CNS infections- bacterial meningitis. Flashcards

1
Q

are encephalitis and meningitis typically viral or bacterial

A

viral

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2
Q

are brain abscesses typically viral or bacterial

A

bacterial

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3
Q

through what 2 mechanisms can pathogens enter the brain and it’s surroundings

A

blood bourne - cross the blood brain barrier or the blood- CSF barrier.
peripheral nerves

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4
Q

why do the levels of protein increase during bacterial and viral infections

A

Presence of dead cells result in higher levels of proteins

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5
Q

why do the levels of glucose decrease upon viral and bacterial infection

A

bacteria and viruses use glucose as a substrate for there energy so that they can function

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6
Q

what type of bacteria neisseria meningitides

A

gram negative diplococcic

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7
Q

what medium does neisseria meningitides require to grow

A

blood

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8
Q

what is the natural habitat of neisseria meningitides in the body.

A

nasopharynx

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9
Q

how does the neisseria meningitides survive in the body.

A

Modifies host inflammatory process to survive.

Capsule- protects against complement mediated bacteriolysis and phagocytosis

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10
Q

how is neisseria meningitides detected

A

PCR

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11
Q

what age group do neisseria meningitides affects

A

Affects

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12
Q

complications of neisseria meningitides infection.

A
  • Fulminant (suddenly occurring) septicaemia
  • Septicaemia with purpuric rash
  • Septicaemia with meningitis
  • Pyogenic (purulent) meningitis with no rash
  • Chronic meningococcal bacteraemia with arthralgia
  • Focal sepsis
  • Conjunctivitis, endophthalmitis
  • Non-blanching rash
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13
Q

treatment for neisseria meningitides infection.

A

antibiotics -Ceftriaxone, cefotaxime, Penicillin

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14
Q

prevention of neisseria meningitides infection.

A

vaccines

Active against Group A and C and W135, Group B

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15
Q

what medium does haemophilius influenza require to grow.

A

blood

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16
Q

what type of bacteria is haemophilius influenza

A

Small, pleopmorphic Gram negative cocco-bacilli or bacilli

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17
Q

how many antigenic types of haemophilius influenza are there

A

6 types.

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18
Q

which antigenic type of haemophilius influenza in the most invasive

A

type b

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19
Q

Which organisms typically carry and host haemophilius influenza

A

humans

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20
Q

haemophilius influenza is found were commonly in the body

A

upper respiratory tract

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21
Q

treatment for haemophilius influenza

A

Ceftriaxone, cefotaxime

Ampicillin

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22
Q

what chemoprophylaxis antibiotic is given to prevent invasive haemophilius influenza and neissera meningitidis

A

rifampicin

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23
Q

prevention of haemophilia influenza

A

H. Influenza Type B conjugates vaccines

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24
Q

what type of bacteria is streptococcus pneumonia

A

Gram positive cocci

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25
Q

what media is required for streptococcus pneumonia to grow

A

blood or serum

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26
Q

where is the normal habitat for streptococcus pneumonia

A

respiratory tract

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27
Q

how does transmission of streptococcus pneumonia occur

A

via droplet spread occur.

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28
Q

treatment for streptococcus pneumonia

A

Ceftriaxone, cefotaxime, Penicillin

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29
Q

is chemoprophylaxis offered for invasive streptococcus pneumonia infections

A

no.

30
Q

prevention of streptococcus pneumonia

A

Conjugate vaccine available against common serotypes

31
Q

what groups of people are streptococcus pneumoniae infections common amongst

A

elderly and immunosuppressed

32
Q

when are strides administered in meningitis infections

A

Must be given shortly before or with first dose of antibiotics

33
Q

what is a commonly used steroid in meningitis.

A

Dexamethasone

34
Q

dexamethasone (steroid), decreases the levels of what antibiotic in CSF

A

vancomycin

35
Q

common pathogens which cause neonatal meningitis

A
  • Group B beta haemolytic Streptococci
  • Escherichia coli
  • Listeria monocytogenes
36
Q

bacteria Listeria monocytogenes is associated with what types of food

A

cheese, pate.

