Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

WI18 Neuro > Howell 2 > Flashcards

Howell 2 Flashcards

1
Q

what organisms cause the purpura rash of meningitis

A

-N. Meningiditis (MC)
-Strep. Pneumoniae
H. Influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the neurologic complications that may occur if this patient’s ICP is permitted to rise?

A

Seizures
Focal Neurologic Deficits
Papilledema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

meningitis labs

A

CBC w/diff, CMP, Coag’s, Blood Cx’s x 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when to CT meningitis before LP

A

Immunocompromised state

History of CNS disease (mass lesion, stroke, or focal infection)

New onset seizure (within one week of presentation)

Papilledema

Abnormal level of consciousness

Focal neurologic deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does Rifampin protect against?

A

Meningicoccal

H. Influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are other organisms tx’d (prophylactically)?

A

There is no targeted tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

normal ct in meningitis… what do you do

A

you LP!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

LP what position

A

lateral recumbent position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

meningitis tx

A

Dexamethasone (+/-), Vancomycin and Rocephin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is important about the dexamethasone and the abx?

A

Give the Dexamethasone First!

Or at least the same time as the abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

symptoms that differentiate meningitis and encephalitis

A

AMS

focal deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most likely source of encephalitis in healthy pt

A

HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

most likely source of encephalitis in unhealthy pt

A

VZV and CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What virus typically manifests with challenges in swallowing and hydrophobia?

A

Rabies virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why when considering Encephalitis do you concern yourself with the history and labs?

A

disttinguse acute arboviral encephalitides as the other acute viral encephalitides, especially HSV encephalitis (HSE) and varicella-zoster encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

normal CSF

Pressure (mmH2O)
Appearance
Protein (mg/dL)
Glucose (mg/dL)
WBC
A

P: 50-200
A: Clear, colorless
P: 10-50
G: 50-80

<5 – all mononuclear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

bacterial meningitis LP findings

A

cloudy (torpid grey)

increased protein and decreased glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

most common bacterial etiology of community-acquired meningitis in adults of all ages

A

Streptococcus pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

encapsulated organisms

A 
Streptococcus pneumoniae
N. meningitidis 
H. influenzae 
Group B streptococcus 
E.Coli
Klebsiella
Salmonella

this is important bc no spleen = increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

organism to suspect in pts with meningitis following vp shunt

A

gram - bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the most common cause of neonatal meningitis?

A

Group B streptococcus andEscherichia coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is the MC source of this for the baby, when less than 6 days?

A

Vertical Transmission

Maternal transmission, MC during delivery. Screening after: 35-37 weeks and providing abx during delivery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the MC cause of disease in neonate after 7 days?

A

Nosocomial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

age/organism

>1 month and < 3 month

A

Group B strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

age/organism
>3 month and < 3 years
> 3 years and 10 years
> 10 yrs and < 19 years

A

Group B strep

N. Meniningiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Infants 1-3 months old receive what regimen

A

Ampicillin and Cefotaxime

27
Q

Children > 3 months old receive what regimen:

A

Ceftriaxone and Vancomycin

28
Q

tx of Everyone up to 50 y/o

A

Ceftriaxone and Vancomycin + Ampicillin

29
Q

Aseptic Meningitis

A

HA

subacute presentation

consider HIV

30
Q

causes of Aseptic Meningitis

A

Viruses, Fungi, Spirochetes, and even Autoimmune/Vasculitic and Hypersensitivity reactions have been reported.

31
Q

how do you determine potential cause of aseptic meningitis

A

epidemiologic setting

recent medication use

32
Q

every pt with aseptic meningitis must be tested for

A

HIV

33
Q

What viral infections occur in the Summer or Fall and is the MC cause of viral associated meningitis?

A

Enteroviruses (Coxsackie, Echovirus, and Non-polio Virus)

34
Q

What is the treatment of choice for most viral meningitis patients?

A

Symptomatic management/supportive care.

35
Q

What virus getting treated with targeted therapies (in meningitis)?

