Brainscape's Knowledge GenomeTM

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


See full index

Year 2- CNS > Infections of the Nervous System > Flashcards

Infections of the Nervous System Flashcards

1
Q

Meningitis?

A

Inflammation of meninges

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

Encephalitis?

A

Inflammation/infection of brain substance

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

Myelitis?

A

Inflammation/infection of spina cord

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

What is the classical triad of symptoms for meningitis?

A

Fever, neck stiffness, altered mental state

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

Meningtism?

A

Clinical syndrome of neck stiffness, photophobia, nausea and vomiting

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

The conscious state can be measured using the Glasgow Coma Scale.
In those with meningitis, what is the GCS usually?

A

<14

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

What else can occur in those with meningitis?

A

Cranial nerve palsies
Seizures
Focal neurological deficits

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

What is a hallmark of meningococcal meningitis?

A

Non-blanching skin rash

->may occur in viral meningitis so not completely specific to bacterial

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

Name three causes of infective meningitis.

A

Bacteria
Virus
Fungus

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

Name a cause of inflammatory meningitis.

A

Sarcoidosis

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

Name a cause of drug induced meningitis.

A

NSAIDs
IVIG

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

What are some malignant causes of meningitis?

A

Metastasis

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

Name the two bacterial which can cause bacterial meningitis.

A

Neisseria meningitidis
Streptococcus pneumoniae

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

What are the viral causes of meningitis?

A

Enteroviruses

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

What usually occurs 4-10 days before neurological features of encephalitis start to occur?

A

Flu-like illness

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

In encephalitis, which symptoms occur after the flu-like illness?

A

Progressive headache
Fever
Progressive cerebral dysfunction
Seizures
Focal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List some of the aspects of the altered cerebral dysfunction seen in those with encephalitis.

A

Confusion
Abnormal behaviour
Memory disturbance
Depressed conscious level

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

Which has a slower onset; meningitis or encephalitis?

A

Encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the infective cause of encephalitis?

A

Viral, most commonly HSV (herpes simplex virus).

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

What are some inflammatory causes of encepalitis?

A

Limbic encephalitis
ADEM

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

What are some of the metabolic causes of encephalitis?

A

Hepatic cause
Uraemic cause
Hyperglycaemic cause

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

What are some malignant causes of encephalitis?

A

Metastatic
Parneoplastic

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

What other issue can present like encephalitis?

A

Migraine

-> patient is less unwell though and the migraine will usually resolve by itself.

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

Name the two types of auto-immune encephalitis.

A

Anti-VGKC (voltage gated potassium channel)
Anti-NDMA receptor

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

What would be seen in a patient with Anti-VGKC autoimmune encephalitis?

A

Frequent seizures
Amnesia
Altered mental state

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

What would be seen in a patient with Anti-NMDA receptor autoimmune encephalitis?

A

Flu like illness
Prominent psychiatric features
Altered mental state and seizures

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

What could Anti-NMDA receptor autoimmune encephalitis lead to?

A

Movement disorder and coma

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

Which investigations are required in meningitis?

A

Blood cultures
Lumbar puncture

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

Which investigations are required in encephalitis?

A

Blood cultures
Imaging (CT +/-MRI)
Lumbar puncture
EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why is imaging carried out before a lumbar puncture in encephalitis?

A

To ensure there is no contraindication for carrying out the lumbar puncture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What would be a contraindication to a lumber puncture?

A

Swelling/mass in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What would focal symptoms or signs suggest?

A

A focal brain mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What would a reduced conscious level suggest about ICP?

A

Raised intracranial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which circumstances would a CT scan be required before carrying out a lumbar puncture?

A

Seizures
Abnormal conscious state
Papilledema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

In the sample of CSF taken in a lumbar puncture, what would be the predominant type of cells found within it if the patient had bacterial meningitis?

A

Neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

In the sample of CSF taken in a lumbar puncture, what would be the predominant type of cells found within it if the patient had viral meningitis/encephalitis?

A

Mainly lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What would the glucose levels be like in a sample of CSF of a patient with bacterial meningitis?

A

Reduced glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What would the glucose levels be like in a sample of CSF of a patient with viral meningitis or encephalitis?

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What would the protein levels be like in a sample of CSF of a patient with bacterial meningitis?

A

High

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What would the protein levels be like in a sample of CSF of a patient with viral meningitis or encephalitis?

A

Slightly increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Why are neutrophils higher in bacterial infections?

A

Neutrophils fight bacterial infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Polymorths?

