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CNS > Infections of the cns > Flashcards

Infections of the cns Flashcards

1
Q

what is meningitis

A

inflamation of the meninges

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2
Q

what is encephalitis

A

inflamation of the brain substance

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3
Q

what is myelitis

A

inflamation of the spinal cord

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4
Q

triad of menigitis

A

fever, neck stifness, altered mental state

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5
Q

symptooms of meningitis

A

fever
meningism - neck stifness, photophobia, nausea and vommmiting

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6
Q

what is the gcs often in menifnitis

A

less thgan 14

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7
Q

what is the type of rash in meningitis

A

petechgial skin rahs

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8
Q

test for menigits rash

A

tumblers test

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9
Q

commonest cuases of meningitis bacteria

A

neisseria meningitidis
streptococcus pneumoniea

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10
Q

how does encephlaitis look like in the beginin

A

like a flu like illess for 4- 10 dyas

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11
Q

what is the sympoms of encephalsits

A

headache, fever
cerebral dysfuction including confusion, abnormal behaviour, memory disturbance, depressed conscious level
seizures
focal symptons/ signs

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12
Q

what is autoimune encephaliists types

A

anti vgkc (voltage gated potassium channels) and anti nmda receptor

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13
Q

what is the frequect presnsiton of autoimmune encephalitis anti vgkc

A

seizures, ammesia anterograde, altered mental state

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14
Q

what are the features of antimdna recport enecephalgis

A

flue like prodome
psychicatic feautes
altered memntal state
seizures
movement disorder
coma

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15
Q

what to do for investigatins in mengingitis

A

blood cultures
lumbar punctures
often immating is not required

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16
Q

what is the investigation of encephaltisi

A

blood cultures
imagaing - ct and mri
lumbar pucnture
eeg

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17
Q

differne in main type of cell seen in viral and bactrail memningits

A

viral minly lymphocytes, bacterial mainly neutorphils

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18
Q

how to test for herpes simplex encephalits

A

pcr of csf fluid

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19
Q

what is the treatment for heperes simplex encephlis

A

aciclovir

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20
Q

when should you start htreatemetn for brain infections

A

straight away on clincial suspicsion, do not wait for tests to return

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21
Q

first treatemtnet for suspected bacteiral memnigtis

A

iv ceftiaxone

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22
Q

where is type 1 and type 2 herpes mainly found

A

type 1 - cold sores
type 2 and type 1 - gentila

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23
Q

when does encephaltis occur after hsv

A

as a later post latent infection

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24
Q

what type of hsv caues encepalitis

A

type 1

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25
Q

where does the hsv lay reminatn

A

in the trigermial or sacal gangilon

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26
Q

how are nterovirus spread

A

by feacal oral route

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27
Q

sub brances of enterovirus

A

poliovirus, coxsakieveirus, echovirus

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28
Q

what is an arbovirus encephalitsi

A

a virus that is taken to a human by a vector such as a tick, or mosquito

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29
Q

what to ask abouot in arbovrius

A

travell

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30
Q

what is a brain abces

A

pus in the brain

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31
Q

clinical features of a brain abcess

A

fever, headache, seizures, dyphagia and hemiparesis

32
Q

sings of incrased intrcial pressure

A

false localising sings
depressed level of concious
papilloedema

33
Q

causes of brain abcess

A

penetraing head injry
spred from another infection site such as a dentla infection
blood born infection
neurological procedular

34
Q

how to dianosi brian abcess

A

ct/mri
invesigate source
blood cultures
biopsy

35
Q

brain abcess most common type of organism

A

lots
most common - streptococci
- strep angiosus, strep intermediu, strep constellauts

36
Q

management of brain abcess

A

surgical drainage
penicllin or ceftriaxone
metrodiazole for anaerobes
cultrures

37
Q

what cna hiv cuaes in the rbian

A

cerebral toxoplasmosisi
aseptic meningits
encephalis
primary cerebal lymphoma
cerebral abcess
cryptocollal menigits
dementia
leucoencephalopy

