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10 - Neuro Clinicals > Infections Of CNS > Flashcards

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
Q

What is meningitis

A

Acute infection of meninges with pyrexia , headache and meningism

26
Q

What is meningism

A

Headache
Photophobia
Neck stiffness - kernig sign, brundzinski sign

27
Q

Other disease where you can see meningism even though it’s not meningitis

A

SAH

28
Q

Most common cause of meningitis

A

Virusee

29
Q

Prognosis of viral meningitis

A

Very good as they are self limiting and do not require therapy

30
Q

Main virus causing viral meningitis

A

Enterovirus

31
Q

Main population at risk of viral meningitis

A

Children and young

32
Q

Clinical features of viral meningitis

A

Acute onset of headache and irritability
meningism

33
Q

Investigation viral meningitis

A

Lumbar puncture - excess lymphocytes , glucose and protein level normal

34
Q

Treatment of viral meningitis

A

No specific treatment because benign and self-limiting

35
Q

Most common organism responsible for neonatal bacterial meningitis

A

Gram-negative bacilli E. coli, proteus
Group B streptococci

36
Q

Most common Organism responsible for bacterial meningitis in preschool child

A

Haemophilus influenza
Neisseria meningitidis
Strep pneumoniae

37
Q

Most common organism responsible for bacterial meningitis in older child and adult

A

N meningitidis
Strep pneumoniae

38
Q

Clinical features bacterial meningitis

A

Headache
Drowsiness
Fever
Neck stiffness
Altered consciousness
Rash

39
Q

Investigations in bacterial meningitis

A

Lumbar puncture (Ct scan to exclude mass lesion )

40
Q

Mortality rate in untreated bacterial meningitis

A

80%

41
Q

Treatment of bacterial meningitis

A

Benzoyl penicillin
Hospital admission

10 - Neuro Clinicals (6 decks)

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