Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neuro 1 > Meningitis > Flashcards

Meningitis Flashcards

1
Q

What do you see with bacterial meningitis? (lab)

A

decreased glucose, increased protein, increased WBC w/ mostly PMNs

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

What do you see with aseptic/viral meningitis? (lab)

A

No change glucose, slightly increased protein, increased wbc (mostly lymphocytes)

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

> 85% viral meningitis associated with _______

Other major causes

A

enteroviruses (coxsackievirus, echovirus, human enteroviruses 68-71)
HSV 2
Arthropod-borne viruses (arboviruses)
HIV?

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

Nuchal rigidity MORE associated with ________

A

bacterial meningitis (vs viral)

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

Big three organisms for bacterial meningitis

A

S. pneumoniae (most common)
N. meningiditis (most common young, dorm, gram -)
H. influenza type b (gram -)

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

Ceftriaxone = _________ kind of abx

A

3rd gen cephalosporin (beta-lactam)

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

primary mechanism of ceftriaxone

A

inhibit transpeptidation of peptidoglycan to inhibit cell wall synthesis

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

spectrum ceftriaxone

A

broad, used for streptococci and more serious Gram - infections, can cross BBB

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

resistance ceftriaxone

A

inactivation of drug by beta-lactamases, change in penicillin binding protein

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

side effects ceftriaxone

A

allergies (beta-lactam, penicillin), seizures

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

Most common

A

group B strep

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

Most common 11-18 (etiology bac. men)

A

Neisseria meningitidis (strep p still high)

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

Most common adults (etiology bac men)

A

strep pneumoniae (most common overall)

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

Listeria most common etiology for bac men for what populations

A

babies, over 65

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

Meningitis develops in __________, which lacks _____ and ________ required for ________

A

Meningitis develops in subarachnoid space, which lacks antibody and complement production required for phagocytosisd

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

Clinical symptoms meningitis

A

Fever and headache

Nuchal rigidity (30% cases), photophobia, rash (gram -), upper respiratory symptoms, anorexia, nausea, vomiting, diarrhea, altered mental state

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

General causes of meningitis (5)

A 
Acute = aseptic (viral, drugs), bacteria
Chronic = mycobacteria, fungi, protozoa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Overview for management of meningitis

A

H&P, blood culture then start empiric tx, neuroimaging if altered MS/papillidema, lumbar puncture, ID organism (gram stain/PCR), switch to definitive tx and/or support

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

Routine lumbar puncture tests

A 
WBC w/ diff
RBC
Glucose
Protein
Gram stain
Bacterial culture
Do other tests if worrying about specific things
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lumbar puncture: needle inserted between –

A

3rd and 4th lumbar vertebrae into subarachnoid space (CSF)

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

tx aseptic meningitis (often viral, maybe noninfectious)

A

supportive tx and recover on their own, but can be fatal in neonatal period

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

aseptic meningitis syndrome incidence highest _____

A

during first year of life

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

enteroviruses: dna or rna

A

rna (+ sense, single stranded)

