Infections of the cns Flashcards
what is meningitis
inflamation of the meninges
what is encephalitis
inflamation of the brain substance
what is myelitis
inflamation of the spinal cord
triad of menigitis
fever, neck stifness, altered mental state
symptooms of meningitis
fever
meningism - neck stifness, photophobia, nausea and vommmiting
what is the gcs often in menifnitis
less thgan 14
what is the type of rash in meningitis
petechgial skin rahs
test for menigits rash
tumblers test
commonest cuases of meningitis bacteria
neisseria meningitidis
streptococcus pneumoniea
how does encephlaitis look like in the beginin
like a flu like illess for 4- 10 dyas
what is the sympoms of encephalsits
headache, fever
cerebral dysfuction including confusion, abnormal behaviour, memory disturbance, depressed conscious level
seizures
focal symptons/ signs
what is autoimune encephaliists types
anti vgkc (voltage gated potassium channels) and anti nmda receptor
what is the frequect presnsiton of autoimmune encephalitis anti vgkc
seizures, ammesia anterograde, altered mental state
what are the features of antimdna recport enecephalgis
flue like prodome
psychicatic feautes
altered memntal state
seizures
movement disorder
coma
what to do for investigatins in mengingitis
blood cultures
lumbar punctures
often immating is not required
what is the investigation of encephaltisi
blood cultures
imagaing - ct and mri
lumbar pucnture
eeg
differne in main type of cell seen in viral and bactrail memningits
viral minly lymphocytes, bacterial mainly neutorphils
how to test for herpes simplex encephalits
pcr of csf fluid
what is the treatment for heperes simplex encephlis
aciclovir
when should you start htreatemetn for brain infections
straight away on clincial suspicsion, do not wait for tests to return
first treatemtnet for suspected bacteiral memnigtis
iv ceftiaxone
where is type 1 and type 2 herpes mainly found
type 1 - cold sores
type 2 and type 1 - gentila
when does encephaltis occur after hsv
as a later post latent infection
what type of hsv caues encepalitis
type 1
where does the hsv lay reminatn
in the trigermial or sacal gangilon
how are nterovirus spread
by feacal oral route
sub brances of enterovirus
poliovirus, coxsakieveirus, echovirus
what is an arbovirus encephalitsi
a virus that is taken to a human by a vector such as a tick, or mosquito
what to ask abouot in arbovrius
travell
what is a brain abces
pus in the brain
clinical features of a brain abcess
fever, headache, seizures, dyphagia and hemiparesis
sings of incrased intrcial pressure
false localising sings
depressed level of concious
papilloedema
causes of brain abcess
penetraing head injry
spred from another infection site such as a dentla infection
blood born infection
neurological procedular
how to dianosi brian abcess
ct/mri
invesigate source
blood cultures
biopsy
brain abcess most common type of organism
lots
most common - streptococci
- strep angiosus, strep intermediu, strep constellauts
management of brain abcess
surgical drainage
penicllin or ceftriaxone
metrodiazole for anaerobes
cultrures
what cna hiv cuaes in the rbian
cerebral toxoplasmosisi
aseptic meningits
encephalis
primary cerebal lymphoma
cerebral abcess
cryptocollal menigits
dementia
leucoencephalopy
diagnosis for hiv brian conditoins
cyrptocall antigen
cmv pcr
hiv pcr
cmv pcr
what type of spirochate is lyme disease
borrelia burgdoferi
what type of spirocheates is syphillis and leptospiroslsi
trepomena pallidum - syphills
leptospinarosi - leptrospinara interrograns
how is lyme disase spread
via ticks
what systems does lyme diseease effect
skin, rhematologica, nuerolgoica, cardiac and opthalamogical
stadge 1 of lyme disease
locilized infection
rash at site of tick
flu like symponts - fatigue, myalgia, arthralgia, headahce, fever, chills, neck stiffness
when does stage 2 of lyme disease occur
weeks to months
what is seen ins stage 2 of lyme disease
spreds through blood or lympahtics
msuclskesl and nruolgica inflvemet
leads to
mononeruopahy
mononeurotisi
painful radiculopnary
crail neruopaty
myeltisi
meningo cephaltis
what is seen in stage 3 lyme disease
musclo skelsta and neurologic invovels
, subacute encephalopay
encephalomyeleits
when dose stage 3 of lyme disease cocur
after months to year
and after a period of latency
investigation for lyme disease
serologicl tesing
csf lymphocytois
mri brian
nerve condtin sudyts
treatment for lyme disease
oral doscyclyine
what are the tests for neurosycs
trepome and non trepomeal speicci antibody test
treatmetn for neruosyspsh
high dose penicillin
what type of virus is poli
enteeroveirus - meaing spread through fecal oral route
what happens in the majortiy and minor of polio infection
majory are asymptomatic
minority cause anteriro horn cell of lower motor neurons and lead to flaccid para
why was poloi vaccine switch from oral to injection route
as it was possible to get polio from oral route
and indigeos poli was irradiated
it also iclcued other antigens
how does rabies virus spread to the body
from peripharl nerves to central nerves
diagnoss of rabies
pcr and serolgy
where is rabies mainly form in the uk
bats
who gets immunisationform rabies
bat handles, reguarl handler of importna animals
people who trale form enzootic areas
how to treat rabies after possible exposure
wash wound
give active rabeis immusion
give human rabies immunoglobing
what infection cuaes teatun
clostidium tetani
how does tetatuns bactiea cuase tatis
it produes sport and work on neruomuslar juciotn which inhibit the transition of neruons
how to prevent tetanus
immunisation
give combied with antige
give penicli and immoglob for high risk paietisn
who mainly gets botlusim
ivdu
what is botulim taype of bactier
clostriduim botlinum
how does botulism work
binds to presynaptic memarne of perpial neruomasal and auntomic nerves junctions, this is irreversible
presenation of botulism
flaccid parayliss
pure motor
respirator failure
autonomic dyficion
diagnosis for botulism
nerve conduction studies
mouse neutralistion bioassys for toxins in blood
culture for debried wound
treatment for botulism
anti toxin, penicllin, radical wound debridment
what is prion disease
a disea spread via bactier and have misforled protiens
types of prion disease
sporraidc, new varient, familar , aqueired
what is the clical freautes of sporadic cjd
dementia
myoclonus
cerebellar ataxia
extraparymai - treamor rigigid, bradykinsae, dystonia
prymal , ewakens, spacisy, higper relex
sezireus
what is new varie cjd associed with
bovine spongifor encepahtliss
how to invest cjd
mri - for pulvinar sign
eeg -
csf - for rasie dproien
passive vs avtice immuination
avtie is logner lasting
active is though vaccivenatio
passive is though inntoration of antiboidsse
