Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Infections of Nervous System > Flashcards

Infections of Nervous System Flashcards

1
Q

what may untreated CNS infection cause?

A

brain herniation and death

cord compression and necrosis with subsequent permanent paralysis

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

what is bacterial meningitis?

A

infection of brain meninges

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

what are the two types of meningitis?

A

acute pyogenic (bacterial) meningitis

acute aseptic (viral) meningitis

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

what causes meningitis in neonates?

A

listeria
group B strep
E. coli

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

what causes meningitis in children?

A

H influenzae

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

what causes meningitis in ages 10-21?

A

neisseria meningitidis

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

what causes meningitis in ages >21?

A

strep pneumoniae > neisseria meningitidis

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

what causes meningitis in ages >65?

A

strep pneumoniae > listeria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what causes meningitis in those with decreased cell mediated immunity?

A

listeria monocytogenes

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

what causes meningitis in those with head trauma / post neurosurgery?

A

staphylococcus

gram negative bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what causes meningitis in those with fracture of cribiform plate?

A

strep pneumoniae

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

what causes meningitis in those with CSF shunt?

A

staph epidermis
staph aureus
aerobic GNR
propionibacterium acnes

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

what is the three main ways bacterial meningitis can colonise?

A

nasopharyngeal colonisation

direct extension of bacteria (from parameningeal foci or across skull defects)

from remote foci of infection (endocarditis etc)

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

what is the pathology of bacterial meningitis?

A

thick layer of suppurative exudate which covers leptomeninges over surface of brain

also exudate in basal and convexity surface

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

what is present in subarachnoid space in bacterial meningitis?

A

neutrophils

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

what are the symptoms of bacterial meningitis?

A 
fever 
neck stiffness 
change in mental state 
headache 
rash 
papilloedema (3%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is gold standard for diagnosis of meningitis?

A

lumbar puncture - send 4 tubes away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

in what cases would you give a CT before lumbar puncture?

A 
immunocompromised 
history of CNS disease
new onset seizure 
papilloedema (raised ICP)
altered level of consciousness 
focal neurological deficit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what additional investigations may you carry out in suspected bacterial meningitis?

A

blood cultures
FBC + coagulation screening
swab rash
throat swab = meningococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is given as empirical treatment before lumbar puncture in bacterial meningitis?

A

10 days of ceftriaxone IV 2g bd and dexamethasone IV 10mg

penicillin allergic = chloramphenicol IV 25mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the treatment once meningococcus (neisseria meningitidis) confirmed?

A

ceftriaxone (5-7 days)

stop dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is given when pneumococcus confirmed?

A

ceftriaxone (10-14 days)

4 days dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is given if listeria suspected (if >60 or immunocompromised)?

A

amoxicillin IV 2g hourly
stop dexamethasone

allergic = co-trimoxazole IV 120mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is given when H influenzae confirmed?

A

10 days ceftriaxone

stop dexamethosone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what do you add to treatment if patient has recently travelled to places with penicillin resistant pneumococcal?

A

vancomycin IV or rifampicin IV / PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

when would a hospital admission be required for bacterial meningitis?

A

signs of meningeal irritation

impaired conscious level

petechial rash

febrile or unwell and have had a recent fit

any illness (especially headache) and are close contacts of patients with meningococcal infection, even if they have received a prophylactic antibiotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what measures can be taken to try and prevent secondary cases of bacterial meningitis?

A

telephone reporting to public health

GPs informed to locate close contacts to implement chemoprophylaxis and vaccination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the 3 options which can be given as contact prophylaxis of bacterial meningitis?

A

rifampicin PO 12-hourly for four doses (adults and children >12 years)

ciprofloxacin PO single dose for adults and children >12 years

ceftriaxone IM single dose in adults, IV single dose in children under 12 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are side effects of rifampicin?

A

reduced efficacy of oral contraceptives

red colouration of urine

staining of contact lenses

30
Q

what are the complications of bacterial meningitis?

A

purulence
invasion
cerebral oedema
ventriculitis / hydrocephalus

31
Q

where does purulence occur when it is a complication of bacterial meningitis?

A

clusters at base of brain

convexities of rolandic and sylvian sulci

exudate around cranial nerves (esp III and VI)

32
Q

how does invasion occur when it is complication of bacterial meningitis?

A

pia prevents meningitis becoming abscess

abscesses can cause secondary ventriculitis and hence meningitis

33
Q

where is neisseria meningitidis usually found in healthy carriers?

