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Neurology Week 3 2018/19 > 3: CNS infections > Flashcards

Flashcards in 3: CNS infections Deck (51)
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1

What are consequences of untreated CNS infections?

Brain herniation (Monro Kellie)

Cord compression and necrosis

2

What is the difference between meningitis and encephalitis?

Meningitis - meninges affected only

Encephalitis - diffuse infection of brain tissue

3

What is the difference between encephalitis and encephalopathy?

Encephalopathy - broader term meaning any disease of the brain

4

What does aseptic meningitis mean?

No bacteria isolated from culture after two days

Could mean inflammation has viral/other origin

5

Chronic CNS infections are common in people who are ___.

What is an example?

immunosuppressed

TB

6

Why are brain abscesses particularly dangerous?

Focal area of pus in the brain

causing FOCAL SYMPTOMS

7

What is pyogenic meningitis?

Meningitis caused by purulent bacteria

8

What does Strep. pneumoniae look like on a Gram film?

Gram positive cocci in chains

9

What does Meningococcus look like on a Gram film?

Encapsulated Gram -ve cocci

10

What does Listeria monocytogenes look like on a Gram film?

Gram positive bacilli

11

What does H influenzae look like on a Gram film?

Gram negative bacillus

12

What is the second most common type of meningitis after bacterial?

Viral meningitis

13

When in the year does viral meningitis tend to present?

Late summer

14

How is viral meningitis investigated?

Pharyngeal swab for viral PCR

Stool sample (for enterococcus)

15

What are the important viruses which cause meningitis?

Enterococcus

HSV

Mumps (in countries which aren't vaccinated for it)

16

 How does meningitis tend to present?

Fever

Headache

Neck stiffness

+/- meningococcal rash

17

What is the difference between the presentations of meningitis and encephalitis?

Meningitis - classic triad of headache, fever and neck stiffness

Encephalitis - diffuse infection, so widespread mental state changes +/- sepsis

18

Neck stiffness tends to be a feature of (meningitis / encephalitis).

meningitis

19

What virus should you worry about in people presenting with encephalitis?

HSV

20

Which treatment is given for suspected encephalitis?

Aciclovir IV

21

Which imaging modality is helpful in diagnosing encephalitis?

MRI brain

22

Which organisms should you strongly suspect in patients with bacterial meningitis?

Neisseria meningitidis / Meningococcus - most common, accompanied by a rash

Strep. pneumoniae - next most common

Listeria monocytogenes - in those > 60, immunosuppressed

H. influenzae - in children who haven't been vaccinated

23

How do most cases of bacterial meningitis start?

Colonisation of nasopharynx by meningococcus

24

What is the gold standard investigation for bacterial meningitis?

Lumbar puncture --> CSF culture

25

In bacterial meningitis, CSF white blood count is raised.

Which value is typical of bacterial meningitis?

>2000

26

In bacterial meningitis, CSF glucose conc. will be (more than / less than) that of blood glucose.

less than

because the bugs are munching it

27

Which investigation amplifies the amount of bug present and helps you to identify the causal agent of a meningitis?

PCR

28

Where does meningococcus colonise?

Nasopharynx

29

What is a cutaneous sign of meningococcal septicaemia?

Widespread, non-blanching purpuric rash

30

Why is H influenzae meningitis much less common nowadays?

Vaccination