VII- Bacterial Infections CNS

Question 1

anatomy/tissues of meningitis

Answer 1

meninges duh and CSF

Question 2

anatomy/tissues of encephalitis

Answer 2

brain parenchyma

Question 3

aseptic meningitis def

Answer 3

viral meningitis
-less severe and fatal than bacterial

Question 4

morphology of strep pneumo

Answer 4

gram: pos, catalase neg
shape: oval/lancet
lab: alpha hemolytic (green) + susceptible to optochin and bile

Question 5

morphology of N. meningitis

Answer 5

gram: neg,
shape: coffee/kidney bean
lab: oxidase, catalase, glucose, maltose pos - need CO2 for growth

Question 6

strep pneumo virulence factors

Answer 6

1. polysac capsule for dissemination
2. pneumolysin for interfere macrophages
3. IgA protease to prevent clearance

Question 7

N. meningitis virulence factors

Answer 7

1. polysac capsule to resist complement and phago
2. endotoxin LOS for organ failure and DIC
3. inflamm resp weakens BBB to cross within neutrophils

Question 8

host factor risks

Answer 8

1. pneumococcal- pneumonia or chronic otitis media
2. meningococcal- recent URTI, complement deficiency, living in schools/military barracks
3. immunocomp always

Question 9

CSF changes bacterial

Answer 9

1. presence of PNMs aka neutrophils
2. dec glucose
3. inc protein
4. inc pressure

Question 10

CSF changes viral

Answer 10

1. mono/lymphocytes
2. rare neutrophils/PNMs
3. normal glucose
4. normal/slight inc protein and pressure

Question 11

pneumo meningitis treatment

Answer 11

initiate treatment before confirming bc medical emergency
-use age, underlying conditions, gram stain

VANCOMYCIN + CEPHALOSPORIN

Question 12

neonates meningitis agents

Answer 12

1. group B strep!!!
2. E. Coli
3. other gram neg enterics
4. listeria monocytogenes

under 1 mo

Question 13

infants meningitis agents

Answer 13

1. Strep pneumo
2. N. meningitides

under 2 years

Question 14

children meningitis agents

Answer 14

1. N. meningitides
2. Strep pneumo

2-18 years

Question 15

adults meningitis agents

Answer 15

1. Strep pneumo
2. N. meningitis
3. Listeria monocytogenes

Question 16

acute bacterial meningitis symptoms

Answer 16

1. fever
2. neck stiffness
3. headache
4. altered mental status

pneumococcal will have acute onset, high mortality, neurologic sequela

Question 17

meningococcal disease

N. meningitis

Answer 17

abrupt onset fever
-normal meningeal symps
-hypotension from bacteremia
-rash

Question 18

meningococcemia

Answer 18

bloodstream infection with or without meningitis
-fever + purpuric rash + hypotension + multiorgan failure

Question 19

meningococcal meningitis treatment

Answer 19

initiate treatment before confirm with age, underlying condition, gram stain

PENICILLIN, prophylactic treat for close ppl

Question 20

Strep agalactiae features

Answer 20

1. gram pos cocci
2. catalase neg
3. beta hemolytic
4. bacitracin resistant

Question 21

risk factors GBS

Answer 21

1. maternal intrapartum GBS for early onset dz in infants
2. lack of maternal antibodies
3. african american
4. mo had previous kid with GBS
5. obstetric problems

Question 22

early onset GBS symptoms

Answer 22

1. bacteremia
2. pneumonia
3. meningitis (fever, lethargy, irritability)
4. permanent neurologic sequela (blind, deaf, mental retardation)

late onset has more meningitis and neuro complications

Question 23

GBS treatment

Answer 23

PENICILLIN
-esp effective before delivery to prevent esarly onset

Question 24

haemophilus influenzae type B

Hib

Answer 24

1. gram neg coccobacilli
2. requires hemin (X) and NAD (V) for growth of chocolate agar
3. PRP capsule

Question 25

Hib meningitis symptoms

Answer 25

1. fever, stiff neck, headache 2. some permanent neurologic sequelae (hearing loss)

Question 26

Hib vaccine

Answer 26

conjugated with anti-PRP antibodies so highly immunogenic -start at 2 mo old

Question 27

Clostridium tetani

Answer 27

1. gram pos rod 2. anaerobic 3. spore forming 4. neurotoxin tetanospasmin (binds motor neurons)

Question 28

tetanus symptoms

Answer 28

1. spastic paralysis bc inhibitory neurotransmitters not released 2. lock jaw/trismus 3. diff swallowing 4. abs rigid 5. general muscle spasms esp back spasms

Question 29

treating tetanus

Answer 29

passive immunization with immunoglobulin + active immunization with tetanus toxoid vaccine

Question 30

Clostridium botulinum

Answer 30

1. gram pos rod 2. anaerobic 3. spores (in meat, fish, veggies, canned foods) 4. botulinum toxin (A-B blocks release of Ach)

Question 31

botulism

Answer 31

1. flaccid paralysis (ocular > laryngeal > respiratory > trunk > extremities) 2. nausea 3. dry mouth 4. blurred vision, involuntary eye movement

Question 32

Listeria monocytogenes

Answer 32

1. gram pos rod 2. motile 3. consumption of milk, soft cheese, poultry

Question 33

infection with Listeria monocytogenes

Answer 33

if in utero can result in stillbirth or premature delivery

Question 34

mycobacterium tuberculosis prez

Answer 34

primary @ lungs but spread to CNS (meningitis, brain abscess, chronic dz)

Question 35

Staph aureus prez

Answer 35

meningitis after bacteremia brain abscesses