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OM2 - Semester 2 - BECOM Exam 2 > Stillwell > Flashcards

Stillwell Flashcards

1
Q

Meningitis

A

-MEDICAL EMERGENCY

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2
Q

what should you do if you aren’t sure if a LP should be done or not?

A

-DO IT ANYWAYS

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3
Q

aseptic meningitis

A

-negative aerobic CSF culture but CAN STILL BE DUE TO INFECTION (actually septic)

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4
Q

which organism likes to invade TEMPORAL lobes causing encephalitis?

A

HSV

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5
Q

Most common organisms to cause meningitis

A
  • strep pneumo #1
  • GBS #2
  • N. meningitides #3
  • H. influenzae (most common w/o HIB)
  • Listeria monocytogenes

-also Strep Suis (pigs/hogs)

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6
Q

neonatal meningitis

A
  • GBS #1
  • E. coli #2
  • Listeria #3
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7
Q

children > months old meningitis

A
  • strep pneumo #1

- N. meningitides #2

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8
Q

adult meningitis

A
  • strep pneumo #1
  • N. meningitides #2

-if over 50 or immunocompromised -> LISTERIA

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9
Q

pulmonary AV malformations

A
  • allow pathogens to enter CNS

- Hx of telangiectasis, Osler-weber syndrome, cardiac malformations

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10
Q

Cavernous sinus thrombosis

A
  • DANGEROUS TRIANGLE
  • retrograde flow of infection -> damage CN3,4,6, V1,V2
  • STAPH AUREUS
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11
Q

meningitis - Treponema Pallidum (syphilis)

A

-tertiary -> ARGYLL-ROBERTSON PUPILS and TABES DORSALIS (dorsal columns) + gummas

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12
Q

neurosyphilis diagnosis

A
  • RPR sometimes neg
  • if neg but still have suspicion -> do FTA-ABS anyways
  • neuro Sx + pos serology -> do LP -> considered pos syphilis if there is any abnormality (VDRL, cell count, glucose, protein)

-67-72% have pos CSF VDRL

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13
Q

-meningitis - Leptospira Interrogans (Weil’s Disease)

A
  • ASEPTIC MENINGITIS, HEPATITIS, ACUTE RENAL FAILURE W/ HEMATURIA, CONJUNCTIVITIS
  • tropics

Tx: Doxy or Azithromycin

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14
Q

Post-Lyme syndrome

A
  • autoimmune, NOT due to infection w/ Borrelia Burgdorferi

- NO antibiotics needed

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15
Q

how to diagnose Borrelia Burgdorferi (Lyme disease)

A
  • SEROLOGY 1ST -> ELISA IgM/IgG -> follow w/ Western blot
  • ECM LESION
  • Tx: Ceftriaxone/Cefotaxime, Penicillin
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16
Q

meningitis - Nocardia

A
  • immunocompromised -> PARENCHYMAL BRAIN ABSCESS

- loves to go brain

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17
Q

meningitis - mycobacteria TB

A
  • BASILAR meningitis -> affect CNs

- need 3 or more specimens to find a +AFB stain

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18
Q

cochlear implants

A

-STREP PNEUMO infection

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19
Q

meningitis - Brain abscess

A

-POLYMICROBIAL

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20
Q

mycotic aneurysm

A
  • usually infected (NOT just fungal)

- Staph Aureus #1, Salmonella #2…abdominal aorta > thoracic aorta and involves vasa vasorum

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21
Q

CNS infection/meningitis in IVDA

A

-Staph aureus #1

  • Clostridium tetani -> tetanus toxin -> lockjaw/tetanus
  • Clostridium botulinum -> botulinum toxin -> descending muscle weakness
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22
Q

treatment for bacterial meningitis

A

-Ceftriaxone or Cefotaxime + Vancomycin (+ Ampicillin for Listeria coverage if >50 y/o or immunocompromised)

23
Q

corticosteroids (Dexamethasone)

A

-lower mortality and most ptxs benefit when started just before 1st dose of antibiotics*** (no help if started after)

24
Q

RMSF

A

-likes to invade endothelial cells

25
Q

the most common cause of meningitis in adults

A

-VIRAL

26
Q

viral meningitis

A
  • lymphocytes, high protein, NORMAL glucose

- 1st 12-24hr. -> NEUTROPHIL predominance then revert to LYMPHOCYTES

27
Q

HSV-1 encephalitis

A

-bilateral, periodic sharp spikes in TEMPORAL regions on EEG

28
Q

most common cause of viral (aseptic) meningitis

A

ENTEROVIRUSES (Coxsackie, Echovirus)

