Infections Of CNS Flashcards

1
Q

Main causes of bacterial meningitis

A

Neisseria meningitis
S pneumoniae
Situational

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2
Q

Pathogenesis of bacterial meningitis

A

Mucus membrane colonization
local tissue invasion
Bacteremia into subarachnoid space or direct invasion through para nasal sinuses/middle ear
Inflammation IL6 , TNF
Vasogenic edema

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3
Q

Bacterial meningitis symptoms

A

Fever
Confusion
Vomiting
Headache
Stiff neck
Photophobia
Irritability

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4
Q

Signs of bacterial meningitis

A

Kernings sign (Resistance or pain and the inability to extend the patient’s knee beyond 135 degrees, because of pain, bilaterally )

Brudzinski sign (involuntary flexing of hips and knees when flexing the neck )

Focal neurologic signs
Seizures
Cranial nerve palsies
Systemic or para meningeal infection evidence
Rash

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5
Q

Lumbar puncture findings in bacterial meningitis

A

Cloudy / turbid
High neutrophils
No red cells
High protein
Low glucose

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6
Q

Treatment bacterial meningitis

A

Iv ceftriaxone
Steroids

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7
Q

Prevention of bacterial meningitis

A

Immunization
Epidemics
Rifampicin to people in contact with positive cases

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8
Q

Chronic meningitis symptoms

A

Chronic headache
Neck/ back pain
Personality change
Facial weakness
Double vision
Visual loss
Hearing loss
Arm/ leg weakness
Arm/ leg numbness
Sphincter dysfunction
Clumsiness

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9
Q

Signs of chronic meningitis

A

Papilledema
Brundzinski / kernings sign
Altered mental status
CNVII palsy
CN III , IV , VI palsy
CNVIII palsy
Papilledema
Optic atrophy
Myelopathy / radiculopathy
Ataxia

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10
Q

viruses in viral meningitis from most common to less common

A

Enteroviruses
Arboviruses
HIV
HSV -2

HSV - 1
LCMV
Mumps

Adenovirus
CMV
EBV
Influenza

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11
Q

Main brain dx caused by viral infection

A

Meningitis
Encephalitis
Meningoencephalitis

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12
Q

Viruses implicated in infections

A

Herpes
Polio
Measles
Rabies
Viral encephalitis
Corona viruses

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13
Q

Herpes simplex percentage in viral encephalitis

A

10-20% sporadic viral encephalitis

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14
Q

Main presentation of herpes encephalitis

A

Fever
Transverse myelitis
Guillain barre syndrome
Focal signs

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15
Q

Diagnosis of herpes

A

HSV antigen
PCR of CSF

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16
Q

Treatment of herpes

A

IV acyclovir in mortality

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17
Q

Characteristics of HSV meningitis

A

Mild
Self limiting
CSF lymphocytosis

18
Q

Characteristics of autoimmune dysfunction in herpes

A

Sacral region affected
Numbness
Tingling
Constipation
Urine retention

19
Q

Types of bacterial infections of CNS

A

Meningitis
Suppurative encephalitis
Brain abscess
Epidural abscess
Tuberculosis
Neuro syphilis
Leprosy
Diphtheria
Tetanus

20
Q

Types of Viral infection of CNS

A

Meningitis
Encephalitis
Transverse myelitis
Progressive multi focal leucoencephalopathy
Poliomyelitis
Subacute sclerosing panencephalitis
Rabies ´hiv

21
Q

Organism causing Prion disease

A

Creutzfeldt-jakob dx
Kuru

22
Q

Organism causing protozoal infections

A

Malaria
toxoplasmosis
Trypanosomiasis
Amoebic abscess

23
Q

Organisms causing helminthic infections of CNS

A

Schistosomiasis spinal cord
Cysticercosis
Hydatid dx
Strongyloidasis

24
Q

Organisms causing fungal infections of CNS

A

Candida meningitis
Cryptococcal meningitis

25
What is meningitis
Acute infection of meninges with pyrexia , headache and meningism
26
What is meningism
Headache Photophobia Neck stiffness - kernig sign, brundzinski sign
27
Other disease where you can see meningism even though it’s not meningitis
SAH
28
Most common cause of meningitis
Virusee
29
Prognosis of viral meningitis
Very good as they are self limiting and do not require therapy
30
Main virus causing viral meningitis
Enterovirus
31
Main population at risk of viral meningitis
Children and young
32
Clinical features of viral meningitis
Acute onset of headache and irritability meningism
33
Investigation viral meningitis
Lumbar puncture - excess lymphocytes , glucose and protein level normal
34
Treatment of viral meningitis
No specific treatment because benign and self-limiting
35
Most common organism responsible for neonatal bacterial meningitis
Gram-negative bacilli E. coli, proteus Group B streptococci
36
Most common Organism responsible for bacterial meningitis in preschool child
Haemophilus influenza Neisseria meningitidis Strep pneumoniae
37
Most common organism responsible for bacterial meningitis in older child and adult
N meningitidis Strep pneumoniae
38
Clinical features bacterial meningitis
Headache Drowsiness Fever Neck stiffness Altered consciousness Rash
39
Investigations in bacterial meningitis
Lumbar puncture (Ct scan to exclude mass lesion )
40
Mortality rate in untreated bacterial meningitis
80%
41
Treatment of bacterial meningitis
Benzoyl penicillin Hospital admission