A

throat

34
Q

how does neisseria meningitidis probably gain access to the meninges?

A

blood stream

35
Q

are the symptoms of neisseria meningitidis are usually due to exotoxin or endotoxin?

A

endotoxin

36
Q

who does neisseria meningitidis most often cause disease in?

A

young children

37
Q

to prevent epidemics of neisseria meningitidis in training camps, military recruits are vaccinated with what?

A

purified capsular polysaccharide

38
Q

as well as meningitis, what else can meningococcal infection cause?

A

local - conjunctivitis, arthritis

meningitis with septicaemia

fulminant septicaemia

39
Q

where is H influenzae normally found?

A

throat

40
Q

what type of H influenzae is most common cause of meningitis in children under 4?

A

type b

41
Q

where is strep pneumoniae commonly found?

A

throat

42
Q

who is most susceptible to pneumococcal meningitis?

A

hospitalised patients
patients with CSF skull fractures
diabetics / alcoholics
young children

43
Q

there is some evidence that pneumococcal meningitis is related to CNS devices such as what?

A

cochlear implants

44
Q

does the conjugate vaccine for pneumococcal pneumonia also protect against pneumococcal meningitis in children?

A

yes

45
Q

who does listeria monocytogenes meningitis usually occur in?

A

neonates
>55
immunosuppressed especially malignancy

46
Q

what type of bacteria is listeria monocytogenes?

A

gram positive bacilli

47
Q

what vaccination is available for neisseria meningitidis?

A

serogroups A and C (W135 and Y)

commonly used in travel vaccination

48
Q

what vaccination is available for haemophilus influenzae meningitis?

A

HiB vaccine

49
Q

what vaccination is available for streptococcus pneumoniae meningitis?

A

pneumococcal vaccines (polysaccharide and conjugate)

50
Q

what is more common - bacterial or viral meningitis?

A

viral

51
Q

when does viral meningitis most commonly occur?

A

late summer / autumn

52
Q

what causes viral meningitis?

A

enteroviruses eg ECHO

other microbes and non-infectious causes

53
Q

how is viral meningitis diagnosed?

A

viral stool culture
throat swab
CSF PCR

54
Q

how is viral meningitis treated?

A

supportive - self limiting

55
Q

what is aseptic meningitis?

A

this is a term used to mean non-pyogenic bacterial meningitis

56
Q

what is the characteristics of the spinal fluid in aseptic meningitis?

A

low WBC
elevated protein
normal glucose

57
Q

what causes aseptic meningitis?

A 
infection 
carcinomatous 
sarcoidosis 
vasculitis 
dural venous sinus thrombosis 
migraine 
drugs - co-trimox, IVIG, NSAIDs
58
Q

what infection must you not forget is a cause of aseptic meningitis?

A

HSV

59
Q

what is encephalitis?

A

infection of brain parenchyma

60
Q

what are the symptoms of encephalitis?

A 
insidious onset
meningismus 
stupor, coma 
seizures, partial paralysis
confusion, psychosis 
speech, memory symptoms
focal or diffuse neurological signs
61
Q

what is most common virus which causes encephalitis?

A

HSV

62
Q

how is encephalitis diagnosed?

A

lumbar puncture
EEG
MRI

63
Q

how do you treat encephalitis?

A

pre-emptive acyclovir

64
Q

what is tuberculosis meningitis?

A

meningitis caused by M tuberculosis

65
Q

who does tuberculosis meningitis usually affect?

A

elderly as reactivation

66
Q

what are symptoms and investigation results in tuberculosis meningitis?

A

often non-specific ill health
previous TB on CXR
poor yield from CSF

67
Q

what is treatment of tuberculosis meningitis?

A

isoniazid + rifampicin key

add pyrazinamide + ethambutol

68
Q

what is cryptococcal meningitis and who does it usually occur in?

A

fungal type of meningitis which usually occurs in those with HIV

69
Q

what is the CD4+ value in cryptococcal meningitis?

A

<100

70
Q

what are the symptoms of cryptococcal meningitis?

A

subtle neurological presentation

disseminated infection symptoms

71
Q

what investigations should take place in cryptococcal meningitis?

A

CSF - aseptic

serum and CSF cryptococcal antigen

72
Q

what is treatment for cryptococcal meningitis?

A

IV amphotericin B + flucytosine for 2 weeks

add fluconazole PO for 8 weeks

Neurology (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions