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Pathoma LAH > Neuro: 17.3: Meningitis > Flashcards

Neuro: 17.3: Meningitis Flashcards

1
Q

Which HSV type is more associated with viral meningitis?

A

HSV-2

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2
Q

If the meningitis is due to a viral cause, what will the LP findings be?

A
  • high WBCs (lymphocytes)
  • normal glucose
  • normal/increased protein
  • normal/increased opening pressure
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3
Q

Organism?

  • gram positive
  • lancet-shaped diplococci
  • encapsulated
A

Strep. pneumo

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4
Q

What layer of the meninges is tightly attached to the brain?

A

the pia mater

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5
Q

Organism?

  • family = picornavirus
  • envelope = no
  • genome = ss positive sense linear
  • capsid = icosahedral
A

Coxsackievirus

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6
Q

What is the tx for Listeria monocytogenes meningitis?

A

ampicillin

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7
Q

Dx?

  • CSF findings = high lymphocytes, low glucose
A

fungal meningitis

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8
Q

What are the 3 most common causes of meningitis in a neonate?

A
  1. Group B strep
  2. E. coli
  3. Lysteria monocytogenes
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9
Q

Organism?

  • 5–10 μm with narrow budding
  • Heavily encapsulated yeast
  • Not dimorphic
A

Cryptococcus neoformans

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10
Q

What special media is Haemophilus influenzae cultured on? Why?

A
  • chocolate agar
  • contains factor V (NAD+) and X (hematin)
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11
Q

Dx?

  • CSF findings = high lymphocytes, normal glucose
A

viral meningitis

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12
Q

What is the tx for Haemophilus influenzae meningitis?

A

ceftriaxone

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13
Q

What is the main virulence factor for Strep. pneumo?

A

the capsule

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14
Q

Organism?

  • gram positive cocci
  • beta-hemolytic
  • Hippurate positive
  • produces CAMP factor
A

Group B strep

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15
Q

Organism?

  • gram negative rod
  • fimbriae
  • K-capsule
  • LPS endotoxin
A

E. coli

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16
Q

What is the prophylaxis for Haemophilus influenzae meningitis?

A

rifampin

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17
Q

What is the standard treatment for meningitis? What if Listeria is suspected?

A
  • ceftriaxone and vancomycin empirically
  • add ampicillin if Listeria is suspected
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18
Q

What is the most common causative agent of meningitis in nonvaccinated infants?

A

H. influenzae

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19
Q

Haemophilus influenzae: IgA protease positive or negative?

A

positive

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20
Q

Neisseria meningiditis: IgA protease positive or negative?

A

positive

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21
Q

What is the gram stain and morphology of Listeria monocytogenes?

A
  • gram positive rod
  • “rocket tails”
  • tumbling
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22
Q

Organism?

  • gram positive rod
  • “rocket tails”
  • tumbling
A

Listeria monocytogenes

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23
Q

Name 5 viral causes of meningitis.

A
  1. enteroviruses (coxsackie)
  2. HSV-2
  3. HIV
  4. West Nile
  5. VZV
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24
Q

Where should you place the needle when performing an LP? Why? What is the landmark to help you?