A

HSV, VZV, and CMV (Acyclovir and Gancyclovir)

36
Q

What form of Meningitis presents as:
This CSF Normal appearance. Proteins were approximately 40 mg/dL and CSF: Serum ratio of glucose was > 0.6; < 1000 wbc’s…mostly Eosinophils

A

Coccidoidal (Aseptic Meninigitis with Eosinphils)

37
Q

What medications are most commonly associated with aseptic meningitis?

A

NSAIDs, Sulfa Based, IVIG, Antiepileptics

38
Q

why did the median age of meningitis switch?

A

H Flu and Strep pneumo vax

39
Q

What vaccination is provided to those living in dorms, and generally provided to those 11-16 y/o? How many in series?

A

Answer: MCV-4

How many in series?
Answer: 2 shots

40
Q

What vaccine is provided as routine childhood immunizations, four shot series (2,4,6, 12 months) and is not generally needed after the age of 5 y/o?

A

Hib (H. Influenzae Type B) + Prevnar 13

41
Q

Which vaccination is for those who are > 65 y/o or for those with poor health?

A

PPSV

42
Q

Why is Pneumovax so important for meningitis prevention?

A

It is the MOST COMMON Bacterial cause of meningitis “broadly”

43
Q

risk factors for meningitis

A

Asplenia and sickle cell disease

Complement deficiency

Alcoholism, IV drug use

HIV infection — immunocompromised; opportunistic pathogens

Recent infection

Crowding

Recent head trauma
Immunosuppression, diabetes mellitus, renal or adrenal insufficiency, cystic fibrosis, glucocorticoid excess

Recent travel to areas with endemic meningococcal disease such as sub-Saharan Africa

44
Q

N. Meninigitidis MC

A

crowding and recent travel to areas endemic

45
Q

diskitis work up

A

Labs- ESR/CRP, CBC, CMP, Blood Cx.

lance that and obtain a wound cx

plain film and ultimately MRI

CT guided bx

46
Q

academic difference of Diskitis and Osteomyelitis?

A

Disc vs. Bone

47
Q

how is Diskitis tx?

A

Vancomycin and Rocephin

Pain mgt. IV therapies, as well as bed rest and brace. – In bed physical therapy

48
Q

epidural abscess s/s+pathoge

A

Bladder, bowel dysfunction and paralysis + organisms

staph

49
Q

LP and epidural abscess

A

no use in doing it

50
Q

epidural abscess tx

A

Vancomycin + Metronidazole +

EitherCefotaxime,Ceftriaxone, (orCeftazidime if considering pseudomonas)

51
Q

what is the difference between a spinal and intracranial abscess

A

Intracranial epidural abscesses (IEAs) are less common than spinal epidural abscess, and less acute in their evolution

IEAs tend to be slow-growing, rounded, and well-localized

52
Q

how do IEAs look onCT

A

Biconvex

53
Q

The most frequent intracranial locations

A 
Frontal-temporal
 Frontal-parietal
 Parietal
 Cerebellar
 Occipital lobes
54
Q

brain abscess on MRI

A

Ring Enhancing Lesion

55
Q

mc organism of brain abscess

A

polymicrobial

56
Q

early stage of brain abscess

A

cerebritis

57
Q

tx for brain abscess

A
  1. Surgical Debridement with Neurosurgery (aspiration dx vs excision) pends on size
  2. Abx: Vancomycin and Rocephin, and Metronidaxole
58
Q

steroids and brain abscess

A

decrease antibiotic penetration into the abscess

slow encapsulation of the abscess site

reduce contrast enhancement on CT

increase risk of ventricular rupture

59
Q

What are the two variances of meningitis determined by the CSF?

A

Bacterial and Aseptic

60
Q

Why is it that the host defenses are lacking in the CSF?

A

Lack of functional opsonic and bactericidal activity

61
Q

meningitis based on timeline

What is Acute

A

Answer: Under 24 hours, MC this is bacterial

62
Q

meningitis based on timeline

What is Subacute

A

1-7 days, MC this is viral

63
Q

meningitis based on timeline

What is Chronic

A

More than 7 days, this lasts longer than 4 weeks

WI18 Neuro (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions