Neurology

Question 1

Viral Meningitis

Answer 1

Causes= HSV2, VZV, EBV, CMV, enteroviruses, mumps, HIV, measles
Enter CSF via BBB, choroid plexus or olfactory nerve (HSV

Question 2

Kernig’s Sign

Answer 2

Hip and Knee flex at 90 degrees

Can’t extend knee

Question 3

Brudzinski’s Sign

Answer 3

Neck flexion causes hip+ knee flexion

Question 4

Viral LP signs

Answer 4

High lymphocytes, slightly high protein, CSF:GLucose normal or a bit low

Question 5

Viral Encephalitis

Answer 5

Causes= HSV1, VZV, EBV, measles, mumps, s pneumoniae, n menigitidis
Treatment= high dose IV aciclovir for 2-3wks

Question 6

ADEM

Answer 6

Acute disseminated encephalomyelopathy
CNS demyelinated due to virus or vaccination
Treatment= steroids or immunosuppression

Question 7

Bacterial Meningitis

Answer 7

Causes= n meningitidis, h influenzae, s pneumoniae, TB, clortistidium tetani
Neonates= group B strep, e coli, listeria
Need ceftriaxone, cefotaxime and maybe steroids

Question 8

Bacterial LP signs

Answer 8

High WBCs (neutrophils)
Low glucose ratio
High protein
+ve gram stain

Question 9

Fungal LP signs

Answer 9

Lymphocytes present
Normal or low glucose ratio
High protein

Question 10

Fungal Meningitis

Answer 10

Causes= cryptococcus
In pts with HIV
Sub-acute
Prolonged treatment with amphoterecin, flucytosine, fluconazole

Question 11

Subdural Empyema

Answer 11

Causes= anerobes, strep, aerobic gram-ve bacilli, s pneumoniae, h influenzae, s aureus
Treatment= drainage and abx

Question 12

Cerebral Abscess

Answer 12

Causes= strep milleri, s aureus, anaerobes, gram -ve enteric (e coli, pseudomonas), fungi, TB
Spreads directly, haematogenously or no focus
Treatment= drainage and abx
Comps= raised ICP, rupture (ventriculitis)

Question 13

Abx which penetrate BBB

Answer 13

Ampicillin, penicillin, cefuroxime, cefotaxime, ceftazidime, metronidazole