Nervous System Infections

Question 1

Types of infections of CNS

Answer 1

Meningitis
Encephalitis
Abscesses

Question 2

Part of nervous system affected by pathogen in meningitis

Answer 2

Meninges
Membrane lining the Brain
Spinal cord

Question 3

Which is worse, bacterial or viral meningitis

Answer 3

Bacterial

Question 4

Primary causative agents of neonatal meningitis

Answer 4

Group B strep
E. coli
Listeria monocytogenes

Question 5

More prevalent bacterial meningitis in children

Answer 5

Neisseria meningitides

Question 6

More prevalent bacterial meningitis in adults and elderly

Answer 6

Strep pneumoniae

Question 7

Can hémophilus influenzae cause bacterial meningitis

Answer 7

Yes

Question 8

Can neisseria meningitis cause medical emergency by causing acute fulminant meningitis

Answer 8

Yes

Question 9

Risk at group in N. Meningitides

Answer 9

2-18yo

Question 10

Risk factors N. Meningitides

Answer 10

Overcrowded quarters living conditions

Question 11

Symptoms and signs N. Meningitides

Answer 11

Stiff neck 
High fever 
Headache 
Altered mental status 
Nausea
Vomiting 
Radiculaire pain 
Increased intracranial pressure signs 
Focal neuroglia deficits

Question 12

Complications of N. Meningitides

Answer 12

Water house friderichsen syndrome
DIC
Coma
Rapid death

Question 13

Diagnosis of N. Meningitides, strep pneumoniae , hemophilus influenzae

Answer 13

Physical -> Kernig and brudzinski signs

Lab -> CSF biopsy for bacterial and culture, high neutrophil, high protein , decreased glucose, skin biopsy if petechiae

Question 14

Is strep pneumoniae as rapid and fulminant as N. Meningitides

Answer 14

No

Question 15

Proportion of survivors that suffer neurological sequalae like deafness, persistent seizures, mental retardation

Answer 15

1/3or4

Question 16

Risk group of hemophilus influenzae

Answer 16

Children under 5yo

Question 17

Means of spread of hemophilus influenzae

Answer 17

Direct sinus

Hematogenous spread

Question 18

Percentage of survivor that sustain permanent neurologic sequalae like deafness and mental retardation

Answer 18

15-35%

Question 19

Group B strep that is leading cause of meningitis in neonates

Answer 19

Strep agalactiae

Question 20

Transmission of Strep agalactiae

Answer 20

Vertical transmission during birth
Community
Nosocomial

Question 21

Risk factors Strep agalactiae

Answer 21

Prematurity
Low birth weight
Preterm labor
Premature or prolonged rupture of membranes
Previous infants affected with Strep agalactiae
Intrapartum fever
History of maternal Strep agalactiae infection

Question 22

Symptoms Strep agalactiae infection s

Answer 22

Non specific Meningitis in newborn

Question 23

Diagnosis of Strep agalactiae in infants

Answer 23

If Fever above 38degrees -> LP to search since there’s no specific symptoms

Latex agglutination test

Question 24

Transmission of E. coli

Answer 24

Vertical transmission

Question 25

Risk factors E. coli

Answer 25

Prematurity | Low birth weight

Question 26

Symptoms E. coli meningitis

Answer 26

``` Fever Irritability Failure to thrive Focal neurologic deficits Decreased feedings Vomiting Jaundice Seizures Apnea Neurologic sequalae ```

Question 27

Diagnosis of E. coli meningitis

Answer 27

``` Blood culture Throat swab CBC PCR ESR C reactive protein Urinalysis CSF , latex agglutination ```

Question 28

Patients at risk of listeria monocytogenes

Answer 28

``` Birth to 3 months Patients above 65yo Immunocompromised Pregnant women Alcoholics ```

Question 29

Are brain abscess possible in listeria monocytogenes

Answer 29

Yes

Question 30

Common source of listeria monocytogenes

Answer 30

Dairy products Unpasteurized milk Soft cheese

Question 31

Neonatal infection with listeria monocytogenes transmission

Answer 31

Birth canal | Transplacental infection

Question 32

Risk factors listeria monocytogenes

Answer 32

Prematurity | Birth weight

Question 33

Symptoms listeria monocytogenes

Answer 33

``` Fever Nuchal rigidity Headache Irritability Poor feeding Lethargy Seizures ```

Question 34

Prognosis of listeria monocytogenes, E. coli , GBS

Answer 34

Good but morbidity high

Question 35

Is mortality higher in elderly or neonate

Answer 35

Yes

Question 36

Person at risk of mycobacterium tuberculosis

Answer 36

Immunocompromised | HIV

Question 37

Signs of mycobacterium tuberculosis

Answer 37

Same as in meningitis

Question 38

Pathogens in fungal meningitis

Answer 38

``` Cryptococcus neoformans Candida albicans Histoplasm capsulatum Blastomycoses Coccidiodes immitis ```

Question 39

Risk factors of fungal meningitis

Answer 39

Immunocompromised Pigeon droppings Smoking

Question 40

Viral meningitis mild or severe

Answer 40

Mild and clear on its own

Question 41

People at risk of severe viral meningitis

Answer 41

Viral meningitis

Question 42

Viruses in viral meningitis

Answer 42

``` Non polio enteroviruses HSV EBV Varicella zoster Measles Influenza HIV West Nile virus Lymphocytic choriomeningitis ```

Question 43

What is encephalitis

Answer 43

Inflammation due to infection on the brain parenchyma

Question 44

Most common agents in encephalitis

Answer 44

``` Viruses HSV CMV Enteroviruses Mumps Varicella Rotavirus Flavivirus ```

Question 45

Bacteria causes of encephalitis

Answer 45

Treponema pallidum | Tuberculosis

Question 46

Protozoan in encephalitis

Answer 46

Amoeba

Question 47

Diagnosis encephalitis

Answer 47

``` Travel history tick or mosquito bite exposure immunocompromised status organ transplant history MRI ```

Question 48

Symptoms of neurosyphilis enceophalitis

Answer 48

``` Cranial nerve abnormalities meningismal signs psychiatric disturbances movement disorders hearing loss dementia stroke like syndrome seizures ```

Question 49

Diagnosis of neurosyphilis encephalitis

Answer 49

Csf VDRl | fluorescent trepanomalmantibody absorption testing of CFS

Question 50

Symptoms of HSV encephalitis

Answer 50

``` Fever headache memory loss AMS confusion ```

Question 51

Sequelae of encephalitis in HSV

Answer 51

Delirium agitation withdrawal hallucinations

Question 52

Diagnosis of HSV encephalitis

Answer 52

LP imaging of the brain PCR of CSF

Question 53

Symptoms of west Nile encephalitis

Answer 53

Non-specific flu like symptoms

Question 54

Diagnosis of west Nile encephalitis

Answer 54

Eliza detection

Question 55

Treatment of west Nike encephalitis

Answer 55

No antiviral therapy