Head & Neck Labs / Neuro infections Flashcards
Schoenwald lectures
What is included in a CSF analysis?
- color
- cells
- protein
- glucose
- graim stain/culture
- syphilis testing
What does red CSF indicated
presence of blood = likely traumatic tap or SAH
What does xanthochromia indicate?
presence of blood = SAH
What does turbid CSF indicate?
increased WBC or protein
CSF with elevated WBC and elevated neutrophils indicates…
bacterial meningitis
CSF with elevated WBCs and lymphocytic cells indicates…
viral meningitis
CSF with elevated protein levels could indicate…
- bacterial meningitis
- viral encephalitits
- can be mildly elevated in MS
CSF with low level of glucose indicates…
bacteria or tumor present
CSF cultures:
____ is gram positive cocci in chains and has a higher mortality rate
Streptococcus pneumoniae
CSF cultures:
____ is gram negative diplococci and is commonly seen among adolescents and college students
Neisseria meningitides
CSF cultures:
____ are gram negatives rods, commonly seen in 1-4 y/o
Haemophilus influenzae
What is contained in a cell wall and is a potent inducer of cytokines associated with fever and septic shock?
Lipopolysaccharides
gram negative
True or False: Viral meningitis is more lethal than bacterial
FALSE
The finding of oligoclonal banding in CSF is highly suspicious for ___
multiple sclerosis
What are common tests to order to try to find reversible cause of dementia?
- CBC (anemia, infection, thrombocytopenia)
- CMP (glu, BUN/Crt, electrolytes)
- UA (UTI)
- Vitamin B12
- Folate
- RPR
- TSH
potential complications from untreated strep throat?
- rheumatic fever
- PTA
- post-streptococcal glomerulonephritis
common Tx for influenza?
- Oseltamivir (Tamiflu)
- Baloxavir (Zofluza)
- Zanamivir (Relenza)
Epstein Barr Virus is transmissible through what
respiratory, saliva
Where is pt with mono (EBV) likely to have lymphadenopathy?
posterior cervical chain
____ is treating with Abx covering for organisms that could cause infection as you wait for culture results to return
Empiric Tx
What type of rash can be associated with meningitis?
petechial rash
Who is at risk for meningitis?
- Newborns/babies
- college campus/military barracks
- underlying medical conditions
- working in a meningitis lab
- travel to sub-saharan Africa & Haaj
Which bacteria is commonly passed from mother to child during birth and can cause meningitis?
- how is this prevented?
Group B Strep (beta-hemolytic)
- screening during week 35-37 of pregnancy
Who is most at risk for meningitis secondary to H. influenzae?
- <4 y/o
- unvaccinated
- Hx of splenectomy
What should someone do if they are in contact with someone with Hib meningitis?
Prophylactic Tx with Rifampin
What should someone do if they are in contact with someone with meningitis caused by N. meningitides?
Prophylactic Tx with Ciprofloxacin
Who is most at risk for meningitis caused by Strep pneumoniae?
- age >50
- Hx of splenectomy (need immunization against strep pneumo)
What should someone do if they are in contact with someone with meningitis caused by Strep pneumoniae?
Nothing (no prohylaxis Tx since mode of transmission less risky – not resp droplets)
What groups are high risk for Listeria monocytogenes meningitis?
- pregnant women
- elderly
- pts with comorbidities/weakened immunities
What Abx is used to treat Listeria monocytogenes meningitis
Ampicillin
What foods have high risk for listeria monocytogenes
- soft cheeses
- unpasteurized milk
- contamination at food plants
True or False: Aseptic meningitis has similar symptoms to bacterial but is shorter lasting
FALSE - Aseptic meningitis is longer lasting
True or False: Aseptic meningitis is less likely to be life threatening
True
West nile Virus is _____ borne and includes what symptoms
- mosquito borne
- fever, neck stiffness, diffuse MP rash
may even be asymptomatic
Pt presents with GAS strep throat but has a beta-lactam allergy. What would you treat with?
- azithromycin, clindamycin, clarithromycin
macrolides and lincosamide - clinda
