Bacterial and Fungal Meningitis

Question 1

A brain abscess has the same symptoms of Encephalitis except in what way?

Answer 1

It has an insidious onset

Question 2

What causes a brain abscess?

Answer 2

Bacteria/maybe parasite

Question 3

What are the three ways in which microorganisms can invade the brain and spinal cord?

Answer 3

> Blood-brain barrier
Blood-CSF barrier
Peripheral nerves

Question 4

In which space can microorganisms invade in the brain and SC?

Answer 4

Subarachnoid space

Question 5

What two pathways can endotoxins cause?

Answer 5

> Alternative complement pathway

> Cytokine production - Inflammatory or Anti-inflammatory

Question 6

What type and shape of bacteria is Neisseria Meningitdis?

Answer 6

Gram negative diplococci

Question 7

What capsular types of Neisseria Meningitidis are most common?

Answer 7

A, B, C, W135 and Y.

Question 8

What can Neisseria Meningitidis cause?

Answer 8

> Fulminant Septicaemia
Septicaemia w/ meningitis
Pyogenic meningitis w/ no rash.

Question 9

What are the two ways in which bacteria can survive intravascularly? (i.e before crossing blood-brain barrier)

Answer 9

1) CAPSULE - Protects against phagocytosis and complement-mediated bacteriolysis.
2) CAN ACQUIRE IRON FROM TRANSFERRIN.

Question 10

What is the treatment of Neisseria Meningitidis?

Answer 10

Ceftriaxone, Cefotaxime and Penicillin.

Question 11

What prophylaxis would be given against invasive disease contact such as Neisseria Meningitidis?

Answer 11

Rifampicin, Ciprofloxacin.

Question 12

What capsular types is the Neisseria Meningitidis vaccine active against?

Answer 12

A, C, W135 not B.

Question 13

What type of bacteria is H.Influenzae?

Answer 13

Gram -ve cocco-bacilli.

Question 14

Which strain of H.Influenzae polysaccharide capsule is the most invasive?

Answer 14

Type B

Question 15

Is non-capsulate strain or capsulate strain of H.Influenzae most common?

Answer 15

Non-capsulate

Question 16

How does H.Influenzae carriage reach the blood stream?

Answer 16

Submucosal infection in the throat.

Question 17

H.Influenzae can cause Influenza. What other disease does it cause in the young?

Answer 17

Meningitis

Question 18

What virulence factors make H.Influenzae aggressive?

Answer 18

> Type B capsule
Outer protein/lipopolysaccharide
Fimbriae

Question 19

What is the treatment of H.Influenzae?

Answer 19

Ceftriaxome, cefotixame, AMPICILLIN.

Question 20

What type of bacteria is S.Pneumoniae?

Answer 20

Gram positive cocci

Question 21

How many capsular types does S.Pneumoniae have?

Answer 21

95

Question 22

How is S.Pneumoniae spread?

Answer 22

Droplet spread

Question 23

If S.Pneumoniae is suspected, what type of medication can be used?

Answer 23

Steroids

Question 24

What is the action of Dexamethasone?

Answer 24

Decreases vanco levels in the CSF

Question 25

Group B beta-haemolytic Streptococci, Escherichia Coli and Listeria Monocytogenes all cause what in: A) Neonates 5 days

Answer 25

A) Septicaemia | B) Meningitis

Question 26

What is the treatment for Neonatal Meningitis ?

Answer 26

Cefotaxmine, Ampicillin and Gentamicin

Question 27

What are the complications of Neonatal Meningitis?

Answer 27

``` > Death > Sepsis > Stroke > Seizures > Delayed devl't > Hydrocephalus > Raised ICP. ```

Question 28

What virus can cause meningitis and then paralysis?

Answer 28

Polio

Question 29

Who is at risk of TB meningitis?

Answer 29

> Alcoholics > Those who live in endemic area > Immunocompromised

Question 30

What are the direct direction methods of TB meningitis?

Answer 30

> Ziehl Neelson | > Fluorescent Anti'B

Question 31

What bacteria spread from the middle ear/sinuses to cause Brain abscesses?

Answer 31

Streptococci Anaerobes

Question 32

What bacteria spread via the blood stream to cause Brain abscesses?

Answer 32

Staphylococcus Aureus

Question 33

What treatment do brain abscesses need?

Answer 33

Anti'Bs.

Question 34

What can toxoplasma gondii encephalitis cause in the brain?

Answer 34

Lesions

Question 35

How is toxoplasma gondii encephalitis spread?

Answer 35

> Mother --> Child > Cat faeces > Cyst contained food

Question 36

What type of organisms causes Cryptococcal Meningitis?

Answer 36

YEAST!

Question 37

In what kind of pt does Cryptococcal Meningitis cause problems?

Answer 37

Late stage HIV pt's.

Question 38

What is present in the CSF for Cryptococcal Meningitis?

Answer 38

Yeast

Question 39

What is the treatment for Cryptococcal meningitis?

Answer 39

> Amphotericin | > Flucytosine/Flucoazole

Question 40

How is Encephalitis diagnosed ? (HINT: Usually Viral)

Answer 40

Viral nucleic acid in CSF.

Question 41

What virus most commonly causes Encephalitis?

Answer 41

Worldwide Japanese Encephalitis Virus

Question 42

What encephalitis is caused through dog, fox and bat bites and has 100% mortality?

Answer 42

Rabis Encephalitis

Question 43

What type of bacteria is Clostridium Tetanu?

Answer 43

An anaerobic gram positive bacilli.

Question 44

How is Clostridium Tetanu transmitted?

Answer 44

Soil contamination - tetanospasmin are found.

Question 45

How does C.Tetani cause voluntary muscle convulsive contraction?

Answer 45

> Encode toxin genes in plasmid > Bloodstream spread > Bound to ganglioside receptor > Release inhibitory interneurons

Question 46

What is the clinical presentation of Tetanus?

Answer 46

``` > Muscle spasms > Trismus (jaw muscle spasm) > Opisthotonus (hyperextended spine) > Resp difficulty > Cardiov instable ```

Question 47

What is the treatment for Tetanus?

Answer 47

``` > Spasm drugs > Muscle relaxants > Resp support > ANTITOXIN > Penicllin ```

Question 48

How is Tetanus prevented?

Answer 48

Using a toxoid