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Kumar Valori > Neurologie - Meningita. Encefalita > Flashcards

Neurologie - Meningita. Encefalita Flashcards

1
Q

Meningita - bacterii posibile - ce procent din meningitele acute bacteriene sunt cauze de aceste organisme?

A

meningococ
pneumococ
stafilococ auriu
streptococ de grup B
Listeria monocytogenes
bacili Gram-neg - ex: E. coli
tbc
sifilis
Hib - considerat eliminat ca si cauza in multe tari datorita imunizarii

70%

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1
Q

Meningita - virusuri posibile

A

enterovirusuri - Coxackie, ECHO
poliomielita - declarata eradicata la nivel mondial
HSV
EBV
HIV
oreion

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2
Q

Meningita - fungi posibili

A

Candida albicans
Cryptococcus neoformans
Coccidioides immitis
SUA:
- Blastomyces dermatitidis
- Histoplasma capsulatum

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3
Q

Meningita - in cat timp se dezvolta simptomatologia din infectia bacteriana acuta (stare de rau intensa, febra, frisoane, dureri de cap severe, fotofobie, varsaturi)

A

minute - ore

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4
Q

Meningita - in cat timp apar rigiditatea gatului si semnul Kernig pozitiv in infectia bacteriana acuta

A

de obicei in cateva ore

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5
Q

Meningita - ce durata au meningitele virale, autolimitate

A

4-10 zile

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6
Q

Meningita - cat timp poate persista durerea de cap dupa o meningita virala

A

cateva luni

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7
Q

Meningita - care este mortalitatea in meningita bacteriana acuta, chiar si in cazul unei ingrijiri optime

A

in jur de 15%

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8
Q

Meningita - modificari LCR - pacient sanatos - monocite

A

< 5 /mm3

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9
Q

Meningita - modificari LCR - pacient sanatos - PMN

A

absente

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10
Q

Meningita - modificari LCR - pacient sanatos - proteine

A

0,2 - 0,4 g/l

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11
Q

Meningita - modificari LCR - pacient sanatos - glucoza

A

1/2 - 2/3 din glicemie

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12
Q

Meningita - modificari LCR - meningita virala - monocite

A

10 - 100 /mm3

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13
Q

Meningita - modificari LCR - meningita virala - PMN

A

absente - totusi pot fi identifate unele PMN in stadiile incipiente ale meningitei virale sau encefalitei

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14
Q

Meningita - modificari LCR - meningita virala - proteine

A

0,4 - 0,8 g/l

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15
Q

Meningita - modificari LCR - meningita virala - glucoza

A

> 1/2 glicemie

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16
Q

Meningita - modificari LCR - meningita bacteriana - monocite

A

< 50 /mm3

17
Q

Meningita - modificari LCR - meningita bacteriana - PMN

A

200-300 /mm3

18
Q

Meningita - modificari LCR - meningita bacteriana - proteine

A

0,5 - 2 g/l

19
Q

Meningita - modificari LCR - meningita bacteriana - glucoza

A

< 1/2 glicemie

20
Q

Meningita - modificari LCR - meningita tbc - monocite

A

100 - 300 /mm3

21
Q

Meningita - modificari LCR - meningita tbc - PMN

A

0 - 200 /mm3

22
Q

Meningita - modificari LCR - meningita tbc - proteine

A

0,5 - 3 g/l

23
Q

Meningita - modificari LCR - meningita tbc - glucoza

A

< 1/2 glicemie

24
Q

Meningita - durata minima tratament atb

A

minim 5 zile

25
Q

Meningita - posologie tratament adjuvant cu steroid in doza mare

A

dexametazona iv 0,6 mg/kgc 4 zile, inceputa inaintea sau cu prima doza de atb

26
Q

Meningita - tratament atb (ce atb se folosesc) piogen necunoscut

A

cefalosporina gen 3 (ex. cefotaxima) + vancomicina in zonele cu rezistenta pneumococica ridicata la penicilina/cefalosporina - alternativa (ex: alergie) = benzylpenicilina si cloramfenicol

+ ampicilina pentru spectru Listeria - > 50 ani / imunocompromis - alternativa (ex: alergie) = clotrimoxazol

27
Q

Meningita - tratament atb (ce atb se folosesc) meningococ

A

empiric cefalosporina de gen 3 (ex: cefotaxim) (rezistenta crescuta la penicilina) - se schimba cu benzylpenicilina daca se confirma sensibilitatea - alternativa (ex: alergie) = cefotaxim

28
Q

Meningita - tratament atb (ce atb se folosesc) pneumococ

A

cefalosporina de gen 3 (ex: cefotaxima) - alternativa (ex: alergie) = penicilina

29
Q

Meningita - tratament atb (ce atb se folosesc) Haemophilus

A

cefalosporina de gen 3 (ex: cefotaxima) - alternativa (ex: alergie) = cloramfenicol

30
Q

Meningita cronica - in cat timp se instaleaza de obicei semnele meningeale

A

cateva saptamani

31
Q

Meningita tbc - cat timp poate trece pana la confirmarea dg prin cultura

A

sateva saptamani

32
Q

Meningita tbc - cat dureaza minim tratamentul cu antituberculoase - cu care? ce se evita si de ce?

A

9 luni - rifampicina, izoniazida, pirazinamida - trebuie evitat etambutolul (complicatii oculare)

33
Q

Meningita tbc - posologie tratament adjuvant steroid

A

prednisolon 60 mg 3 saptamani - se scade gradual doza

34
Q

Meningita tbc - mortalitate, in ciuda tratamentului precoce

A

> 60%

35
Q

Encefalita - frecventa febra

A

90%

36
Q

Encefalita virala - procent limfocite LCR

A

95%

37
Q

Encefalita virala - cat timp de la debutul simptomelor poate fi PCR din LCR fals negativ

A

48 ore

38
Q

Encefalita virala - posologie tratament antiviral in suspiciunea de encefalita HSV/VZV

A

aciclovir iv 10 mg/kgc 3x/zi 14-21 zile

39
Q

Encefalita autoimuna - encefalita limbica paraneoplazica (PLE) - procent Ac pozitivi si care sunt cei mentionati in text?

A

60%
anti-Hu, anti-Ma2

40
Q

Encefalita autoimuna - encefalita limbica cu implicarea VGKC (canallelor de potasiu voltaj-dependente) - la ce varsta este mai frecventa

A

> 50 ani

Kumar Valori (5 decks)

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