Brainscape's Knowledge GenomeTM

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


See full index

Neurology > Infections of the Nervous System > Flashcards

Infections of the Nervous System Flashcards

1
Q

What is meningitis?

A

Inflammation/infection of the meninges

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

What is encephalitis?

A

Inflammation/infection of the brain tissue

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

What is myelitis?

A

Inflammation/infection of the spinal 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 in meningitis?

A

Fever
Neck stiffness
Altered mental status

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

What rash should be looked for in suspected meningitis?

A

Petechial skin rash (tumbler test)

Hallmark test for meningococcal meningitis but can also occur in viral form

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

How is neck stiffness in meningitis tested?

A

Passively bending the neck forward

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

What is an inflammatory Ddx for meningitis?

A

Sarcoidosis

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

What are some malignant DDx for meningitis?

A

Metastatic malignancy

Haematological malignancy

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

What are some drug caused DDx for meningitis?

A

NSAID use

IVIG use

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

What are the two main causative bacterial agents of meningitis?

A 
Neisseria meningitides (meningococcus)
Streptococcus pneumonia (pneumococcus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are a key group of viral agents that can cause viral meningitis?

A

Enteroviruses

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

What are the clinical features of encephalitis?

A 
Flu-like symptoms for 4-10 days
Progressive headache associated with fever
Meningism may or may not be present 
Cerebral dysfunction
Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is the onset of viral meningitis slower or faster than that of bacterial meningitis?

A

Generally slower

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

Give some inflammatory DDx for encephalitis

A

Limbic encephalitis - anti VGCK/ anti NMDA receptor

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

What is the most common cause of encephalitis?

A

Viral - HSV most common

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

What should be considered if a patient has several seizures with little or no recovery period afterwards?

A

Viral encephalitis

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

What are the two forms of auto-immune encephalitis?

A

Anti-VGKC (voltage gated potassium channel)

Anti-NMDA receptor - more common

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

What are the features of auto-immune encephalitis causes by anti-VGKC type?

A

Frequent seizures
Amnesia (unable to retain new memories)
Altered mental state

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

What are the features of auto-immune encephalitis caused by the anti-NMDA receptor type?

A

Flu-like prodrome
Prominent psychiatric features
Altered mental state and seizures
Progressing to movement disorder and coma

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

What are the priorities when investigating and treating suspected meningitis and encephalitis?

A

Priority is to exclude infection and treat

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

What are the Ix for meningitis?

A

Blood cultures
LP (CSF culture/microscopy
No need for imaging if no contraindications to LP

22
Q

What are the Ix for encephalitis?

A

Blood cultures
Imaging - CT +/- MRI
LP
EEG

23
Q

What are the contraindications to LP?

A

Focal neurological deficit, not including cranial nerve palsies
New-onset seizures
Papilloedema
Abnormal level of consciousness, interfering with proper neurological exam (GCS)
Sever immunocompromised state

24
Q

What does observing the contraindications to LP aim to prevent?

A

If there is raised ICP, one of the compensatory mechanisms is the shunt CSF from the brain into the spinal cord. This creates a high pressure in the cord of fluid that it essentially exerting an upwards force on the brain. In this situation if an LP is done, the pressure in the cord will decrease, allowing the brain to move towards the are a of lower pressure at which point herniation, coning and resultant death are likely to follow

25
Q

Describe the opening CSF pressure in bacterial meningitis

A

Increased

26
Q

Describe the opening CSF pressure in viral meningitis and encephalitis

A

Normal, may be increased

27
Q

Describe the CSF white cell count in bacterial meningitis

A

High, mainly neutrophils

28
Q

Describe the CSF white cell count in viral meningitis and encephalitis

A

High, mainly lymphocytes

29
Q

Describe the CSF glucose content in bacterial meningitis

A

Reduced

30
Q

Describe the CSF glucose content in viral meningitis and encephalitis

A

Normal (60% of blood glucose level)

31
Q

Describe the CSF protein content in bacterial meningitis

A

High

32
Q

Describe the CSF protein content in viral meningitis and encephalitis

A

Slightly increased

33
Q

What is a cardinal sign of bacterial meningitis upon visualisation of the CSF

A

CSF is cloudy

34
Q

What is the normal white cell count in CSF?

A

0-5

35
Q

What are the two causative agents of bacterial meningitis and which is sensitive to penicillin?

A

Streptococcus pneumoniae - sensitive to penicillin

Nisseria meningitides

36
Q

What is the commonest cause of encephalitis i Europe?

A

HSV

37
Q

What is the test for HSV in encephalitis?

A

PCR of CSF for viral DNA

38
Q

What is the treatment for HSV induced encephalitis UPON CLINICAL SUSPICION?

A

Treat with aclovir

39
Q

What is the mortality for encephalitis caused by HSV if untreated?

A

70%

40
Q

Where does the HSV remain after primary infection?

A

Trigeminal or sacral ganglion

41
Q

What form of HSV causes encephalitis in all but neonates?

A

Type 1

42
Q

Describe the enterovirus cause of encephalitis

A

Enteroviruses are a large family of RNA viruses
They tend to cause CNS infections
Spread by the faecal-oral route
Many can cause non-paralytic meningitis
They DO NOT cause gastroenteritis
Include polioviruses, coxsackiviruses and echoviruses

43
Q

What is a brain abscess?

A

Localised area of pus within the brain

44
Q

What is a subdural empyema?

A

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

45
Q

What are the clinical features of brain abscess and empyema?

A 
Fever 
Headache
Focal symptoms and signs 
Signs of raised ICP
Meningism may be present 
Features of underlying source e.g. dental, sinus or ear infection
46
Q

Give some causes of brain abscess and empyema

A

Penetrating head injury
Spread form adjacent infection
Blood borne infection e.g. bacterial endocarditis
Neurosurgical procedure

47
Q

What is required for a diagnosis of brain abscess and or empyema?

A

CT/MRI
Investigate source
Blood cultures
Biopsy (drainage of pus)

48
Q

What bacterial organism is present in 70% of brain abscess cases, and what what group own particular? What is clinically significant about this group?

A

Streptococci, ‘strep millenni’ group

They are sensitive to penicillin

49
Q

Outline the management for brain abscess

A

Surgical drainage
Penicillin or ceftriaxone to cover streps
Metronidazole for anaerobes
High doses required for penetration
High mortality without appropriate treatment

50
Q

Give eight brain illnesses that may indicate HIV

A 
Cerebral toxoplasmosis
Aseptic meningitis/encephalitis
Primary cerebral lymphoma
Cerebral abscess
Cryptococcal meningitis
Space occupying lesion of unknown cause
Dementia
Leucoencephalopathy

Neurology (42 decks)

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