38
Q

diagnosis for hiv brian conditoins

A

cyrptocall antigen
cmv pcr
hiv pcr
cmv pcr

39
Q

what type of spirochate is lyme disease

A

borrelia burgdoferi

40
Q

what type of spirocheates is syphillis and leptospiroslsi

A

trepomena pallidum - syphills
leptospinarosi - leptrospinara interrograns

41
Q

how is lyme disase spread

A

via ticks

42
Q

what systems does lyme diseease effect

A

skin, rhematologica, nuerolgoica, cardiac and opthalamogical

43
Q

stadge 1 of lyme disease

A

locilized infection
rash at site of tick
flu like symponts - fatigue, myalgia, arthralgia, headahce, fever, chills, neck stiffness

44
Q

when does stage 2 of lyme disease occur

A

weeks to months

45
Q

what is seen ins stage 2 of lyme disease

A

spreds through blood or lympahtics
msuclskesl and nruolgica inflvemet
leads to
mononeruopahy
mononeurotisi
painful radiculopnary
crail neruopaty
myeltisi
meningo cephaltis

46
Q

what is seen in stage 3 lyme disease

A

musclo skelsta and neurologic invovels
, subacute encephalopay
encephalomyeleits

47
Q

when dose stage 3 of lyme disease cocur

A

after months to year
and after a period of latency

48
Q

investigation for lyme disease

A

serologicl tesing
csf lymphocytois
mri brian
nerve condtin sudyts

49
Q

treatment for lyme disease

A

oral doscyclyine

50
Q

what are the tests for neurosycs

A

trepome and non trepomeal speicci antibody test

51
Q

treatmetn for neruosyspsh

A

high dose penicillin

52
Q

what type of virus is poli

A

enteeroveirus - meaing spread through fecal oral route

53
Q

what happens in the majortiy and minor of polio infection

A

majory are asymptomatic
minority cause anteriro horn cell of lower motor neurons and lead to flaccid para

54
Q

why was poloi vaccine switch from oral to injection route

A

as it was possible to get polio from oral route
and indigeos poli was irradiated
it also iclcued other antigens

55
Q

how does rabies virus spread to the body

A

from peripharl nerves to central nerves

56
Q

diagnoss of rabies

A

pcr and serolgy

57
Q

where is rabies mainly form in the uk

A

bats

58
Q

who gets immunisationform rabies

A

bat handles, reguarl handler of importna animals
people who trale form enzootic areas

59
Q

how to treat rabies after possible exposure

A

wash wound
give active rabeis immusion
give human rabies immunoglobing

60
Q

what infection cuaes teatun

A

clostidium tetani

61
Q

how does tetatuns bactiea cuase tatis

A

it produes sport and work on neruomuslar juciotn which inhibit the transition of neruons

62
Q

how to prevent tetanus

A

immunisation
give combied with antige
give penicli and immoglob for high risk paietisn

63
Q

who mainly gets botlusim

A

ivdu

64
Q

what is botulim taype of bactier

A

clostriduim botlinum

65
Q

how does botulism work

A

binds to presynaptic memarne of perpial neruomasal and auntomic nerves junctions, this is irreversible

66
Q

presenation of botulism

A

flaccid parayliss
pure motor
respirator failure
autonomic dyficion

67
Q

diagnosis for botulism

A

nerve conduction studies
mouse neutralistion bioassys for toxins in blood
culture for debried wound

68
Q

treatment for botulism

A

anti toxin, penicllin, radical wound debridment

69
Q

what is prion disease

A

a disea spread via bactier and have misforled protiens

70
Q

types of prion disease

A

sporraidc, new varient, familar , aqueired

71
Q

what is the clical freautes of sporadic cjd

A

dementia
myoclonus
cerebellar ataxia
extraparymai - treamor rigigid, bradykinsae, dystonia
prymal , ewakens, spacisy, higper relex
sezireus

72
Q

what is new varie cjd associed with

A

bovine spongifor encepahtliss

73
Q

how to invest cjd

A

mri - for pulvinar sign
eeg -
csf - for rasie dproien

74
Q

passive vs avtice immuination

A

avtie is logner lasting
active is though vaccivenatio
passive is though inntoration of antiboidsse

75
Q
A

CNS (36 decks)

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