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Adams Principles of Neurology > Infection > Flashcards

Infection Flashcards

1
Q

Bacteria caused by these conditions are the only apparent predecessors to meningitis

A

Pneumonia and Endocarditis

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2
Q

T/F: Meningitis is always cerebrospinal.

A

True

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3
Q

Reaction of the CNS to bacteria

A

1) hyperemia of the meningeal venues and capillaries with increased permeability
2) Exudation of protein with migration of neutrophils into the pia and subarachnoid space

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4
Q

When does the cellular exudate becomes organised into two layers?

A

2 weeks

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5
Q

4th most common type of nonsurgical bacterial meningitis in Adults

A

L. monocytogenes

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6
Q

Seizures are encountered most often with this type of meningitis

A

H. influenzae meningitis

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7
Q

Most usual pathogen in recurrent bacterial meningitis

A

S. pneumoniae

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8
Q

T/F: Viral meningitis is far more common than bacterial meningitis

A

True

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9
Q

It is characterised by recurrent meningitis with iridocyclitis and depigmentation of nails and skin

A

Koyanagi-Harada Syndrome

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10
Q

T/F: The use of corticosteroids in bacterial meningitis was not found to affect mortality in children but reduces the incidence of sensorineural hearing loss and other neurologic sequelae especially in H. influenza meningitis.

A

True

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11
Q

The improvement after giving corticosteroids in adults with bacterial meningitis is sen largely among those infected with what organism?

A

Pneumococcus

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12
Q

Osler triad

A

pneumococcal meningitis, pneumonia, endocarditis

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13
Q

Treatment of choice in Listeria meningoencephalitis?

A

Ampicillin + Gentamicin

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14
Q

Treatment of choice in Melioidosis?

A

Intensive eradication with ceftazidime for 10-14 days followed by cotrimoxazole with or without doxycycline

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15
Q

Acute meningoencephalitis, papilledema and increased intracranial pressure attributable to ingestion of raw milk

A

Brucellosis

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16
Q

Most common incriminated organism in septic thrombophlebitis?

A

Streptococci and Staphylococci

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17
Q

The sinuses most frequently implicated in abscesses

A

Frontal and sphenoid

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18
Q

2/3 of abscesses originating in the ear lies in what part of the brain?

A

middle and inferior part of the temporal lobe

1/3 in the anterolateral part of the cerebellar hemisphere

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19
Q

T/F: In brain abscess, it is the subsequent evolution of the process that is dependent on the inherent tendency of the organism to be invasive.

A

True

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20
Q

How many % of cases of congenital heart disease are complicated by brain abscess?

A

5%

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21
Q

By far the most common congenital heart anomaly implicated in brain abscess?

A

Tetralogy of Fallot

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22
Q

Most frequent initial symptoms of intracranial abscess

A

Headache

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23
Q

T/F: The abscess capsule tends to be thinner on the side directed to the lateral ventricle.

A

True

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24
Q

This must be added as the 5th drug in case of INH and EMB-resistant organism

A

Ethionamide

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25
Q

It is the invariable accompaniment of all forms of neurosyphilis

A

Meningeal inflammation

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26
Q

T/F: Asymptomatic neurosyphilis can be recognised only by changes in the CSF.

A

True

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27
Q

Earliest change in the CSF of congenital neurosyphilis.

A

Pleocytosis and elevation of protein

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28
Q

When does the symptoms of meningeal syphilis usually occur?

A

Within the first two years

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29
Q

Most common form of neurosyphilis

A

Meningovascular syphilis

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30
Q

Severe and painful meningoradiculitis of the caudal equine in Lyme disease

A

Bannworth syndrome

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31
Q

T/F: In Cryptococcus meningitis, the administration of Amphothericin B intrathecally in addition to intravenous route appears not to be essential

A

True

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32
Q

Unlike any other rickettsioses, this is characterised with low-grade meningitis and not associated with an exanthem

A

Q fever

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33
Q

T/F: Treated mother with Toxoplasmosis can be assured that there is little carryover risk of producing a second infected infant.

A

True

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34
Q

More often characterized by chorioretinitis, hydrocephalus, microcephaly, cerebral calcifications and psychomotor retardation.

A

Congenital Toxoplasmosis

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35
Q

It is the most common cause of focal cerebral lesions in patients with AIDS

A

Acquired Toxoplasmosis

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36
Q

Cerebral malaria complicates 2% of cases of this malarial infection

A

Falciparum malaria

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37
Q

Characterised by winter bottom sign and Kerandal hyperaesthesia

A

Trypanosomiasis

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38
Q

Characterised by large fluid filled cyst and solid chitinoma

A

Hydatid disease (Echinococcus)

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39
Q

Usual trematode that infects the nervous system

A

Schistosoma japonicum

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40
Q

Type of schistosome infection which tends to localise in the spinal cord causing an acute or subacute myelitis that is concentrated in the conus medullaris

A

Schistosoma mansoni

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41
Q

Most common viral infection confined to meningeal cells

A

Enteroviruses

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42
Q

T/F: Mumps meningitis affects males 3x more frequently than females

A

True

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43
Q

T/F: Brachial neuritis may occur when parvovirus is contracted from the child by an adult.

A

True

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44
Q

It is by far the most common sporadic cause of encephalitis and has no seasonal or geographic predilection.

A

HSV

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45
Q

Most common cause of HSV Encephalitis

A

HSV-1

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46
Q

T/F: Status Epilepticus is rare in HSV Encephalitis.

A

True

47
Q

Dose of Acyclovir in HSV Encephalitis

A

30 mg/kg/day x 10-14 days

48
Q

This disease is distinguished with the presence of this cytoplasmic eosinophilic inclusions

A

Negri bodies

49
Q

These are focal collections of microglia in Rabies

A

Babes nodules

50
Q

Most common dermatome affected in Zoster

A

Thoracic dermatomes particularly T5-T10

51
Q

Retrovirus that induce tropical spastic paraparesis

A

HTLV-I

52
Q

Most common nonfocal neurologic complication of AIDS

A

CMV and Cryptococcus

53
Q

This is the only clearly demonstrated mechanism of spread of the usual type of CJD

A

Iatrogenic

54
Q

Most common isoform type of prions

A

MM1

55
Q

This test is particularly useful in separating CJD from other non-inflammatory dementing disease

A

14-3-3 test

56
Q

It is the most important test to establish the diagnosis of healthcare associated ventriculitis and meningitis

A

CSF cultures

57
Q

Organisms associated with infection of pulse generators

A

S. aureus and propionibacterium acnes

58
Q

T/F: Creutzfeldt-Jakob disease has a prdilection for both cerebral and cerebellar hemispheres.

A

True

59
Q

The only clearly demonstrated mechanism of spread of the usual type of CJD

A

Iatrogenic

60
Q

Most common type of CJD overall.

A

MM1

61
Q

The pathologic changes in Fatal Insomnia, consisting of neuronal loss and gliosis, are found in which part of the brain?

A

Medial thalamic nuclei

62
Q

Prion disease that is not found to be transmissible by inoculation of infected brain material.

A

Fatal insomnia

63
Q

Most common cause of acute aseptic meningitis.

A

Enterovirus

64
Q

T/F: Practically all cases of rabies are the result of transdermal viral inoculation.

A

True

65
Q

Part of the CNS most usually involved in patients with rabies manifesting as hydrophobia and frothing of the mouth?

A

Tegmental medullary nuclei

66
Q

The most common neurologic complication in the later stages of HIV infection.

A

AIDS dementia complex

67
Q

What antiretroviral is purported to cause a myopathy similar to the inflammatory polymyositis caused by HIV?

A

Zidovudine

68
Q

What is the most common focal infectious complication of AIDS?

A

Toxoplasmosis

69
Q

The most frequent fungal complications of HIV infection

A

Cryptococcal meningitis and solitary cryptococcoma

70
Q

Most commonly involved nerve in neurosarcoidosis

A

Cranial Nerve 7

71
Q

First line ideal treatment in the first stage of borreliosis?

A

Doxycycline

72
Q

First line ideal treatment in the later stage of Borreliosis.