37
Q

where do the pathogens which infect neonates arise from

A

pathogens in the birth canal- from the gut.

38
Q
define in terms of days
early
intermediate
late
neonatal meningitis
A

early 5 days

39
Q

what is the treatment for neonatal meningitis

A
  • Cefotaxime
  • Ampicillin – against all streptococci
  • Gentamicin- against E coli.
40
Q

complications of meningitis

A
  • Death
  • Overwhelming sepsis
  • Raised intracranial pressure
  • Longer term problems
  • Deafness
  • Delayed development
  • Seizures
  • Stroke
  • Hydrocephalus
41
Q

what antibiotic can be used for all streptococci infections

A

ampicillin

42
Q

what type of pathogen most commonly causes lymphocytic meningitis

A

Virus- enetrovirus and herpes simplex

43
Q

what is the name of the bacteria which via a STI can cause meningitis

A

spirochete

causes syphillitic meningitis

44
Q

what bacteria can cause lyme disease

A

spirochete

45
Q

Is TB meningitis slow onset or fast onset

A

slow

46
Q

how is TB diagnosed

A

AFB (acid fast bacilli)
Ziehl Neelsen stain- alcohol and acid fast- if caused by Tb the stain doesn’t go when washed with alcohol.
Fluorescent antibody stain-easily see bacteria.

47
Q

treatment for TB meningitis

A

12 months standard TB treatment and steroids.

48
Q

where is toxoplasma gondii pathogen typically found

A

cat faeces

49
Q

what types of brain infection does Toxoplasma gondii cause

A

encepahlitis

50
Q

what group of individuals does Toxoplasma gondii most commonly affect

A

immunocompromised

51
Q

what type of brain infection does Cryptococcus cause

A

meningitis

52
Q

In what chronic condition is cryptococcus meningitis a end stage complication

A

HIV

53
Q

treatment for Cryptococcus meningitis

A

Amphotericin, flucytosine or fluconazole.

54
Q

is Cryptococcus meningitis slow or fast onset

A

slow.

55
Q

what is the most common cause of encephalitis

A

Japanese encephalitis

56
Q

prevention for Japanese encephalitis

A

vaccine

57
Q

how is Japanese encephalitis transmitted form person to person

A

arbovirus transmitted by arthropod vectors

58
Q

treatment for Japanese encephalitis

A

aciclovir and maybe steroids

59
Q

The bites of which 3 animals cause rabies encephalitis

A

dog, fox or bat bite.

60
Q

prevention of rabies encephalitis

A

vaccine

61
Q

what type of bacteria is clostridium tetani

A

Gram positive spore forming bacillus

62
Q

what shape is the clostridium tetani

A

drumstick

63
Q

in what conditions does the clostridium tetani thrive

A

anaerobic

64
Q

How is clostridium tetani most commonly obtained

A

wound which is contaminated with soil

65
Q

pathogenesis of clostridium tetani

A

toxin spreads via bloodstream and retrograde tarnsport
binds to ganglioside receptors and blocks release of inhibitory interneurones
causes convulsive contraction of voluntary muscles

66
Q

most common symptom of clostridium tetani

A

muscle spasm

67
Q

what parts of the body are most commonly affected by clostridium tetani muscle spasms

A

– Trismus- spams of the jaw
– Opisthotonus- hyperextension and spasticity in which an individual’s head, neck and spinal column enter into a complete “bridging” or “arching” position.
Respiratory difficulties
cardiovascular instability

68
Q

define Trismus

A

spasm of jaw

69
Q

define Opisthotonus

A

hyperextension and spasticity in which an individual’s head, neck and spinal column enter into a complete “bridging” or “arching” position.

70
Q

treatment for clostridium tetani

A

Antitoxin (horse or human)

Penicillin or metronidazole

71
Q

treatment for muscle spasm in clostridium tetani

A

o Muscle relaxants

o Respiratory support

72
Q

prevention of clostridium tetani

A

o Toxoid- antibody against the toxin.

o Vaccine