Module 5: Neroinfectious Disease

Question 0

CSF is made where? Drains where?

Answer 0

Choroid plexus; arachnoid granulations

Question 1

Basic categories of Inflammatory states of the nervous system?

Answer 1

#Meningitis
#Encephalitis
#Myelitis (spinal cord)
#Radiculitis (PSNS)

Question 2

Key features of meningitis?

Associated features?

Answer 2

#Headache
#Neck stiffness
#Fever (if infectious)

#CN palsies – of nerves that run through subarachnoid space (6 > 4 > 3)
#Diffuse cerebral edema
#Seizures
 #infarcts if arteries rupture

Question 3

Causes of meningitis?

Answer 3

#Bacteria
#Viruses
#Fungi
#Parasites
#Chemicals – NSAIDs
#Cancer (leptomeningeal)

Question 4

Catastrophic sequela of meningitis?

Answer 4

Diffuse cerebral edema

Question 5

Etioligy of meningitis that can cause deafness?

Answer 5

H influenzae

Question 6

CSF profile in bacterial meningitis WBCs? Protein? Glucose? Gram stain?

Answer 6

PMNs; high; low; 70% positive

Question 7

CSF profile in viral meningitis WBCs? Protein? Glucose? Gram stain?

Answer 7

Lymphocytes, high, normal, negative

Question 8

CSF profile in fungal/mycobacterial meningitis WBCs? Protein? Glucose? Gram stain?

Answer 8

Lymphocytes; high; low; negative

Question 9

Patient presents with suspected meningitis – management?

CT needed if?

Answer 9

#Blood cultures
#Steroids
#Antibiotics – ceftriaxone + lincomycin (+ ampicillin)
#LP

Lethargy, confusion or hemiparesis

Question 10

Key features of encephalitis?

Answer 10

#Focal deficits
#Seizures
#Personality/mental status changes
#fever/headache

Question 11

Most common infectious causes of encephalitis? Treatment?

Answer 11

#West Nile virus
#HSV
#VZV

Acyclovir

Question 12

Type of Non-infectious encephalitis? Symptoms? Associated with?

Answer 12

Limbic encephalitis

#Amnesia
#Temporal lobe dysfunction
#Seizures
#Schizophrenia like psychosis

Ovarian teratoma (NMDA receptor encephalitis)

Question 13

Types of myelitis?

Answer 13

#Transverse myelitis – disease at one or more segments of spinal cord with dysfunction below level
#Slowly progressive spastic paraparesis – HTLV
#Acute flaccid paralysis – polio/West Nile

Question 14

PolyRadiculitis – definition? Presents with?

Answer 14

Infection of the nerve roots as they exit the spinal cord

#Shooting radicular pain
#Weakness in the muscles supplied by the roots

Question 15

Polyradiculitis may be confused with? Differences?

Answer 15

GBS

#Sensory defects
#Autonomic dysfunction
# LP Has lymphocytes (in GBS, LP should be normal)

Question 16

Patient with neuromuscular junction dysfunction affecting lungs – changes in pulse ox?

Answer 16

None – oxygenation (SPO2) is preserved.

Ventilation (PCO2) is affected

Question 17

Bacteria gain access the nervous system via?

Answer 17

#Hematogenous spread (bacteremia, septic emboli)
#Direct extension – ears, sinuses, penetrating trauma
#Iatrogenic – ventricular shunt, surgical, LP

Question 18

Causes of bacterial meningitis in neonates?

Answer 18

#GBS
#E. coli
#Listeria

Question 19

Causes of bacterial meningitis in children/adults?

Answer 19

Meningococcus

Pneumococcus

Question 20

Causes of bacterial meningitis and older adults and immunosuppressed?

Answer 20

Meningococcus
Pneumococcus
Listeria