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THIRD YEAR > Neuro > Flashcards

Neuro Flashcards

1
Q

BM neonates

A

listeria, group b strep, EColi

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2
Q

BM elderly

A

pneumococcal >listeria

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3
Q

BM children

A

HI

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4
Q

BM 10-21

A

meningococcal

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5
Q

BM 21>

A

pneumococcal >meningococcal

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6
Q

meningococcus meningitis treatment

A

IV ceftriaxone 2g bd (chloramphenicol IV 25mg/kg qds) for 5-7 days and stop dexa

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7
Q

pneumococcal meningitis

A

ceftriaxone 10 days or 14 if not responding

4 days of dexa

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8
Q

penicillin/cephalasporin resistant meningitis

A

ceftriaxone 14 days and vancomycin and 4 days of dexa

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9
Q

listeria meningitis

A

21 days amoxacillin IV 2g 4 hourly (PA co tramox IV 120mg/kg qds)
stop dexa

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10
Q

meningitis post op

A

IV ceft 2g 8 hourly and IV flucoxacillin and IV vancomycin

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11
Q

Early in patient management of meningitis bacterial

A

IV ceftriaxone 2g bd and IV amox 2g qds if listeria suspected or >55yo
vancomycin +/- rifampicin if pneumococcal penicillin resistance suspected
steroid (dexa) 10mg IV 15-20 mins before or with first AB dose and then every 6 hourly for 4 days

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12
Q

who is dexa contra indicated in

A

post surgical meningits
severe immunocompromised
meningococcal/septic shock
hypersensitivity to steroids

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13
Q

viral meningitis cells
colour
protein
glucose

A

lymphocytes
gin clear
normal/slightly high
normal

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14
Q

bacterial meningitis cells
colour
protein
glucose

A

polymorphs / neutrophils
cloudy
high
<70% of BG

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15
Q

normal glucose

A

2.3-4.5

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16
Q

normal protein

A

0.1-0.4

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17
Q

TB cells
colour
protein
glucose

A

lymphocytes
cloudy/yellow
high/very high
<60%

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18
Q

close contacts of people with meningitis have a increased risk for how long

A

6 months

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19
Q

prophylaxis regimes for bacteria mengingitis

A

600mg rifampicin PO 12 hourly 4 doses for adults and >12
10mg/kg PO 12 hourly 4 doses for 3-11m

500mg ciprofloxacin PO single dose in adults and over 12 yo

250 mg IM ceftriaxone single dose in adults
125mg IV single dose in under 12s

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20
Q

adverse effects of rifampicin

A

decreased efficacy of oral contraception, red discolouration of urine, contact lenses are stained

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21
Q

Hib
pneumococcal vaccine and conjugate
travel vaccine, group c conjugate

A

HI
strep pneumonia
nesisseira meningits

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22
Q

viral menignis who
when
cause

A

infants, young, elderly
late summer/autumn
enterovirsuses

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23
Q

ix for viral

A

viral stool culture, throat swab and CSF PCR

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24
Q

aseptic meningitis CSF

which kind of patients can it occur

A

low WBC, minimally elevated protein, normal glucose

HIV px

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25
Q

causes of viral encephalitis

A 
herpes simplex
varicella zoster
CMV
HIV
measles
west nile
Jab b encephalitis
tick borne encephalitis
rabies
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26
Q

extreme lethargy

A

west nile

27
Q

delay in ix for encephalitis

A

start high dose IV aciclovir anyways

28
Q

aciclovir in encephalitis dose

A

neonates -3m 20mg/kg
3m-12yo 500mg/m2
>12 - 10mg/kg
adjust for renal failure

29
Q

how long is aciclovir given for

A

given for 14 days

21 if immunocompromised or 3m-12yrs

30
Q 
fungal opening pressure
colour
cells
CSF/glucose
protein
A 
high/very high
clear/cloudy
lymphocytes
normal/low
0.2-5
31
Q

normal opening pressure of CSF

A

10-20cm

32
Q

cerebral abscess spread from brain

A

mastoiditis, otitis media, sinusitis

33
Q

cerberal abscess blood borne

A

cyanotic heart disease, dental abscess, lung infection, pelvic infection, skin infection, abd infection

34
Q

organisms in cerebral abscess immunocomp

A

fungal, toxoplasmic gondii

35
Q

ix for cerebral abscess

A

contrast enhanced CT/MRI - ring enhancing lesion

if dx in doubt do stereotaxic biopsy

36
Q

treatment for cerebral abscess normal
if staph infection suspected
if PA or MRSA infec suspected/proven

how long

A

IV ceftriaxone 2g qds and IV metro 500mg 8 hourly

IV flucox 2g qds

IV vancomycin

4w

37
Q

what is the highest cause of deaths in under 40s

A

glioblastomas

38
Q

tumour headache

A

worse in mornings and increases with coughing, leaning forward

39
Q

increased ICP symptoms

A

headache
vom - pressure on medula
mental changes - pressure on frontal lobe
seizures

40
Q

meningiomas are typically what

A

benign

41
Q

having what increases the chance of getting meningiomas

A

NF2

42
Q

meningiomas 1 type
who
symp

A

arachnoid cap cells, extraxial
F>M
asymp

43
Q

meningiomas 2 symp

A

headache, CN neuropathies, regional anatomical disturbances

44
Q

meningiomas 3

A

benign
slow growing
can have mets

45
Q

meningiomas aggressors who are these most common in and where

A

childhood leukaemia in midline

46
Q

treatment for meningiomas

A

pre op embolisation
surgery
radio

47
Q

astrocytic tumours grade 1

A

truly benign
slow growing
children and young adults

48
Q

astrocytic tumours grade 1 symp
ix
rx

A

child - blind in 1 eye, extreme hunger
enhance on contrast
surgery curative

49
Q

grade 2 (low grade) astrocytic tumour symp

A

seizures, temp lobe in adults, post frontal, ant parietal

50
Q

what happens to grade 2

A

eventually becomes grade 3/4

51
Q

poor prognostic factors of astrocytoma 2

A

> 50, seizures, short duration of symp, increased ICP, altered consciousness, enhancement on contrast studies

52
Q

grade 3 astrocytic tumours

A

can arise de novo

av survival 2y

53
Q

grade 4 astrocytic tumours
is what
mean survival
spread

A

glioblastoma multiforme
most common primary tumour
12-14m
white matter tract, CSF pathways

54
Q

poor prognostic factors of muktiforme

A

> 45
crossing midline
6cm
incomplete resection

55
Q

treatment of grades 3 and 4

A

surgery
post op radio
temozolomide

56
Q

better prognosis if what

A

MGMT methylated tumour

57
Q

oligodendrogal tumours grade 1
who
symp

A

24-45s and 6-12yo

seizures

58
Q

oligo type 2

A

difficult to extinguish from astrocytomas

59
Q

treatment of oligo

A

chemo-sensitive. surgery

radio contraversion but reduces incidence of seizures

60
Q

gamma knife for treatment of schwannoma

A

hearing decreases over time

61
Q

pineal tumours in who

symp

A

children

hydrocephalus. symp of increased ICP

62
Q

GCT who

A

<20s esp 10-12yo

63
Q

most common CNS GCT

A

germinomous

radiosensitive

64
Q

non germatus CNS GCT

A

teratoma, yolk sac, choriocarcinoma, embryonic carcinoma

THIRD YEAR (27 decks)

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