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neurology 1 > Infection - Infection in the CNS > Flashcards

Infection - Infection in the CNS Flashcards

1
Q

infection/ inflammation of the meninges

a.meningitis
b.encephalitis
c.meningoencephalitis
d.prion disease

A

meningitis

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2
Q

which of these meningitis infections is more common and self limiting

a.bacterial
b.viral

A

b.viral

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3
Q

most organisms causing meningitis invade the meninges across which barrier

a.blood brain
b.csf

A

b.csf

somewhat porous as endothelium of vessels is porous

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4
Q

inflammation of the white matter of the brain

a. meningitis
b.encephalitis
c.meningoencephalitis

A

b.encephalitis

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5
Q

most organisms causing encephalitis invade the brain across which barrier

a.blood brain
b.csf

A

a.blood brain

not fenestrated so harder to penetrate

viruses with tropism for nervous tissue

infection of peripheral nervous system ascends to CNS

eg herpes simplex, varicella zoster and rabies

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6
Q

which of these pathogens does NOT invade the peripheral nerves

a.rabies
b.varicella zoster
c.herpes simplex
d.e coli

A

d.e coli

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7
Q

a combination of meningeal and white matter inflammation/ infection

a. meningitis
b.encephalitis
c.meningoencephalitis

A

c.meningoencephalitis

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8
Q

in which of these conditions does the presence of a specific protein alter the configuration of proteins to cause white matter loss

a. meningitis
b.encephalitis
c.meningoencephalitis
d.prion disease

A

d.prion disease

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9
Q

what are the 3 main bacteria that case CNS infections

(NHS)

A

neisseria meningitis
haemophilus influenza
streptococcus pneumonae

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10
Q

what type of bacteria is neisseria meningitis

a.gram positive rod
b.gram positive coccus
c. gram negative rod
d, gram negative coccus

A

d, gram negative coccus

in pairs so diplococcus

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11
Q

what gram stain is haemophilus influenzae type B

a.a.gram positive rod
b.gram positive coccus
c. gram negative rod
d, gram negative coccus
e.gram negative cocco bacillus

A

e.gram negative cocco bacillus

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12
Q

which of these is a gram negative coccus

a.neisseria meningits
b.haemophilus influenzae
c. strep pneumonae

A

a.neisseria meningits

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13
Q

which of these is a gram negative cocco- bacillus

a.neisseria meningits
b.haemophilus influenzae
c. strep pneumonae

A

b.haemophilus influenzae

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14
Q

which of these is a gram positive coccus

a. neiseeria meningitis
b.haemophilus influenzae
c. strep pneumonia

A

c. strep pneumonia

occurs in pairs so diplococcus

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15
Q

what gram stain is strep pneumonae

a.a.gram positive rod
b.gram positive coccus
c. gram negative rod
d, gram negative coccus
e.gram negative cocco bacillus

A

b.gram positive coccus

in pairs so diplococcus

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16
Q

where can all of the 3 main CNS infection bacteria commence ?

a.GI tract
b.GU tract
c.upper respiratory tract
d.lower respiratory tract

A

c.upper respiratory tract

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17
Q

what does meningitis usually occur from

a.direct infection of brain
b.blood stream spread from upper Respiratory tract infection

A

b.blood stream spread from upper Respiratory tract infection

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18
Q

when are the 3 NHS meningitis organisms vaccinated against

a.primary school
b.secondary school
c.adulthood
d.as a baby

A

a.primary school

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19
Q

which organism is a gram positive rod

a.neisseria menigitis
b.haemophilus influenzae
c. strep pneumonae
d.listeria monocytogenes

A

d.listeria monocytogenes

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20
Q

what type of organism is listeria monocytogenes

a.a.gram positive rod
b.gram positive coccus
c. gram negative rod
d, gram negative coccus
e.gram negative cocco bacillus

A

a.a.gram positive rod

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21
Q

which organism is not a common cause of meningitis but is seen in the elderly, neonates and immunocompromised patients

a.neisseria menigitis
b.haemophilus influenzae
c. strep pneumonae
d.listeria monocytogenes

A

d.listeria monocytogenes

NHS organisms common

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22
Q

how is listeria monocytogenes spread

a. droplets
b.food borne
c.close communities
d.dirty water

A

b.food borne

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23
Q

who is commonly effected by TB meningitis

a.elderly
b.neonates
c.teenagers
d.young children

A

d.young children

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24
Q

which type of meningitis occurs shows as a military appearance on chest x ray

a.Nesseria menigitis
b.haemophilus influenzae
c.strep pneunoneae
d.TB

A

d.TB

disseminated TB

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25
Q

pregnant women are advised to avoid food borne sources eg unpasteurised soft cheeses of which pathogen

a.Nesseria menigitis
b.haemophilus influenzae
c.strep pneunoneae
d.TB
e.listeria monocytogenes

A

e.listeria monocytogenes

vaginal colonisation

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26
Q

other than the core list NHS of bacteria causing meningitis in neonates which bacteria should be considered.

A

GBS - group B strep
E coli
listeria monocytogenes

GEL

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27
Q

in early infection (within 7 days) of a neonate with GBS how is the infection acquired

a.during birth from mother
b.other children
c.hospital

A

a.during birth from mother

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28
Q

late infection of a baby with GBS is most likely from what

a.mother during birth
b. hospital acquired
c.other children at nursery

A

c.other children at nursery

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29
Q

a pregnant women is given prophylaxis at the time of delivery for which organism if it is found in the vagina/urine during pregnancy

a.GBS
b.e coli
c. Listeria monocytogenes
d.TB

A

a.GBS

type B strep

30
Q

which organism is specifically associated with HIV/AIDS patients and patients recieveing chemotherapy

a.GBS
b.e coli
c. Listeria monocytogenes
d.TB
e.cryptococcus neoformans

A

e.cryptococcus neoformans

yeast like fungi
immunocompromised pre disposed for fungal infections

31
Q

how is CNS infection with cyptococcus neoformans ( HIV/AIDS patients/ chemotherapy) diagnosed

a.gram stain
b.indian ink stain of blood
c.indian ink stain csf

A

c.indian ink stain csf

shows capsule

and antigen detection tests

32
Q

what is a significant cause of CNS infection in those with impaired T cell immunity that is associated with cats and a mild fever with swollen lymph nodes

a.GBS
b.e coli
c. Listeria monocytogenes
d.toxoplasma gondii
e.cryptococcus neoformans

A

d.toxoplasma gondii

33
Q

which of these is a protozoa

a.GBS
b.e coli
c. Listeria monocytogenes
d.toxoplasma gondii
e.cryptococcus neoformans

A

d.toxoplasma gondii

34
Q

other than NHS what organisms are important to consider for CNS infection in immunocompromised patients

TLC

A

Toxoplasma gondii - protozoa associated with cats , mild fever and swollen lymph nodes , HIV with low CD4

listeria monocytogenes

cyptococcus neoformans- fungi, HIV and chemotherapy patients

35
Q

confusion, seizures, altered conscious and abnormal behaviour are symptoms of what

a. meningitis
b. encephalitis
c.encephalomeningitis

A

b. encephalitis

36
Q

which of these encephalitis organisms causes flaccid paralysis ascending from the peripheral nerves to the CNS and causes non severe encephalitis

a.mumps
b.polio
c.rabies

A

a.mumps

37
Q

which of these encephalitis organisms causes long term disability

a.mumps
b.polio
c.rabies

A

b.polio

38
Q

which of these encephalitis organisms causes fatality

a.mumps
b.polio
c.rabies

A

c.rabies

39
Q

what is the most common cause of encephalitis in the UK

a.mumps
b.polio
c.rabies
d.herpes simplex

A

d.herpes simplex

40
Q

headache, fever, irritability , neck stiffness and photophobia indicate what

a. meningitis
b. encephalitis
c.encephalomeningitis

A

a. meningitis

may also have prodromal sore throat

41
Q

what is the characteristic sign of meningococcal septicaemia

a.headache
b.neck stiffness
c.photophobia
d.non blanching rash
e.blanching rash

A

d.non blanching rash

42
Q

what is the first thing to do if meningitis is suspected

a.give antibiotucs
b.imaging
c.lumbar puncture
d.blood for culture
e.throat swabs

A

a.give antibiotucs

43
Q

in normal adult csf there are….white cells

a.some
b.no

A

b.no

44
Q

a high number of neutrophils and high protein count in the csf indicates what

a.bacterial infection
b.fungal infection
c. viral infection
d. protozoa infection

A

a.bacterial infection

`(cloudy appearance to csf)

45
Q

high numbers of t lymphocytes and normal protein in the csf indicates what

a.bacterial infection
b.fungal infection
c. viral infection
d. protozoa infection

