Neurological infections

Question 1

types of neurological infections

Answer 1

by location:
-in brain, spinal cord or meninges
by microbe:
most often viral or bacterial

Question 2

for a neurological infection ______ has to enter into CNS

Answer 2

pathogen has to enter into CNS - CNS tightly guarded

Question 3

pathogen entry into CNS by:

Answer 3

• fracutre of cranium
• compromised blood brain barrier
• direct extension from a contigous area (cotigous area=conjoining area, contigous areas w brain are middle ear, oral cavity, scalp)
• along axon (where nerves, cord, etc enter & exit)

Question 4

Bacterial meningitis

Answer 4

• meningeal inflammation due to bacterial infection

- is life threatening (d/t lack of space compresses brain)

Question 5

Etiology of Bacterial meningitis

Answer 5

-bacteria enters cranium (could be any bacteria but 2 common ones) :
streptococcus pneumonia
neisseria meningitidis (meningoccal meningitis) both are present in nasopharynx if become established there can go to cranium

Question 6

predisposing factors to bacterial meningitis

Answer 6

• head trauma
• post neuro surgery
• congruent infection (eg. sinusitis, infection in middle ear getting into brain, infection in sinus getting to brain)
• immunocomprimised (decreased immunity)

Question 7

Patho of bacterial meningitis

Answer 7

• bacteria proliferation & lysis of bacteria cell, normal cells & defense cells causing inflammation
• vascular congestion & infarct
• mennigeal thickening & adhesion
• Flow of CNS obstructed
• purulent exudate (pus) on brain & surface in CNS

Question 8

what is hydrocephalus

Answer 8

water on brain, CSF accumulation in ventricles, ventricles expand needs more space, intracranial pressure & CSF

Question 9

mnfts of bacterial meningitis

Answer 9

• fever
• headache (not a systemic mnfts a local mnfts), Nausea & vomiting (resulting from reflexes for both theses in brain, d/t swelling stimulate reflex centers causing nausea & vomiting)
• nuchal rigidity(neck stiffness) , back pain (from inflammatory changes in brain
• usually postive for Brudzinkskis & Kernigs Signs

Question 10

diagnosing bacterial meningitis

Answer 10

-history, physical exam (involves part of neuro exam, kernigs & brudzinskis)
-C & S
-CSF: protein content will be elevated due to inflm causing marcrophages, nuetorphile, purulent exudate pus
decreased glucose in CSF because bacteria metabolizing glucose

Question 11

Treating bacterial meningitis

Answer 11

• Antibioitcs
• Steroids (as anti-inflammatory) (deal with inflm because lysis is already happening, more lysis will happen with antibiotics causing more inflm)

Question 12

Treating bacterial meningitis

Answer 12

• Antibiotics
• Steroids (as anti-inflammatory) (deal with inflm because lysis is already happening, more lysis will happen with antibiotics causing more inflm)

Question 13

Viral meningitis

Answer 13

• aseptic meningitis
• d/t several different viruses (virus causing mumps most common virus)
• usually self-limiting (takes about 2 wks for body to deal with infection)

Question 14

most common virus causing viral meningitis is

Answer 14

mumps

Question 15

Viral meningitis is usually ________ limiting

Answer 15

self limiting: (takes about 2 wks for body to deal with infection)
-cannot leave alone to let cure though, monitor & treat mnfts that arrive not treating the viral infection

Question 16

where do viruses replicate

Answer 16

inside cells

Question 17

patho for viral meningitis

Answer 17

patho same as bacterial meningitis but happens within cells

Question 18

what will happen to CSF during viral meningitis

Answer 18

• Increased lymphocytes (dealing with virus)
• moderately increased proteins compared to bacterial (less severe, less exudate)
• normal glucose (virus does not metabolize glucose)

Question 19

treatment for viral meningitis

Answer 19

symptomatic treatment for viral meningitis because self-limiting

Question 20

What is Encephalitis

Answer 20

inflm of parenchyma (brain or spinal cord)

Question 21

encephalitis usually caused by

Answer 21

VIRUS that gets into brain, can be caused by bacteria

Question 22

2 common types of viruses that cause encephalitis

Answer 22

• herpes simplex type 1

- arbovirus (arthropods = crustaceans, lobsters, Ticks)

Question 23

Patho for encephalitis

Answer 23

• localized necrosis & hemorrhage then generalized then edema
• degeneration of cell bodies (because virus affects cellls & replicate inside cells)
• course is unpredictable (no uniform presentation)

Question 24

mnfts of encephalitits

Answer 24

• headache, fever, nuchal rigidity (same as meningitis)
• lethargy, seizures, coma
• arboviurs usually self-limiting subsides in 2 wks
• herpes simplex more severe (severe neurological impairment, possibly can end up with dementia) (30% mortality rate with herpes simplex)

Question 25

arboviurs that causes encephalitis is usually __________ and subsides in

Answer 25

self-limiting and subsides in 2 wks

Question 26

herpes simplex is more

Answer 26

severe may cause severe neurological impairment (possibly pt can end up with dementia )

Question 27

treatment for encephalitits caused by herpes simplex 1

Answer 27

aggressive treatment (IV acyclovir) antiviral

Question 28

with bacterial meningitis pt usually presents positive for what signs

Answer 28

• kernigs

- brudzinskis

Question 29

kernigs sign

Answer 29

pt lies on back lifts legs to 90 degree angle, tries to straighten leg, pain and resistance when trying to straightene leg

Question 30

brudzinskis sign

Answer 30

patient lies prone with knees flexed, try to flex neck pain and resistance in neck