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Neurology Y3 > YearClub 2026 Neurology session (infective conditions) > Flashcards

YearClub 2026 Neurology session (infective conditions) Flashcards

1
Q

What are the 4 types of meningitis?

A

Pyogenic - bacterial
Aseptic - (viral, non-infectious)
Focal Suppurative (abscess)
Chronic Bacterial (TB)

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2
Q

What are meningitis routes of infection?

A

Otitis media (most common)
Nasopharynx
Sinusitis
Haematogenous (IE - infective endocarditis)

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3
Q

Signs/symptoms of meningitis

A

MAIN TRIAD: headache, neck stiffness, and fever

Other symptoms can include:
- Photophobia
- Vomiting
- Sudden onset

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4
Q

Septicaemia what is it and appearance?

A

Another term used to describe blood poisoning. It is an infection caused by large amounts of bacteria entering the bloodstream.

(little clots/infections bud off)
Non-blanching, petechial rash
purpuric

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5
Q

Pyogenic meningitis indicates pathogen of viral origin. True/false?

A

False

Pyogenic = pus
Bacteria make pus! Viruses DO NOT

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6
Q

Risk factors of Pyogenic meningitis?

A

Immunocompromised in some way

I.e. extremes in age (old/young), unvaccinated

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7
Q

Community acquired bacterial meningitis bacterial cause (neonates)?

A

Listeria monocytogenes

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8
Q

Community acquired bacterial meningitis bacterial cause (children-unvaxxed)?

A

H.influenzae

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9
Q

Community acquired bacterial meningitis bacterial cause (age 10-21)?

A

Strep pneumoniae, neisseira meningitidis

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10
Q

Community acquired bacterial meningitis bacterial cause (age 21-65)?

A

Strep pneumoniae

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11
Q

Community acquired bacterial meningitis bacterial cause (age 65+)?

A

Strep pneumoniae

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12
Q

Community acquired bacterial meningitis bacterial cause (immunocompromised)?

A

Listeria monocytogenes

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13
Q

Community acquired bacterial meningitis bacterial cause (head trauma)?

A

Staph aureus (cribriform plate fracture = strep pneumoniae)

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14
Q

What does lumbar puncture show for bacterial meningitis?

A

Neutrophils (polymorphic cells)
High protein (causing cloudy CSF)
Reduced glucose

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15
Q

What does lumbar puncture show for viral cause?

A

Lymphocytes
Normal protein
Normal glucose

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16
Q

What is standard treatment for bacterial meningitis?

A

Antibiotic + steroid!
Ceftriaxone + dexamethasone
(give steroids immediately or 15 mins before antibiotics -> reduce oedema)

17
Q

Antibiotic given if patient has penicillin allergy?

A

chloramphenicol - may be used if patient has history of immediate hypersensitivity reaction to penicillin or cephalosporins.

Cefotaxime - a cephalosporin option that can be used as alternative for those with penicillin allergy

18
Q

Antibiotic given for listeria monocytogenes?

A

amoxicillin

19
Q

Antibiotic given if patient presents with the symptoms and has undergone recent travel?

A

vancomycin

20
Q

Viral meningitis summary?

A

Most common type of aseptic meningitis.

RF: late summer/autumn, travel

Cause: enterovirus e.g ECHO virus, coxsackie, mumps, HSV

Dx: viral stool PCR + culture, throat swab, LP PCR, HIV test

Tx: supportive - is self limiting

21
Q

What is encephalitis (summary)?

A

Infection of the brain parenchyma.
Cause: VZV, HSV (older px/immunocomp)

Signs: meningitis + neuro symp
Partial paralysis
confusion/psychosis
Speech symptoms
Insidious onset (up to 10 days)
Neck stiffness
Seizures
Photophobia
Headache

Ix: LP PCR, EEG, MRI
MRI => bright white temporal lobe and parahippocampal gyrus

Tx: preemptive aciclovir IV (ASAP!!)

22
Q

Risk factors and causative organisms of lyme disease?

A

RF: hikers, walkers, campers- outdoors!

Vector: ticks
Causative organism: borrelia burgdorferi (spirochaete)
(this and syphilis are only spirochaetes u gotta know)

23
Q

Signs of lyme disease?

A

Signs:
RASH! (can be target/bullseye lesion) => 1-4 weeks post bite
Expanding rash
tick/tick bite
General - fatigue, myalgia, headache, fever

24
Q

Investigations and treatments of lyme disease?

A

Investigations:
Clinical

Treatment:
Doxycycline for 3 weeks (adult)

(children - amoxicillin)

25
Q

Botulism summary?

A

Causative Organism: Clostridium botulinum infection.
Source: soil, food, can contaminate wounds
RF: IVDU

Botulinum toxic is an exotoxin.
It acts on motor neuron terminals to block vesicle docking in presynaptic membrane, irreversibly inhibit Ach release.

Signs:
Rapid onset weakness w/out sensory loss
Ascending paralysis

26
Q

Difference between weakness and paralysis?

A

Weakness => reduction in power
Paralysis => no contraction

27
Q

What is Guillian Barre syndrome?

A

ACUTE, PARALYTIC polyneuropathy affecting PERIPHERAL nervous system.

Acute, symmetrical, ascending weakness as well as sensory loss.

Usually predisposed by infection (including but not limited to EBV, campylobacter jejuni {check: diarrhoea}, cytomegalovirus)

28
Q

Signs/symptoms of Guillian Barre syndrome?

A

Symmetric, ascending weakness
Reduced reflexes
Peripheral loss of sensation
Neuropathic pain
MIGHT progress to CNS and cause facial weakness.
Usually occurs within 4 weeks of infection
Peak symptoms occur at 2-4 weeks (recovery takes months-years)

29
Q

Diagnosis and treatment of Guillian Barre syndrome?

A

BRIGHTON CRITERIA
Perform:
Nerve conduction studies
Lumbar puncture (raised protein in CNS)

30
Q

Treatment/management of GBS?

A

IV immunoglobulins or plasma exchange
Supportive care

31
Q

Viral meningitis on CSF will show raised protein, decreased glucose and will be a cloudy/purulent colour. true/false?

A

False

This is the case for bacterial meningitis.

Viral meningitis will show:
normal protein and glucose.
raised lymphocytes
clear or slightly haze colour

32
Q

Level of lumbar puncture sample site in spine?

A

Between L3 and L4, advanced to the subarachnoid space

Since it is below the spinal cord in majority of patients, so no risk of cord damage

33
Q

Where is CSF contained in the spine?

A

In the subarachnoid space between the arachnoid mater and pia mater.

34
Q

Contraindications to lumbar puncture?

A

Signs or causes of raised ICP i.e. papilloedema.
Focal neurology
Intracranial tumours

35
Q

What symptoms differentiate meningitis from encephalitis?

A

Meningitis presentation: altered mental state, fever, neck stiffness, headache (any of the 2 mentioned).

Encephalitis presentation: altered mental state (consciousness, cognition, personality, behaviour).

36
Q

What are the 3H’s of viral encephalitis?

A

Hot (fever)

Hectic (seizures)

Hysterical (personality changes)

37
Q

What sign can be indicative of meningitis?

A

Kernig’s sign

38
Q

What is a positive kernig’s sign?

A

Patient is kept in supine position, hip and knee are flexed to a right angle, and then knee is slowly extended by the examiner.

The appearance of resistance or pain during extension of the patient’s knees beyond 135 degrees indicates a positive Kernig’s sign.

Neurology Y3 (40 decks)

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