A

Ceftriaxone

73
Q

The most common cause of brain abscess in immunovompetent patients

A

Anaerobic bacteria

74
Q

Probably the most frequent initial symptom of intracranial abscess

A

Headache

75
Q

T/F: the temporal lobe lesions in HSV encephalitis are usually bilateral but not symmetrical.

A

True

76
Q

The most frequent neurologic manifestation of poliovirus infection.

A

Aseptic meningitis

77
Q

Most frequent presentation of neurocystocercosis

A

Seizure

78
Q

Most commonly affected cranial nerve in tuberculous meningitis

A

Abducens nerve

79
Q

Most vulnerable nerve affected following extensive sensory loss in leprosy.

A

Ulnar nerve

80
Q

It is by far the most common sporadic cause of encephalitis and has no seasonal or geographic predilection.

A

HSV

81
Q

Most common cause of bacterial meningitis in a 40 year old man two days after undergoing ventriculostomy.

A

Staphylococcus aureus
History of splenectomy-haemophilus influenza type b
History of ethanol abuse-acinetobacter
History of heart implantation-Listeria monocytogenes
Immunocompetent adult-streptococcus pneumoniae

82
Q

T/F: Postherpetic neuralgia follows shingles in 5-10% of patients but occurs almost 3x more often among individuals older than 60 years.

A

True

83
Q

Antibiotic added as a 5th drug in countries with high rates of resistance to INH.

A

Ethionamide

84
Q

Cerebral malaria complicates how many percent of falciparum malaria

A

2%

85
Q

Seizures are encountered most often in meningitis involving this organism

A

H. influenza

86
Q

Most common manifestation of tubrrculous meningitis

A

Stiff neck

87
Q

Probably the most frequent opportunistic fungus infection

A

Candidiasis

88
Q

T/F: Aspergillosis does not present as meningitis but as infectious vasculitis.

A

True

89
Q

Latency period of SSPE

A

6-8 years

90
Q

In the early stages of subacute sclerosing panencephalitis, demyelination starts in this lobe.

A

Occipital lobe

91
Q

Most common congenital CNS infection

A

Congenital CMV

92
Q

Blueberry muffin baby

A

Congenital rubella syndrome

93
Q

Most common pathogen of cranial epidural abscess

A

Staphylococcus aureus

94
Q

The most common agent believed to cause benign recurrent lymphocytic meningitis

A

Herpes simplex type 2

95
Q

Most common nonepidemic viral cause of viral encephalitis

A

HSV-1

96
Q

Distinguishing feature of AIDP from idiopathic GBS?

A

Lymphocytic pleocytosis

97
Q

Most frequent primary cause of meningitis in AIDS patients

A

Cryptococcus

98
Q

Most common cause of aseptic meningitis

A

Coxsackie virus, echovirus

99
Q

Most common virus associated with neonatal herpes encephalitis

A

HSV-2

100
Q

Isolated from the CSF of patients with recurrent bouts of benign aseptic meningitis (mollaret meningitis)

A

HSV-1

101
Q

Botulinum toxin most commonly involved in botulinism

A

BTX A

102
Q

Most common complication of AIDS

A

HIV-associated sensory neuropathy

103
Q

Most common cause of subdural empyema

A

Sinusitis

104
Q

Common feature of the TORCH infections

A

Chorioretinitis

105
Q

Most common complication of acute bacterial meningitis

A

Sensorineural hearing loss

106
Q

By far the most common anomaly implicated in brain abscess

A

Tetralogy of fallot

107
Q

Type of edema in the surrounding white matter of a brain abscess

A

Interstitial edema

108
Q

Most frequent complaint in brain abscess

A

Headache

109
Q

The most frequent sign of neurocysticercosis

A

Seizure

110
Q

Durck nodes are associated with which CNS infection?

A

Malaria

111
Q

Primary CNS Lymphoma can be differentiated in immunosuppressed and immunocompetent host by which characteristic?

A

Association with Epstein Barr virus

112
Q

Brudzinski and Kernig’s signs are reflective of flexor protective reflex known as

A

Fulton’s nocifensive response

113
Q

Calcifications are widely distributed in this TORCH infection

A

Toxoplasmosis

114
Q

Cardiac lesions are only present in this TORCH infection

A

Rubella

Adams Principles of Neurology (19 decks)

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