Neuro Infections/Inflammatory Disease

Question 1

what is meningitis

Answer 1

acute inflammation of the meningeal tissue of the brain and spinal cord

Question 2

what is the cause of meningitis

Answer 2

infection of the lungs or blood stream or penetrating wounds

Question 3

what bacteria is often the cause of meningitis

Answer 3

streptococcus pneumoniae
neisseria meningitis
enterovirus

Question 4

what are the three layers of the meninges

Answer 4

from outer to inner:
- dura mater
- arachnoid
- pia mater

Question 5

what is the role of the meninges

Answer 5

to protect the brain and spinal cord

Question 6

what are the risk factors for meninges

Answer 6

• infections of the areas near the hear
• compact communities like college students, prisons, military bases

Question 7

what time of year does meningitis typically occur

Answer 7

fall through winter

Question 8

how is meningitis typically spread

Answer 8

respiratory droplet
- come into contact with infected saliva or resp tract secretions

Question 9

what is the pathogenesis of meningitis

Answer 9

• inhaled and attached to epithelial cells of the nasopharynx
• cross the mucosal barrier and travel in the blood stream to the BBB
• migrate and infect the arachnoid mater and CSF
• inflammatory response and pus secretion
• increase in CSF production
• Increase in ICP

Question 10

what is the triad of meningitis

Answer 10

fever
headache
stiff neck

Question 11

what are the clinical manifestations of meningitis

Answer 11

N/V
photophobia
altered mental status (drowsy –> coma, seizures)
meningococcus –> skin rash, petechiae
positive kernig sign
positive brudzinski sign

Question 12

what is a positive kernig sign

Answer 12

resistance to leg extension bc of pain

Question 13

what is a positive brudzinski sign

Answer 13

neck flexion causes pain so pt brings hip/knees in to flexion

Question 14

what is the difference between bacterial and viral meningitis

Answer 14

bacterial
- most common
- high fatality rate if not treated fast enough
- can have long term side effects of hearing loss, seizure or brain damage
viral:
- milder form, sometimes dont even have inc WBC
- no really long term effects

Question 15

what is the treatment for bacterial meningitis

Answer 15

aggressive abx therapy
- ceftizaone and vanc (to fight MRSA strain)
- acyclovir (in case viral)
steroid therapy to dec inflammation
prophylaxis: vaccines

Question 16

what is encephalitis

Answer 16

acute inflammation of the brain

Question 17

what cause encephalitis

Answer 17

virus
- west nile
- measles, chicken pox, mumps
- herpes -1

Question 18

what are the clinical manifestations of encephalitis

Answer 18

• sx wont appear for about 2-3 days
• range from mild to coma
• fever
• headache
• N/V
  depends on where the infection is

Question 19

what is the pharm for encephalitis

Answer 19

• acyclovir for HSV –> reduce mortality, does not reduce neurological complications
• anti-seizure meds
• provide fluids, antiemetics, acetaminophen

Question 20

what is a brain abscess

Answer 20

accumulation of pus within the brain tissue

Question 21

what is the cause of a brain abscess

Answer 21

local or systemic infection
- typically from ear, tooth, mastoid or sinus infection

Question 22

what bacteria typically cause a brain abscess

Answer 22

streptococcus and staphylococcus aureus

Question 23

what are the clinical manifestations of a brain abscess

Answer 23

head ache
fever
N/V
signs of inc cranial pressure: drowsy, confusion, seizures
focal symptoms may reflect area of infection: ex = temporal lobe causes visual field defects