Infections Flashcards

1
Q

CNS infections are medical emergencies. True/False?

A

True

Brain and spinal cord do not regenerate once injured

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

List the main differential diagnoses for CNS infections causing fever and/or altered mental state

A
Meningitis
Encephalitis
Meningoencephalitis
Encephalomyelitis
Severe sepsis syndrome
Abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is the typical onset of viral meningitis?

A

Late summer/autumn

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

Which viruses are typically responsible for viral meningitis?

A

Enteroviruses most common e.g. ECHO

HSV and other microbes also

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

List investigations/diagnostic tools for viral meningitis

A

Viral stool culture
Throat swab
Lumbar puncture for CSF PCR

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

Outline treatment for viral meningitis

A

Supportive - paracetamol, fluids, rest, dark room

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

Which part of the brain does viral encephalitis affect?

A

Infection of brain parenchyma

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

List the main causes of viral encephalitis

A
Herpes simplex
Varicella zoster
CMV, HIV, measles
Travel-viruses
Rabies
Non-infectious (autoimmune)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which viruses are the only treatable causes of viral encephalitis?

A

HSV

Varicella zoster

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

List clinical features of viral encephalitis

A
Meningismus (rigidity, photophobia, headache)
Comatose
Seizures
Paralysis
Confusion, psychosis
Speech and memory deficit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List investigations for viral encephalitis

A

Lumbar puncture
Electroencephalography (EEG)
MRI

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

What is the main treatment for viral encephalitis?

A

IV aciclovir

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

List the main causes of bacterial meningitis in neonates

A

Listeria monocytogenes
Group B Strep.
E. coli

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

Which antibiotic combats Listeria monocytogenes?

A

Ampicillin/amoxicillin

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

Which organism is the main causes of bacterial meningitis in children?

A

H. influenzae

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

Which organism is the main cause of bacterial meningitis in 10-21 year olds?

A

Neisseria meningitides from the throats of healthy carriers

17
Q

List the main causes of bacterial meningitis in adults

A

Strep. pneumoniae

Neisseria meningitides

18
Q

A fracture of the cribriform plate increases the risk of which bacterial meningitis?

A

Pneumococcal (Strep. pneumoniae)

19
Q

List the main causes of bacterial meningitis in the immunocompromised

A
Strep. pneumonia
Neisseria meningitides
Staph aureus
Listeria
Aerobic Gram -ves
Mycobacterium
Cryptococcus neoformans
20
Q

List clinical features of bacterial meningitis

A
Meningismus
Vomiting
Pyrexia
Stiffness
Confusion
Rash
21
Q

Signs of bacterial meningitis are often absent in the very young, very old and immunocompromised. True/False?

A

True

22
Q

List investigations for bacterial meningitis

A

Blood cultures
Throat swab (meningococci)
Lumbar puncture for CSF

23
Q

CSF must be interpreted in 5 tubes - list them and their contents

A

1: haematology- cell count, differential
2: microbiology- gram stain, cultures
3: biochemistry- glucose, protein
4: haematology- cell count, differential
5: PCR if necessary

24
Q

A low ratio of blood sugar : CSF sugar is indicative of bacterial meningitis. True/False?

A

True

25
Q

What is aseptic meningitis?

A

Non-pyogenic bacterial meningitis: low WBC count, normal glucose, small elevated protein

26
Q

List indications for hospital admission for bacterial meningitis

A

Altered consciousness
Petechial rash
Febrile, headache

27
Q

Which antibiotics are given for bacterial meningitis pre-hospital?

A

Penicillin

Ceftriaxone

28
Q

A CT scan should delay treatment in bacterial meningitis. True/False?

A

False

An urgent CT scan should be requested but does not delay treatment

29
Q

Why are steroids given to all patients suspected of bacterial meningitis?

A

Dampen down cerebral swelling caused by antibiotic treatment

30
Q

If a patient is penicillin-allergic, what antibiotic is given for bacterial meningitis?

A

Chloramphenicol