Nonviral CNS infections Flashcards

1
Q

Whos is at the highest risk for bacterial infections of the CNS?

A

newborns at highest risk, then 3-8 months old

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2
Q

What bacterial pathogen has the highest mortality rate when it infects the CNS?

A

pneumococcus

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3
Q

For a fever to count it needs to be greater than…

A

101.3

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4
Q

What test is positive if a supine pt cannot extend their knee fully?

A

Kernig’s sign

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5
Q

If a pt is having ssx of sz, focal deficit, consciousness, papilledema, or herniation, what should I do?

A

start empiric abx and steroids

do CT or MRI

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6
Q

How should a pt be positioned in an LP if we want to make sure that opening pressure is accurate?

A

lateral recumbent with bell side of needle up

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7
Q

What is the empiric tx for 0-3 mo old with bacterial meningitis?

A

ceftriaxone and ampicillin

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8
Q

for pts with bacterial meningitis 3 mo to 50 yo, I will tx the pt with…

A

ceftriaxone and vancomycin

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9
Q

For a pt with bacterial meningitis greater than 50 yo, I will tx them with…

A

ceftriaxone, ampicillin, and vancomycin

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10
Q

For a pt with bacterial meningitis who is postsurgical, post head injury, or i/c, I will tx the pt with

A

ceftazidime and vancomycin

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11
Q

What should be given to infants and children, 2 mo old and older, prior to their first dose of abx for txing bacterial meningitis? Why?

A

dexamethasone, for its anti-inflammatory properties

reduces hearing loss

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12
Q

What am I going to tx meningococcal meningitis with?

A

rifampin

vaccines for kids as young as 9 mo

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13
Q

alcoholism, debilitation, malnutrition, URI or following trauma to skull base

these are all risk factors for …

A

pneumococcal meningitis

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14
Q

When is the peak incidence of haemophilus influenze meningitis?

A

2 yo

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15
Q

What are the 5 types of neurosyphilis?

A
  1. syphilitic - weeks to years sp inf. Argyll Robertson pupil
  2. meningovascular - psych abnl
  3. general paresis - 3- 30 y sp, chronic dementia, change in personality
  4. tabes dorsalis - vision loss, loss of reflexes, spastic gait
  5. gummas
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16
Q

What is Argyll Robertson Pupil?

A

a/w tertiary syphilis

accomodates but doesnt react to light

17
Q

A subdural effusion is (serous/purulent) while a subdural empyema is (serous/purulent)

A

serous

purulent

18
Q

What is the MCC of meningitis in pts with AIDS?

A

cryptococcus neoformans

19
Q

What is the first line tx for fungal CNS infection? second line?

A

Amphotericin B

Fluconazole

20
Q

What are the top three things affected in prion disease?

A

sleep

psych

movement abnl

21
Q

What CSF protein am I looking for in CJD?

A

14-3-3 protein

22
Q

What will I see on MRI of CJD?

A

cortical ribboning, putamen/caudate hyperintensities

23
Q

What is the pathognomic EEG finding in CJD?

A

1-2 hz, triphasic sharp wave pattern

24
Q

MC reason world wide for epilepsy?

A

Neurocysticercosis

ingestion of eggs of pork tapeworm

taenia solium

25
Q

How do you tx neurocysticercosis?

A

albendazole or praziquantel

steroids

surgical excision