A

c. viral infection

clear appearance to csf

46
Q

what is the first line drug for most cases of bacterial meningitis

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol

A

a.ceftriaxone

47
Q

what is added to ceftriaxone (elderly) or cefotaxime (neonates) to cover listeria in bacterial meningitis

a. flucloxacillin
b.erythromycin
c.gentamicin
d. amoxicillin

A

d. amoxicillin

48
Q

what is the first line for bacterial meningitis in neonates

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol

A

c.cefotaxime

49
Q

what is added to cefotaxime and amoxicillin in neonates to cover gram negatives

a. flucloxacillin
b.erythromycin
c.gentamicin
d. amoxicillin

A

c.gentamicin

50
Q

what is given for bacterial meningitis if the patient has a life threatening penicillin allergy

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol

A

d.chloramphenicol

51
Q

close contacts of those with meningococcal meningitis should be offered prophylaxis with which drug

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol
e.ciprofloxacin

A

e.ciprofloxacin

52
Q

infective encephalitis is most often cause by

a.bacteria
b.viruses

A

b.viruses

53
Q

herpes simplex leading to viral encephalitis is most often due to reactivation of latent virus in the trigeminal ganglia that ascends typically causing infection in which lobes

a. temporal
b.occipital
c. parietal
d.temporal

A

a. temporal

54
Q

what is the key to diagnosing encephalitis

a.gram stain
b. csf pcr
c.imaging
d.throat swabs

A

c.imaging

CT MRI

can show raised intra cranial pressure which contraindicates a lumbar puncture as it can cause brainstem to be pulled down through foramen magnum (coning)

55
Q

vesicular rashes in encephalitis indicate what cause

a.herpes simplex
b.mumps
c.measles
d.eneterovirus meningoencephalitis

A

a.herpes simplex

56
Q

non vesicular rash in encephalitis is suggestive of what cause

a.herpes simplex
b.mumps
c.measles
d.eneterovirus meningoencephalitis

A

d.eneterovirus meningoencephalitis

57
Q

how is encephalitis disgnosed

A

scanning PCR from throat, swabs of rash vesicles, blood , lumbar puncture

58
Q

what is used to reduce swelling in encephalitis

a.steroids
b.antibiotics
c.NSAIDs
d.diuretics

A

a.steroids

59
Q

which antiviral is given as the first step of treatment for encephalitis

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol
e.aciclovir

A

e.aciclovir

60
Q

how is acyclovir given for herpes simples encephalitis

a,oral
b.ointment
c.IV

A

c.IV

61
Q

which of these drugs competes with deoxyguanosine to be incorporated into the viral
DNA stopping viral DNA synthesis

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol
e.aciclovir

A

e.aciclovir

62
Q

which of these is often a primary infection with HSV

a.herpetic gingivostomatitis

b.herpes labialis - cold sores

A

a.herpetic gingivostomatitis

63
Q

in cases of keratoconjunctivitis (HSV eye infection) what should be done

a.antibiotic eye drops
b.oral antibiotics
c.urgent specialist referral
d.specialist referral

A

c.urgent specialist referral

64
Q

what is used topically to treat herpes labialis

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol
e.aciclovir

A

e.aciclovir

65
Q

what is the secondary infection of varicella known as

A

shingles

varicella = chickenpox

66
Q

what is used for shingles when the patient is immunocompromised; the pain
of the infection is severe; the facial dermatomes are involved (branches of the
trigeminal nerve which supply sensory supply to the face.)

a.ceftriaxone
b.amoxicillin
c.cefotaxime
d.chloramphenicol
e.aciclovir

A

e.aciclovir

67
Q

what is used IV for treatment of cmv infection

a.ceftriaxone
b.amoxicillin
c.ganciclovir
d.chloramphenicol
e.aciclovir

A

c.ganciclovir

68
Q

what is used topically for the treatment of herpes keratitis

a.ceftriaxone
b.amoxicillin
c.ganciclovir
d.chloramphenicol
e.aciclovir

A

c.ganciclovir

69
Q

what is the main side effect of ganciclovir

a.vomiting
b.GI upset
c.agranulocytosis
d. bone marrow suppression

A

d. bone marrow suppression

70
Q

what is used for prophylaxis of cmv

a.ceftriaxone
b.valaciclovir
c.ganciclovir
d.chloramphenicol
e.aciclovir

A

b.valaciclovir given orally

71
Q

who is at specific risk of cmv infection

A

neurology 1 (44 decks)

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