Module 5: Neroinfectious Disease 2

Question 0

Other signs if meningococcus meningitis?

Answer 0

#Rash
#Adrenal crisis

Question 1

Patient presents with meningitis after otitis media or sinusitis – organism? Also seen more frequently in these patients?

Answer 1

Pneumococcus; alcoholic’s

Question 2

H influenza meningitis most commonly seen in?

Answer 2

Unvaccinated children with nasosinus infections

Question 3

Meningitis causing organisms that can also mimic brainstem encephalidities?

Answer 3

Listeria rhombenencephalitis

Question 4

Patient presents with meningitis – when should empiric Ampicillin be given?

Answer 4

Age under 12 weeks for over 50 years

Question 5

Immunocompromise patient presents with bacterial meningitis – antibiotics?

Answer 5

Ceftazidime and vancomycin

Question 6

Do brain abscesses present with fever?

Answer 6

No - 1/2 don’t due to decreased immune surveillance in brain, large abscesses may not present with fever

Question 7

Brain abscess – organisms?

Answer 7

2/3 of the time - anaerobes (strep milleri >staph aureus >gram-negative bacilli)

1/3 of the time – Bacteroides, fusobacterium, Clostridium

Question 8

Patient with suspected intracranial abscess – test of choice? Avoid this test?

Answer 8

MRI with gadolinium

Avoid LP (30% of patients will deteriorate)

Question 9

Treatment of intracranial abscess?

Answer 9

#Antibiotics – cefotaxime and metronidazole (+vancomycin if post op)
#Antiepileptics (90% of survivors develop epilepsy)
#Steroids if increased ICP

Question 10

Tuberculosis in central nervous system may cause?

Answer 10

#Tuberculosis meningitis
#tuberculoma
#Pott's disease

Question 11

CNS syndromes associated with neurosyphilis? Tx?

Answer 11

#Acute syphilitic meningitis
#Cerebrovascular syphilis
#Tabes dorsalis
#General paresis
#Gummatous neurosyphilis

Question 12

Common causes of viral meningitis? Course?

Answer 12

#Enterovirus
#Coxsackie
#Arbovirus (flavivirus, Reovirus, bunyavirus)
#Herpesviruses
#Mumps
#lymphocytic choriomeningitis virus
#Early HIV disease
#West Nile

Benign course (fever, headache) that usually remits in 7-10 days

Question 13

Unlike bacterial meningitis, do not expect to see these symptoms in viral meningitis?

Answer 13

Increased ICP

Question 14

Patient presents with fever as well as medial temporal lobe and Frontal dysfunction (deficits in memory and personality) – suspected diagnosis? EEG will show?

Answer 14

HSV encephalitis

PLEDS

Question 15

Patient develops encephalitis after stem cell transplant – suspected diagnosis?

Answer 15

HHV-6

Question 16

Most common cause of sporadic, fatal encephalitis in the US? Mortality w/o tx? Treatment, percentage of patients that develop permanent deficits?

Most cases of probably due to?

Answer 16

HSV encephalitis; 70%; 70%

Reactivation of latent infection in trigeminal ganglia

Question 17

Incubation period for polio? Types of vaccinations?

Answer 17

7-14 days

Sabin: live attenuated
Salk: whole killed

Question 18

Natural history of VZV infection?

Answer 18

#Radicular pain lasting 4-6 weeks
#3-4 days later, painful vesicular rash lasting 10-14 days