A

Neutrophils

->these can be used interchangeably

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Monocytes?

A

Lymphocytes

->these can be used interchangeably

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the most common cause of encephalitis in Europe?

A

Herpes Simplex Virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How is herpes simplex encephalitis diagnosed in a lab?

A

PCR of CSF

46
Q

What is the treatment for herpes simplex encephalitis?

A

Aciclovir

->if suspicious, prescribe this, it can be stopped if you get lab results confirming diagnosis of something else

47
Q

Herpes simplex is one of the herpes viruses. Name some others.

A

Varicella zoster virus
Epstein-Barr virus

48
Q

There is type one and two or herpes simplex virus. Which type do more people come into contact with?

A

Type 1 herpes simplex

49
Q

What can type 1 herpes simplex virus cause?

A

Cold sores

50
Q

Can herpes virus be treated?

A

No, lies latent in body for the rest of life

51
Q

What can type 2 herpes simplex cause?

A

Genital herpes

->can also be caused by type one but type two is more common

52
Q

Enteroviruses are a large family of RNA viruses which can cause CNS infections. How are they spread?

A

Faecal-oral route

53
Q

Give some examples of enteroviruses.

A

Poliovirus
Coxsachievirus
Echovirus

54
Q

How are arbovirus encephalititides, a cause of encephalitis, spread?

A

Transmitted to man by a vector e.g. mosquito or tick

55
Q

Which type of history is especially important in terms of arbovirus encephalitides?

A

Travel history

56
Q

What is a brain abscess?

A

A localised collection of pus within the brain

57
Q

What is a subdural empyema?

A

Thin layer of pus between the dura and arachnoid membranes over the surface of the brain

58
Q

What are the clinical features of a brain abscess/ subdural empyema?

A

Fever
Headache
Raised intracranial pressure
Meningism, especially in empyema

59
Q

What are some signs of raised intracranial pressure?

A

Papilloedema
Depressed conscious level

60
Q

What is the differential diagnosis for brain abscess and empyema?

A

Any focal lesion, commonly a tumour
Subdural haematoma

61
Q

What are some causes of a brain abscess/empyema?

A

Penetrating head injury
Spread from adjacent infection
Blood borne infection
Neurosurgical procedure

62
Q

What can be used for the diagnosis of brain abscess and empyema?

A

Imaging- CT or MRI
Blood cultures
Biopsy- drainage of pus

->MRI will be a lot better quality and give more information but CT usually initial investigation

63
Q

Brain abscesses can be polymicrobial, meaning there are many different microorganisms present in the pus sample.
Which microorganism is commonly found?

A

Streptococci- particularly penicillin-sensitive Strep.milleri group

64
Q

What is the management of a brain abscess?

A

Surgical drainage of pus if possible
Antibiotics to cover strep. bacteria

65
Q

Which antibiotics may be given?

A

Penicillin or ceftriaxone to cover strep. bacteria
Metronidazole for anaerobes

66
Q

Which antibiotic would be used the target organism is not known?

A

Ceftriaxone

67
Q

Which system does HIV affect?

A

Immune system

68
Q

Spirochaetes in the CNS can cause infection.
They are not seen on staining or bacterial cultures.
Give some examples of spirochaete caused conditions.

A

Lyme disease
Syphilis
Leptospiroisis

69
Q

Which species causes Lyme disease?

A

Borrelia burgdorferi

70
Q

Which species causes syphilis?

A

Treponema pallidum

71
Q

Which species causes laptospirosis?

A

Leptospira interrogans

72
Q

Ticks are the vectors for lyme disease. In which type of conditions are ticks more prominent?

A

Wooded areas

73
Q

There are three stages of Lyme’s disease. What happens in stage one?

A

-Target rash expanding from site of tick bite
-50% get flu like symptoms within the first week (fever, chills, headache, neck stiffness, fatigue).

74
Q

There are three stages of Lyme’s disease. What happens in stage two?

A

Spreads to affect other organ systems

75
Q

Which organ systems are most commonly affected by Lyme’s Disease?

A

Musculoskeletal and neurological

76
Q

In Lyme’s disease, if there is neurological involvement, is it more likely to be in the CNS or PNS?

A

PNS

77
Q

There are three stages of Lyme’s disease. What happens in stage three?

A

Chronic infection which can last years
Occurs after a period of latency
Again, musculoskeletal and neurological involvement most common

78
Q

List some of the potential neurological involvement in stage 2 of Lyme’s disease.

A

Mononeuropathy
Myelitis
Meningo-encephalitis
Cranial neuropathy

79
Q

What are the investigations used in the diagnosis of Lyme’s disease?

