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Clin Med 3 Final Exam > Lecture 5- CNS infections > Flashcards

Lecture 5- CNS infections Flashcards

1
Q

bacterial meningitis from NP

A

S. pneumo

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2
Q

bacterial meningitis assoc. w/ military/college

A

N. meningitidis

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3
Q

bacterial meningitis assoc. w/ head trauma

A

staph

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4
Q

bacterial meningitis assoc. w/ neuro procedures (2)

A

staph

gram-

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5
Q

bacterial meningitis assoc. w/ newborn - 1 mo. (3)

A

GBS
Listeria
E. coli

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6
Q

bacterial meningitis assoc. w/ 1-3 mo. (6)

A 
GBS
listeria
E. coli
S. pneumo
H. flu
N. meningitidis
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7
Q

bacterial meningitis assoc. w/ 3 mo.-55 years (3)

A

S. pneumo
H. flu
N. meningitidis

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8
Q

bacterial meningitidis > 55 years (4)

A

S. pneumo
H. flu
Listeria
G-

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9
Q

bacterial meningitis triad

A

Fever
nuchal rigidity
AMS

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10
Q

CSF lab findings bacterial meningitis (4)

A

> 1000 WBC
glucose less than 40
CSF:glucose less than 0.4
protein 100-500

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11
Q

indications for CT in bacterial meningitis (6)

A 
immuncompromised
hx CNS disease
new onset seizure
papilledema
abn LOC
focal neuro deficit
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12
Q

newborn empiric abx for bacterial meningitis

A

Ampicillin + Ceftoxamie (or gentamycin)

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13
Q

1 mo. - 50 years empiric abx for bacterial meningitis

A

Ceftriaxone + vancomycin

dexamethasone

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14
Q

> 50 y/o empiric abx for bacterial meningitis

A

Ceftriaxone + ampicillin + vanco

dexamethasone

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15
Q

immunosuppressed empiric abx for bacterial meningitis

A

Cefepime/Meropenem + ampicillin + vanco

dexamethasone

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16
Q

empiric abx for bacterial meningitis for the PCN allergic

A

vanco + moxifloxacin + bactrim

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17
Q

dexamethasone effect on bacterial meningitis (2)

A

decr. rate of hearing loss

decr. neuro sequelae

18
Q

most common cause of aseptic meningitis

A

enterovirus

19
Q

drug rxn causing aseptic meningitis (2)

A

NSAIDs

antibiotics

20
Q

aseptic meningitis labs (5)

A 
WBC less than 500
> 50% lymphocytes
Normal glucose
normal or mildly elevated protein
negative gram/culture
21
Q

gold standard for aseptic meningitis

A

viral cultures

22
Q

aseptic meningitis treatment

A

symptomatic- analgesics, antipyretics

23
Q

hallmark of encephalitis

A

abn brain function

24
Q

bacterial assoc. w/ delivery (2)

A

E. coli

GBS

25
Q

viral invasion of the CNS w/ neuronal involvement

A

primary encephalitis

26
Q

immune-modulated, neuron-sparing inflammation of the CNS

A

postinfectious encephalitis

27
Q

HA, AMS, seizures, hemiparesis, CN palsies, incr. DTRs, ulcers/vesicles

A

encephalitis

28
Q

most common cause of encephalitis & where do you see it?

A

HSV-1

temporal lobe

29
Q

encephalitis labs/imaging findings? (3)

A

CT/MRI: possible abnormalities of the temporal lobes
EEG: abn
CSF: consistent w/ aseptic meningitis (negative culture)

30
Q

encephalitis tx (2)

A

Acyclovir 10 mg/kg IV q8h

seizure prophylaxis

31
Q

direct spread sources of cerebral abscess (many)

A

otitis media, mastoiditis, meningitis, head trauma, sinusitis, dental infection, s/p neuro procedure

32
Q

unilateral HA, fever, nuchal rigidity, vomiting, AMS, focal neuro deficits, seizures

A

cerebral abscess

33
Q

MRI finding for cerebral abscess

A

ring-enhancing lesion

34
Q

early cerebral abscess (1-2 weeks) (4)

A

lesion poorly demarcated
localized edema
acute inflammation
no tissue necrosis

35
Q

late cerebral abscess (> 2 weeks) (2)

A

necrosis & liquefaction

lesion surrounded by fibrotic capsule

36
Q

tx cerebral abscess (2)

A

CT-guided aspiration or surgical excision

abx for 4-8 weeks based on source

37
Q

abx for cerebral abscess, oral/otogenic/sinus source?

A

Metronidazole + Pen G (oral source) or Ceftriaxone (otogenic or sinus source)

38
Q

abx for cerebral abscess, hematogenous source

A

vanco + metronidazole

39
Q

abx for cerebral abscess postop neurosurg pts

A

vanco + ceftazidime/cefepime/meropenem

40
Q

abx for cerebral abscess, penetrating trauma source

A

vanco + ceftriaxone/cefotaxime

41
Q

abx for cerebral abscess, unknown source?

A

vanco + ceftriaxone/cefotaxime + metronidazole

Clin Med 3 Final Exam (6 decks)

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