Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
CNS Infections
CM Neurology
| Question | Answer |
|---|---|
| Clinical Presentation of Meningitis | inflammation of the tissues surrounding the brain - typically an acute illness evolving over hours to at most days, usually with fever, headache, neck stiffness, and lethargy. Usually without focal signs. |
| Encephalitis definition | generalized or diffuse inflammation or infection of the brain tissue itself – usually with fever, headache, lethargy or confusion and sometimes coma – usually without focal neurologic manifestations |
| Brain Abscess definition | a focal infection in the brain which typically presents with focal manifestations due to “space-occupying” nature of the abscess – may or may not have fever, chills or other signs of infection. |
| Which type of meningitis is considered to be the 'typical meningitis'? | Purulent meningitis. Onset over 1-2 days. Neck is stiff on exam. Pt needs emergent lumbar puncture and empiric abx coverage |
| Name the typical organisms that cause purulent meningitis | N. meningitidis, S. pneumonia, H. influenzae |
| CSF results in purulent meningitis | markedly elevated WBC's (predominantly PMN's), low CSF glu, elevated protein and protein and opening pressure |
| Most common organisms cauing chronic meningitis | fungi and tuberculosis |
| CSF results in chronic meningitis | WBC's mildly elevated (mostly lymphocytes), CSF glu low (if really low, then TB), low protein, opening pressure is mildly-moderately elevated |
| Where do you perform a lumbar puncture? | L3 interspace |
| If nothing grows out of the culture, the pt likely has | asceptic meningitis. May be indistiguishable from purulent meningitis initially. Asceptic has more lymphocytes than PMN's |
| What is a serology | An immune test for antibodies for a specific organism. Quicker than culture which waits on growth of an organism. |
| A recent treatment for _______ is a red flag for partially treated meningitis | otitis media; or anything for which patient may have received abx that masks the full symptoms and CSF findings of purulent meningitis |
| An infected, swollen brain | encephalitis. Almost always lethargic and confused. |
| Common cause of encephalitis | Viruses (herpes or arboviruses). CSF may be normal or only mildly abnormal |
| Which is the only encephalitis for which there are antivirals? | Herpes Simplex. Most will be treated empirically for Herpes Simplesx, Otherwise, supportive care. |
| What is the normal route of bacteria getting to the brain? | Via the bloodstream. |
| Cerebritis | bacteria in the brain cause a focal inflammation. bacteria multiply and our immune system reacts, this area coalesces into a “pocket” of pus with a surrounding capsule.lesions cause surrounding edema with significant mass-effect. Often ring-enhancing |
| When should you avoid lumbar puncture? | If brain abscess is suspected because herniation could occur and the CSF studies are rarely helpful. Treat with abx |
| Brain abscesses present with what type of symptoms? | compression symptoms (space-occupying lesion) |
| What number of WBC's in the CSF indicates likelihood of infection? | Over 100 WBCs |
| Predominance of PMNs in the CSF suggests | bacterial meningitis |
| Predominance of lymphocytes in the CSF suggests | usually not bacterial, viral or some other form of inflammation |
| Depressed glucose in the CSF suggests | bacterial or TB (possibly fungal) |
| Most common cuase of meningitis in adults | Streptococcus pneumoniae |
| Gram positive cocci meningitis is treated with | vancomycin |
| This type of meningitis is found among close contacts (ex: military recruits) | Neisseria meningitidis (Meningococcal Meningitis) |
| Which meningitis is associated with petechial rash? | Meningococcal meningitis (N. Meningitidis) |
| What is the tx of choice for Meningococcal meningitis? | Acqueous Pen G |
| ______ meningitis becomes a consideration in pts who develop meningitis in the setting of otitis or sinusitis | H. Flu Meningitis |
| Tuberculous Meningitis has what type of onset | slow. Has a prediliction for the base of the brain (where your cranial nerves are and your pituitary). CN palsies, TB elsewhere - CXR should be abnormal |
| Focal deficits with increased ICP rather than high fever, or meningismus | Brain abscess |
| Ring-enhancing lesion on CT is seen in | Brain abscesses |
| Treatment for Brain abscess | IV abx for a prolonged course and usually surgical drainage |
| What is the incubation period for rabies | >10 days - usually 3-7 weeks. Symptoms follow |
| Ascending Paralysis (over days to a week) is associated with | Rabies |
| What is the primary method of prevention for arboviral encephalitis? | Prevention of mosquito bites |
| Rapidly progressive (over months) dementia plus tremors, think of | Creutzfeld-Jakob Disease. |
Created by:
ltm12