29
Q

poliovirus

A
  • Afghanistan and Pakistan

- ACUTE FLACCID PARALYSIS

30
Q

HSV-2

A
  • MENINGITIS

- recurrent “Mollaret’s” meningitis -> reactivation of HSV-2 -> GHOST and MOLLARET cells (footprints)

31
Q

HSV-1

A
  • ENCEPHALITIS

- TEMPORAL LOBES (bilateral)

32
Q

CMV meningitis/encephalitis

A
  • congenital -> periventricular calcifications
  • HIV+ ptx -> diffuse micronodular encephalitis, MYELITIS, POLYRADICULOPATHY

-OWLS EYE

33
Q

MYELITIS vs. POLYRADICULOPATHY in CMV

A
  • myelitis: UMN -> hyperreflexia, +babinski

- polyradiculopathy: LMN -> hyporeflexia

34
Q

EBV meningitis/encephalitis

A

-PRIMARY CNS LYMPHOMA (diffuse large B cell) in HIV ptxs -> SOLITARY deep white matter, subependymal lesions on MRI/CT

35
Q

HHV-6 (Roseola)

A

-child w/ high fever, FEBRILE SEIZURES, and maculopapular rash (torso -> extremities)

36
Q

Eastern equine encephalitis virus

A
  • arbovirus -> mosquitos
  • MOST SEVERE
  • FLORIDA
37
Q

Japanese encephalitis virus

A
  • arbovirus -> mosquitos
  • ASIA and WESTERN PACIFIC
  • seizures and Parkinsonian syndrome
  • vaccine in US
38
Q

California encephalitis virus

A
  • arbovirus -> mosquitos

- SEIZURES in CHILDREN

39
Q

Powassan virus

A
  • arbovirus -> Ixodes ticks

- NE/North central; upper Midwest US

40
Q

Colorado tick fever virus

A
  • arbovirus -> Dermacentor tick

- SADDLEBACK/biphasic fever

41
Q

Chikungunya virus

A
  • arbovirus -> mosquitos
  • also biphasic fever
  • RASH and severe ARTHRALGIAS/ARTHRITIS***
  • meningoencephalitis
42
Q

Zika virus

A
  • mosquito and sexual
  • RASH, ARTHRALGIAS, CONJUNCTIVITIS
  • palmar rash
  • microcephaly
43
Q

Measles/Rubeola

A
  • SUBACUTE SCLEROSING PANENCEPHALITIS (SSPE)j

- 7-10 years later

44
Q

Rabies (Rhabdovirus)

A
  • neurotropic
  • histo: NEGRI BODIES (bullet shaped)
  • parasthesias, hydrophobia, aerophobia, hyper salivation/lacrimation/sweat or ascending paralysis
45
Q

Cryptococcus Neoformans

A
  • cryptococcomas in brain and lungs
  • NARROW base budding and India ink
  • Dx: CRYPTO ANTIGEN on CSF best***
  • Tx: liposomal amph. B + 5-FC
  • keep OP <20cm H2O w/ LPs
46
Q

Aspergillus

A
  • brain abscess
  • 45 degree branching
  • high serum golactomannan and beta D glucan
47
Q

Mucomycosis

A
  • brain abscess
  • 90 degree branching
  • black necrotic lesions
48
Q

Naegleria Fowleri

A
  • amoebia
  • fatal meningitis
  • motile trophozoites
  • check both uncentrifuged and centrifuged CSF -> TEARS UP AMOEBAE***
49
Q

Acanthamoeba and Balmuthia

A
  • amoebas
  • granulomatous encephalitis
  • giant cells and granulomas
50
Q

Toxoplasma gondii

A

-MULTIPLE ring enhancing lesions on brain abscesses

51
Q

rat lungworm from ASIA after eating undercooked snails/vegetables that causes EOSINOPHILIC meningitis

A
  • ANGIOSTRONGYULUS CANTONENSIS***

- also Gnathostoma spinigerum and Baylisascariasis

52
Q

Lyme disease

A

Bell’s palsy

53
Q

which organism loves to invade endothelial cells?

A

RMSF

54
Q

non-ring enhancing lesions on CT in immunocompromised ptx

A

PML of JC virus

OM2 - Semester 2 - BECOM Exam 2 (7 decks)

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