A
  • lymphocytic pleocytosis, low glc, up protein
  • poor yield CSF culture
  • PCR
25
Q

Chronic meningitis

TB tx

A

-long term anti-TB tx

26
Q

Chronic meningitis

Cryptococcus neoformans sx

A
  • secondary to AIDS

- chronic fever, headache

27
Q

Chronic meningitis

cryptococcus neoformans dx

A
  • no CSF WBC elevation

- serum/CSF antigen test

28
Q

Chronic meningitis

cryptococcus neoformans tx

A

-long-term anti-fungal

29
Q

HSV Encephalitis

definition/sx

A
  • infx’n of brain parenchyma
  • accompanied by meningitis
  • altered consciousness, neuro, seizures
30
Q

HSV Encephalitis

dx

A
  • CSF analysis
  • lymphocytic pleocytosis, elevated RBC
  • HSV PCR
  • temporal lobe changes on MRI
  • EEG spikes
31
Q

HSV Encephalitis

tx

A
  • acyclovir

- but high mortality, btw

32
Q

Brain Abscess

predisposing factors

A

-otitis, mastoiditis, sinusitis, dental infx’n,
head trauma, neurosurgery
-hematogenous spread
-endocarditis, lung abscess

33
Q

Brain Abscess

dx

A

-MRI

34
Q

Brain Abscess

tx

A

-surgical drainage, empiric abx

35
Q

CNS Toxoplasma

What is it?

A

-intracellular protozoan!

36
Q

CNS Toxoplasma

transmission

A
  • food (esp meats)
  • maternal-fetal
  • AIDS (CD4<100)
37
Q

CNS Toxoplasma

clin/sx

A
  • focal CNS mass

- seizures, CN palsy, meningitis, neuro sx

38
Q

CNS Toxoplasma

dx

A
  • imaging: rring-enhancing lesions

- serum IgG titers

MID Exam 3 (13 decks)

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