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

enterovirus transmission

A

hand to mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
type of virus enterovirus
ss +RNA capsid symmetry, icosahedral naked
26
Development of bacterial meningitis:
1. Mucosal colonization at nasopharynx 2. Invasion and multiplication in bloodstream 3,4. Cross blood brain barrier and egress into CSF 5. Release of inflammatory cytokines in CSF by astrocytes and microglia 6. Increased permeability of BBB 7. Diapedesis of leukocytes into CSF 8. Edema and increased intracranial pressure 9. Neuronal injury including hearing loss (cranial nerve VIII)
27
Virulence factors: N. menin
capsule, IgA protease, Pili, endotoxin (gram neg), outer membrane proteins
28
Virulence factors: H. ib
capsule, IgA protease, Pili, endotoxin (gram neg), outer membrane proteins
29
Virulence factors: S. pneu
capsule, IgA protease (gram +)
30
endotoxin (=?) is shed from outer cell membrane of gram _____ bacteria
lipopolysaccharide | negative
31
N. men structure slightly different =
lipooligosaccharide, which mimics brain sphingolipids so recognized as self
32
LPS activates ________ leading to ______
macrophages --> release of NO (hypotension, shock), and IL-1 (fever) and can activate disseminated intravascular coagulation leading to purpuric skin rash
33
Pili allow ------ (vf)
colonization of nasopharynx
34
IgA protease ------ (vf)
cleaves IgA facilitating colonization of mucosa
35
Capsule composed of acidic polysaccharides protects from ------- (vf)
phagocytosis by polymorphonuclear granulocytes
36
meningococcal meningitis pathogen
n. meningitidis
37
outbreaks of mm associated with
spring, winter | overcrowding (dorms)
38
mm transmission
respiratory droplets
39
mm: LOS -->
thrombocytopenia, assoc. with disseminate intravascular coagulation leading to hemorrhagic skin rash (doesn't fade under pressure)
40
mm tx
definitive and prophylactic tx w/ ceftriaxone
41
pneuomococcal meningitis pathogen
streptococcus pneumonia
42
s. pneu type of bacteria
lancet shape | gram + diplococci
43
pm transmission
respiratory droplets
44
pm secondary to
paranasal sinusitis and otitis media
45
most common cause of meningitis over 2 months old
s. pneu
46
s. pneu and previously on abx
predict resistant strain 19A-resistant s. pneu, treat w/ vanco
47
mm vaccine
13 serogroups, vaccine covers 4 ACWY (b new)
48
pm vaccine
heptavalent protein-conjugate vaccine
49
Hib bacteria type
gram neg coccoid-rod
50
Hib common in
unvaccinated infants/young children
51
Hib infection can be followed by
hearing loss
52
Hib prevention
Hib vaccine - B capsular polysaccharide
53
Hib lab test
chocolate agar w/ factors V (NAD+) and X (hematin)
54
Perinatal meningeal infections pathogens
group b strep, e. coli, listeria monocytogenes
55
GI and GU tract flora --> meningitis
group B strep (strep agalactiae)
56
transmission group b strep
vertical to infant (in utero or during vaginal delivery)
57
prevention transmission group b strep
pregnant women screened (25% carriers) and give penicillin G as prophylactic
58
group b strep lab results
bacitracin resistant, catalase neg, CAMP reaction (synergistic hemolysis of RBC by phospholipase of GBS and B hemolysin of S. aureus)
59
e. coli K1 bacteria type
gram neg rod
60
e. coli pathogeneiss
enteric organism --> bacteremia --> transcellular permeation of BBB LPS, K1 capsular polysacc prevents fusion with lysosome
61
e coli tx
if expressing b-lactamases, ceftriaxone not enough, use carbapenem
62
Listeria monocytogenes bacteria type
gram pos rod
63
L. mono common in
immunosuppressed, pregnancy, older adults, newborns
64
sxs L. mono
fever, HA, no nuchal rigidity, diarrhea
65
L. mono pathogenesis
intracellular bacteria, internalin induces phagocytosis by epithelial cells of intestine, phospholipase and listeriolysin O allow escape from vacuole, actin tails facilitate spread from adjacent cells
66
L. mono testing
50% blood tests come back negative
67
L. mono tx
ampicillin + gentamicin for 3 weeks
68
test mycobacterium tuberculosis
acid fast bacilli stain (ziehl-neelsen) and culture
69
tx m. tuberculosis
RIPE = rifampin, isoniazid, pyrazinamide, ethambutol
70
vaccine m. tuberculosis
BCG vaccine
71
prevalence m. tuberculosis
25% miliary cases have meningeal involvement | more common in immunocomprimised
72
rifampin mechanism
inhibits DNA-dependent RNA polymerase, | induces formation of drug-metabolising enzymes including cytochrome P450
73
isoniazid mechanism
inhibits mycolic acids (mycobacterial wall). | Note: acetylation by liver varies genetically and fast acetylators may require faster dose.
74
pyrazinamide mechanism
unknown
75
ethambutol mechanism
inhibits cell wall synthesis by binding arabinosyl transferase
76
__________ inhaled as spores and can disseminate hematogenously to CNS in IC individuals
cryptococcus neoformans (fungus)
77
C. neoformans tx
liposomal amphotericin + flucytosine until culture negative, followed by fluconazole for 3-12 months, or life
78
test c. neoformans
stain w india ink, latex agglutination test
79
amphotericin B mechanism
binds ergosterol creating holes in fungi membrane --> leakage of electrolytes
80
flucytosine mechanism
antimetabolite selectively taken up and converted to 5-fluorouracil in fungi, interferes w DNA/RNA synthesis
81
Fluconazole mechanism
binds fungal P-450 enzyme to block production of ergosterol (associated with drug interactions)
82
Sxs viral men vs bac men
viral - less stiff neck, less mental confusion, photophobia bacterial - stiff neck, neurological dysfunction, irritability Both headache, fever

Neuro 1 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions