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
DU PA CNS Infections
Duke PA CNS Infections
| Question | Answer |
|---|---|
| patients with CNS infections usually exhibit some combination of __ | fever, headache, altered mental status, depressed sensorium, seizures, focal neurologic signs, and stiff neck |
| inflammation of the leptomeninges caused by infectious or noninfectious processes | meningitis |
| the most common noninfectious causes of meningitis | subarachnoid hemorrhage, cancer, and sarcoidosis |
| the three categories of infectious meningitis | acute bacterial, aseptic, subacute to chronic meningitis |
| 3/4 of patients with meningitis present before the age of __ years | 15 |
| most cases of infectious meningitis occur in the __ | winter and spring |
| most cases of infectious meningitis involve children younger than __ | 5 |
| __ meningitis is a disease of childhood | haemophilus influenzae |
| __ meningitis is a disease seen in all ages | pneumococcal |
| the bacteria that cause most community-acquired meningitis transiently colonize the oropharynx and nasopharynx of __ | healthy individuals |
| patients with bacterial meningitis may exhibit | fever, headache, lethargy, confusion, irritability, and stiff neck |
| stiff neck is absent in about __ of all patients with meningitis | 1/2 |
| although not pathognomonic, __ is very suggestive of N. meningitidis infection | palpable purpura |
| in bacterial meningitis symptoms usually progress over __ days | 1-7 |
| in acute bacterial meningitis the CSF usually contains 500-10,000 cells/mcL, mostly __ | neutrophils |
| in bacterial meningitis glucose in the CSF __ | decreases |
| in bacterial meningitis protein level __ | rises |
| a low level of CSF glucose usually indicates infection but can also occur following a __ | subarachnoid hemorrhage |
| at the time when bacterial meningitis is first suggested, __ procedures should be initiated | respiratory isolation |
| about __% of adults with bacterial meningitis die of the infection | 30 |
| patients with suggested bacterial meningitis should be treated with antibiotics withing __ minutes of reaching medical care | 30 |
| __ are the most frequent cause of aseptic meningitis | viral infections |
| of those cases in which a specific causal agent can be established in viral meningitis, 97% are due to __ | enteroviruses (coxsackievirus B, echovirus, mumps virus) herpes virus, adn leptospira |
| the syndrome of aseptic meningitis of viral origin begins with the acute onset of | headache (worst ever, exacerbated by sitting, standing, or coughing), fever, photophobia, and meningismus associated with CSF pleocytosis |
| in __ meningitis the CSF shows a pleocytosis of 10-2000 white blood cells/mcL | viral |
| __ meningitis is generally benign and self limited | viral |
| patients affected by HSV commonly describe a prodrome of 1-78 days of upper respiratory tract symptoms followed by the sudden onset of headache and fever | HSV |
| untreated HSV has a __% mortality rate | 70 |
| WNV occurs mainly during the __ months | summer |
| __ encephalitis is always fatal, requiring major attention on prevention | rabies |
| 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 | meningitis |
| 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 | encephalitis |
| a focal infection in the brain which typically presents with focal manifestations due to "space occupying" nature of the abcess- may or may not have fever, chills or other signs of infection | brain abcess |
| this is the typical meningitis. Progressive headache, fever, neck stiffness and perhaps lethargy, over hours to 1-2 days. True medical emergency. | purulent meningitis |
| emergent treatment for purulent meningitis | STAT lumbar puncture and empiric antibiotic coverage |
| extremely low CSF glucose is usually due to __ meningitis | tuberculosis |
| CSF of purulent meningitis usually reveals __ | increased WBC's (predominantly PMN's), low CSF glucose, elevated protein, elevated opening pressure |
| usually not due to typical bacteria and is much more indolent. Few or gradual increase in symptoms. Most common organisms involved are fungi and tuberculosis. | chronic meningitis |
| CSF of chronic meningitisi usually reveals __ | WBC's mildly elevated, CSF glucose low, CSF protein elevated, opening pressure is mildly-moderately elevated |
| generally refers to any acute meningitic syndrome which is not caused by acute bacterial infection. Most often this is viral and self-limiting. | aseptic meningitis |
| the major diagnostic distinction is that usually aseptic meningitis has __ | more lymphocytes than PMN's, often the glucose is not as low, and the WBC's are not as high |
| Partially treated meningitis may be mistaken for __ | aseptic meningitis |
| encephalitis is usually due to __ and because it is a diffuse infection of the brain usually is associated with confusion, lethargy and often seizures | viruses |
| __ are often ring enhancing lesions | brain abcesses mostly and brain tumors |
| when bacteria reach the brain itself there is often a focal area of inflammation we often call __ | cerebritis |
| __ is a localized, usually bacterial, parenchymal brain infection which usually causes symptoms via compression | brain abcess |
| if meningitis is suspected, and emergent __ is necessary, even though most times the patient will get a CT scan first if available | lumbar puncture |
| if a brain abcess is suspected, __ is to be avoided because herniation could occur and the CSF studies are rarely helpful | lumbar puncture |
| don't do a lumbar puncture first on a patient with suspected meningitis and __ on physical exam | focal deficits |
| increased WBC's in the CSF indicates __ but not necessarily infection | inflammation |
| CSF gram stain with gram positive cocci in an adult with meningitis symptoms and no rash. The most likely etiologic agent is __ | Streptococcus pneumoniae |
| antibiotic to give when a patient is suspected to have pneumococcal meningitis | ceftriaxone |
| if gram negative diplococci are seen in the CSF of an adult pateint suspected to have meningitis | vancomycin |
| the meningitis associated with petechial rash in most cases | Neisseria meningitidis |
| gram negative intracellular diplococci found in the CSF of a patient with symptoms of meningitis | Neisseria meningitidis |
| usually gradual in onset, with listlessness and irritability, may have cranial nerve palsies | tuberculosis meningitis |
| brain abcesses may be associated with sinustitis, surgical procedures or hematogenous spread of other infections. Most common organisms are __ | streptococcus, staphylococcus or anaerobes |
| treatment of brain abcess | IV antibiotics for a prolonged course and usually surgical drainage |
| __ rhabdoviral infection transmitted by animal bite introducing infected saliva into the wound | rabies |
| incubation period for rabies | >10 days usually 3-7 weeks |
| prodromal symptoms include pain at the inoculation site, fever, malaize, nausea and vomiting | rabies |
| about 10 days after innoculation the CNS manifestations of rabies | delirium, painful swallowing, rage alternating with calm. Or acute ascending paralysis |
| presents in later life with rapidly progressive dementia, myoclonus, ataxia and somnolence | Creutzfeld-Jakob disease |
Created by:
bwyche
Popular Medical sets