CNS Infections

Question 0

Habitat of strep pneumoniae?

Answer 0

Respiratory tract - droplet spread

Question 1

Class of streptococcus pneumoniae?

Answer 1

Gram positive diplococi. Alpha-haemolytic activity.

Question 2

Treatmeant for strep pneumoniae?

Answer 2

Ceftriaxone, cefotaxamine, vaccine. Penicillin resistant strains common.

Question 3

Class of neisseria meningitidis?

Answer 3

Gram negative diplococci

Question 4

Habitat of neisseria meningitidis?

Answer 4

Nasopharynx - needs blood for growth

Question 5

Treatment for neisseria meningitidis?

Answer 5

Ceftriaxone, cefotaxime, penicillin, vaccine

Question 6

Class of haemophilus influenzae?

Answer 6

Gram negative cocco-bacilli.

Question 7

Habitat of haemophilus influenzae?

Answer 7

Invasion of sub mucosa-bloodstream. Restricted to humans.

Question 8

Treatment for haemophilus influenzae?

Answer 8

Ceftriaxone, cefotaxime, ampicillin, type b vaccine

Question 9

Symptoms of Enteroviral meningitis?

Answer 9

Fever, vom, anorexia, rash, URTI.

Question 10

Commonest cause of meningitis in uk?

Answer 10

Enteroviral meningitis - Coxsackie, echo viruses

Question 11

Viral meningitis aetiology?

Answer 11

Echoviruses (coxsackie and parecho), and herpes viruses (HSV, VZV, CMV, EBV, HHV6/7)

Question 12

Clinical features of viral meningitis?

Answer 12

Same as bacterial

Question 13

Investigations in viral meningitis?

Answer 13

Lymphocytic, neutrophilic, protein/glucose normal.

Question 14

4 methods of aetiology of brain abscess?

Answer 14

1. Direct spread from ear, teeth, sinuses
2. Haematogenous spread from distant focus
3. Trauma
4. Crypto genie

Question 15

Bacterial causes of brain abscess?

Answer 15

Streptococci (60-70%), staph aureus (10-15%), anaerobes, gram negative enteric bacteria.

Question 16

Complications of brain abscess?

Answer 16

Raised ICP, coming, rupture into ventricles

Question 17

Cause of subdural empyema?

Answer 17

Steptococci, anaerobes, strep pneumoniae, haemophilus influenzae

Question 18

Where does subdural empyema come from?

Answer 18

Sinuses, middle ear, mastoid

Question 19

Main cause of viral encephalitis?

Answer 19

90% = HSV1 - VZV, EBV, CMV, measles, adenovirus, influenza, rubella, HIV.

Question 20

Clinical features of viral encephalitis?

Answer 20

Different from meningitis - fever, headache, meningism, altered mental state, +/- focal neuropathy - seizures, weakness, dysphasia, CN palsy, ataxia.

Question 21

Investigations in viral encephalitis?

Answer 21

EEG - abnormal temporal lobe activity, CSF same as viral meningitis.

Question 22

Treatment for viral meningitis?

Answer 22

Aciclovir - mortality high despite treatment - some have neurological sequelae.

Question 23

Acute disseminated encephalomyelopathy?

Answer 23

Immune mediated CNS demyelination. Follows viral illness or vaccination.