A
  • place needle btw L3-L4 or L4-L5
  • the spinal cord ends at L2
  • landmark = the level of the iliac crest
  • *** “to keep the cord alive, keep the needle between L3 and L5”
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25
Strep. pneumo: optochin sensitive or resistant?
sensitive
26
What is the gram stain and morphology of Haemophilus influenzae?
* gram negative coccobacillary rod
27
What does Neisseria meningiditis ferment?
* maltose and glucose * \*\*\* "**M**enin**G**ococci ferment **M**altose and **G**lucose"
28
What is the most common causative agent of meningitis in adults and elderly pts?
Strep. pneumo
29
Where is the arachnoid mater found?
btw the dura (on the skull) and the pia (on the brain)
30
Why does meningitis cause nuchal rigidity?
bend neck = stretch meninges = pain
31
What is the most common causative agent of meningitis in children and teenagers?
Neisseria meningiditis
32
What is the diagnostic test for meningitis?
lumbar puncture
33
What are the leptomeninges?
the light meninges- the Pia and arachnoid together
34
If the meningitis is due to a fungal cause, what will the LP findings be?
* high WBCs (lymphocytes) * low glucose * increased protein * increased opening pressure
35
What is the tx for Neisseria meningiditis?
* ceftriaxone * penicillin G
36
What layer of the meninges is tightly attached to the skull?
the dura mater
37
Photophobia is a more common symptom in meningitis due to \_\_\_\_\_\_.
viruses
38
What is the prophylaxis for Neisseria meningiditis?
* Rifampin * ciprofloxacin * ceftriaxone
39
What is the prophylactic tx for mothers testing positive for Group B strep?
intrapartum penicillin
40
What is the gram stain and morphology of Strep. pneumo?
* gram positive lancet-shaped diplococci * encapsulated
41
What is the tx for cryptococcal meningitis?
* amphotericin B * with/without flucytosine
42
If the meningitis is due to a bacterial cause, what will the LP findings be?
* high WBCs (neutrophils) * low glucose * increased protein * increased opening pressure * positive gram stain and culture
43
What is the gram stain and morphology of Group B strep?
* gram positive cocci * beta-hemolytic
44
Organism? * "Rusty" sputum
Strep. pneumo
45
Organism? * gram negative coccobacillary rod * grows on chocolate agar
Haemophilus influenzae
46
Organism? * gram negative diplococci * polysaccharide capsule * ferments maltose and glucose * produces IgA proteases
Neisseria meningiditis
47
What is a good rule of thumb for what the normal level of CSF glucose should be?
2/3s that of serum glucose (approx. 66)
48
Why does meningitis cause HA?
bc the meninges wrap around the brain
49
In which pts. would fungi cause meningitis?
immunocompromised
50
What is the gram stain and morphology of E. coli?
* gram negative rod * fimbriae * K-capsule
51
What is the most common viral cause of meningitis? How is it transmitted?
* coxsackivirus * fecal-oral
52
What does meningitis mean?
* inflammation of the leptomeninges * leptomeninges = the light meninges: the Pia and arachnoid together
53
What viral family does Coxsackievirus belong to? * Is it enveloped? * What kind of genome does it have? * What is its capsid symmetry?
Coxsackievirus * family = picornavirus * envelope = no * genome = ss positive sense linear * capsid = icosahedral
54
How does Neisseria meningiditis get to the meninges?
nasopharynx --\> blood --\> meninges
55
Dx? * CSF findings = high neutrophils, low glucose
bacterial meningitis
56
Strep. pneumo: IgA protease positive or negative?
positive
57
From where are you trying to obtain a CSF sample when you perform an LP?
the subarachnoid space
58
What is the classic triad of symptoms for meningitis? What are some others?
* triad = * HA * stiff neck * fever * others = * photophobia * vomiting * altered mental status
59
The spinal cord ends at \_\_\_\_\_.
L2
60
Organism? * Spherule (much larger than RBC) filled with endospores
Coccidioidomycosis
61
Starting at the skin, what are the order of the layers penetrated to perform an LP?
1. **S**kin 2. **Super**ficial fascia 3. **Supra**spinous ligament 4. Interspinous ligament 5. **L**igamentum flavum 6. **E**pidural space containing the internal vertebral venous plexus 7. **D**ura mater 8. **A**rachnoid 9. **S**ubarachnoid space containing CSF * \*\*\* "**S**ome **Super Supra I**nteresting **LEDs A**re **S**exy"
62
The spinal cord ends at L2, but the subarachnoid space and the cauda equina continue to \_\_\_\_.
S2
63
What are the complications of meningitis? Which causative agent makes these most likely?
* herniation --\> death * fibrosis and scarring --\> * hydrocephalus * hearing loss * seizures
64
What is the gram stain and morphology of Neisseria meningiditis?
* gram negative diplococci * polysaccharide capsule

Pathoma LAH (77 decks)

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