A

Complex serology
CSF lymphocytosis
MRI brain/spine if CNS involvement
Nerve conduction studies if PNS involvement

80
Q

What is the treatment for Lyme’s disease?

A

Prolonged antibiotic treatment -> oral doxycycline and IV ceftriaxone

81
Q

Neurosyphilis also has three stages of presentation.
How long does it take for the tertiary stage of the disease take to occur after the primary infection?

A

Years/decades

82
Q

What is the treatment for neurosyphilis?

A

High dose penicillin

83
Q

Which type of cells would be increased in CSF of someone with neurosyphilis?

A

Lymphocytes

84
Q

Polio is a virus which affects the CNS. What causes polio?

A

Polio virus type 1, 2 or 3.
All three types are nerteroviruses

85
Q

What is a rare complication of polio and why does it happen?

A

Paralytic disease can occur in <1% of those with polio as infects the anterior horn cells of LMN

86
Q

What are the symptoms for the majority of individuals with polio?

A

Asymptomatic in 99%

87
Q

What is rabies?

A

Acute infectious disease of the CNS affecting almost all mammals

88
Q

How is rabies transmitted?

A

By bite or salivary contamination of open lesion

89
Q

What are the initial signs of rabies?

A

Paraesthesia at site of original lesion

90
Q

What can rabies go on to cause?

A

Ascending paralysis
Encephalitis

91
Q

Which investigations are used for the diagnosis of rabies?

A

PCR and serology

92
Q

What are the most common sources of rabies virus?

A

Dogs in Africa/Asia
Bats in developed world

93
Q

What is the rabies post-exposure treatment?

A

Wash wound
Give active rabies immunisation
Give human rabies immunoglobulin immunisation if high risk

94
Q

Which microorganism causes tetanus?

A

Clostridium tetani

95
Q

Tetanus does not cause a wound but the microorganism releases a toxin. Where does this toxin act upon and what does it do?

A

Neuro-muscular junction- blocks inhibition of motor neurons.

96
Q

When the toxin blocks the inhibition of motor neurons, what can this cause?

A

Muscle rigidity and spasm

97
Q

What is used in the prevention of tetanus?

A

Immunisation
Given with other antigens e.g. DTaP

->penicillin and immunoglobulins given for high risk wounds/patients

98
Q

Botulism is a rare but serious illness causing breathing difficulty, muscle paralysis and even death.
Which microorganism causes it?

A

Clostridium botulinium

99
Q

What dos the neurotoxin do in botulism?

A

Binds irreversibly to presynaptic membranes of peripheral neuromuscular and autonomic nerve junctions.
This blocks the release of acetylcholine

100
Q

Where is Clostridium botulinum naturally present?

A

Soil, dust, aquatic environments

101
Q

Name the three modes of infection of botulism.

A

Infantile via intestinal colonisation
Food-borne
Wound, usually by injection in IVDU

102
Q

In Botulism, there is an initial incubation period for 14 days. Describe the clinical presentation after this incubation period.

A

Descending symmetrical flaccid paralysis
Resp. failure
Autonomic dysfunction, usually pupil dilation

103
Q

Which investigations can be used in the diagnosis of botulism?

A

Nerve conduction studies
Culture from debrided wound (dead tissue)

104
Q

What is the treatment of botulism?

A

Anti-toxin A, B, E
Prolonged treatment of penicillin/metronidazole
Radical wound debridement (process of removing dead tissue from a wound)

105
Q

Which type of microorganism causes Creutzfeldt-Jakob Disease?

A

Prions

106
Q

There are many different types of CJD. How does sporadic CJD present?

A

Early behavioural abnormalities
Rapidly progressive dementia
Myoclonus (sudden, brief involuntary movement)
Motor abnormalities
Cortical blindness
Seizures may occur

107
Q

When should sporadic CJD be considered?

A

In rapidly progressing dementia

108
Q

What are some of the differential diagnosis’s for sporadic CJD?

A

Alzheimer’s with myoclonus
Subacute sclerotising panencephalitis
CNS vasculitis
Inflammatory encephalopathies

109
Q

What is the prognosis of sporadic CJD like?

A

Rapid progression, death often within 6 months

110
Q

When is new variant CJD linked to?

A

Ingestion of infected meat

->e.g. mad cow disease, eating beef after that was a bit more risky

111
Q

Which investigations are looked at in CJD?

A

MRI
EEG
CSF

112
Q
A

Year 2- CNS (49 decks)

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