Infections

Question 1

Name 7 neurological complications of HIV

Answer 1

Neuropathy
Dementia
Viral infec: CMV encephalitis
Fungal and parasitic infec: cryptococcal meningitis
Progressive multi-focal leukoencephalopathy (PML)
CNS lymphomas
Vacuolar myelopathy

Question 2

What is Gerstmann- straussler - Scheinker syndrome? Where is lesion and cause.

Answer 2

Inherited prion disease caused by autosomal mutations to PRNP gene. Spongiform encephalopathy. Affects the left parietal lobe in the region of the angular gyrus.

Question 3

Clinical presentation of Gerstmann (angular gyrus) syndrome (6)

Answer 3

Dementia
Ataxia
Acalculia, finger agnosia, agraphia, left-right disorient tetrad

Question 4

Meningitis bacterial findings CSF (5)

Answer 4

Appearance: turbid/pus
Neutrophils: very high (200-10000mm3)
Lymphocytes: normal (<5)
Protein: raised (0,5-2 g/L)
Glucose: low (<1/3 blood glucose)

Question 5

Viral meningitis CSF findings (5)

Answer 5

Appearance: clear or turbid
Neutrophils: none (normal)
Lymphocytes high (10-100 /mm3)
Protein slightly elevated (0.4-0.8 g/L)
Glucose low (<1/2 blood glucose)

Question 6

TB meningitis CSF findings (5)

Answer 6

Appearance: turbid/viscous
Neutrophils: normal or high (0-200 /mm3)
Lymphocytes: very high (100-300)
Protein: elevated (0.5-3.0 g/L)
Glucose: very low (<1/3 blood glucose)

Question 7

Empiric Treatment bacterial meningitis

Answer 7

Ceftriaxone 2g iv bd

Question 8

Treatment cryptococcal meningitis

Answer 8

Amphotericin B IVI X2 weeks and add fluconazole oral high dose x 8 weeks then low dose maintenance lifelong