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Pathophysiology Of Infectious Diseases > CNS > Flashcards

CNS Flashcards

(68 cards)

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1
Q

Meningitis is more commonly ______ infection

A

bacterial

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2
Q

Aseptic meningitis

A

pathogens that don’t grow on typical bacterial media (virus, fungi, parasites, non infectious causes)

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3
Q

Chronic meningitis is more likely caused by…

A

mycobacterium or fungi

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4
Q

Meningitis @infants is most commonly caused by

A

E.coli
S.pneumonniae type B

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5
Q

Meningitis @children is most commonly caused by

A

H.influenzae & S.pneumoniae

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6
Q

Meningitis @young adults is most commonly caused by

A

N.meningitis

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7
Q

Meningitis @elderly is most commonly caused by

A

S.pneumoniae

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8
Q

Meningitis by Retrograde infection is transported by _______

A

cranial and peripheral nerves

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9
Q

Retrograde transport @meningitis is present @

A

viral illness

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10
Q

Common etiology of Meningitis

A

Otitis media
Sinusitis
CSF leak after trauma/surgery
Sepsis

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11
Q

What pathogen causes Neonatal meningitis

A

E.coli

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12
Q

Risk factors for meningitis infection

A

Crowded occupational/living conditions
Immunocompromised
Close contact with infected

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13
Q

Pathophysiology of Meningitis

A

Hematogenous
Contagious
Retrograde
Traumatic

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14
Q

Virulence factor of S.pneumoniae

A

Polysaccharide capsule
Neumolisins → pores

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15
Q

Virulence factor of N.meningitis

A

Pilis

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16
Q

Early and Late symptoms @Neonatal Meningitis

A

Early:
Lethargy
Muscle Hypotonia
Irritability
Poor apetite
Vomiting
Dyspnea

Late:
Fontalle buldging
High-pitchh cry
Seizure

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17
Q

T or F: In neonatal meningitis the Triad is also present

A

F

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18
Q

Meningitis Triad

A

Fever
Neck Stiffness
Headache

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19
Q

Petechial or Purpuric rash suggest…

A

Neisseria meningitis infection

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20
Q

Meningococcal

A

Neiseria Meningitis

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21
Q

WaterHouse-Friderishen Syndrome @

A

N.meningtis

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22
Q

Myalgia + Purpuric Rash suggest

A

Meningococcal infection

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23
Q

Prodrome and Flu-like symptoms followed by Neurological symptoms suggest…

A

Viral Meningitis

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24
Q

Classic Triad of Meningitis + >Sudden Onset + Lose of consciousness suggest…

A

Dx Diferencial → Subarachnoid hemorrhage

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25
Clinical features @Meingismus
Triad Altered mental tatus Photophobia Seizure Nausea, Vomiting Malaise Cranial Nerve Palsies
26
Meningismus @Physical Examination
Neck Stiffness Kernig + Brudzinski sign → Meningeal irritation Fever Hypotension Tachycardia → Inflammation Papiledema → Increased Intracraneal Pressure Bulging+ Redness @timpanic memb. = Otitis Media Skin manifestations ( petechiae, maculopapular rash) → Underlying infection
27
T or F: Blood culture should be taken BEFORE starting empiric antibiotics
T
28
Findings @CBC in Bacterial Meningitis
↑ WBC (specifically Neutrophils)
29
When is a Lumbar Puncture contraindicated?
Increased Intracranial Pressure Bleeding Disorders Local infection or lesions
30
What tests are preformed with the sample of CSF
CSF analysis PCR Gram stain
31
CSF analysis @Bacterial Meningitis
Cloudy/Purulent ↑ Leukocytes (PMN) ↑ Granulocytes ↑ Openning Pressure (because of edema) ↑ Protein ↑ Lactate ↓ Glucose
32
CSF analysis in a Viral infection
Clear ↑Lymphocytes Normal Glucose
33
Where is a Lumbar Puncture preformed?
L3-L4
34
Empiric Tx @Meningitis
Ceftriaxone Vancomycin Dexamethasone (corticosteroid) = inflammation
35
When is Ampicillin indicated in the Empiric Tx of meningitis
@High Risk of Listeria Meningitis = - Immunocompromised - >50 yo
36
Postexpousure Prophylaxis for close contact @Meningitis
Rifampin or Ceftriaxone
37
Postexpousure Prophylaxis for close contact pf Meningitis @Pregnant women
Ceftriaxone
38
Tx of Cyptococcal Meiningitis
Fluconazole or Amphotericin B
39
Viral Meningitis Tx
Acyclovir
40
Petechial Rashed Meningococo indicates....
Thrombocytopenia
41
Point of NO RETURN @Meningococo infection
16 hrs
42
Most common cause of Sporadic Encephalitis
HSV-1
43
Encephalitis is more commonly caused by ______ infections
Viral
44
CMV and EBV can cause Encephalitis @
Immunocompromised
45
Incidence of HSV infection
Bimodal <20yo >50yo
46
What type of HSV is most commonly @Neonates
1 and 2
47
Type(s) of HSV more common @Adults
1
48
How does HSV-1 spread towards the brain?
From oropharynx it spreads via Trigeminal or Olfactory nerve towards the brain
49
Where does HSV stay latent in the body for future reactivation?
Trigeminal ganglia
50
First sign of infection of HSV
Gingivistomatitis
51
HSV mainly affects ______ lobe causing which focal neurological effect?
Temporal Crisis Convulsivas
52
T or F: Triad of Meningism is ONLY present @Meningitis
F
53
What part of the brain does Enterovirus infection affects
ANY part
54
Pathophysiology of Enterovirus Encephalitis
Viremia "Caballo de Troya" = Macrofagos Retrograda = Miocitos (via motora)
55
Focal Neurological Deficit= Ataxia Which part of the brain is affected?
Cerebelo
56
Focal Neurological Deficit = Comportamiento Alterado Which part of the brain is affected?
Frontal
57
Alteraciones Oftlmologicas @Encephalitis Which part of the brain is affected?
Occipital lobe
58
Subacute onset of: Psychiatric symptoms + Seizures + Focal Neurological Deficits suggest....
Encephalitis
59
Neurological Symptoms @Encephalitis
Altered Mental Status Memory loss Seizures Focal Neurological Deficit Dysatonomia
60
Psychiatric symptoms @Encephalitis
Behavioral changes Hallucinations Anxiety Pschosis
61
Dx @Encephalitis
MRI with contrast - to look for Hyperintense temporal lobe edema @HSV Electroencephalography @inconclusive dx of seizures Lumbar Puncture Tissue Analysis
62
What smear is done in the tissue analysis of Encephalitis?
Tzanck Smear = look for HSV @ suspicious skin lesions
63
Findings of Encephalitis @Brain Biopsy
Cowdy Type A inclusions @HSV infection Temporal Lobe Necrosis @HSV
64
Tx for Enterovirus Encephalitis
Symptomatic
65
Tx for HSV Encephalitis
Acyclovir
66
Prognosis of Viral Meningitis
Resolves spontaneously **There may be residual symptoms
67
Prognosis @Bacterialmeningitis
Fatal if left untreaed
68
Why is Ceftriazone contraindicated as Tx in Meningitis @Infants?
High risk of Kernicterus and Hiperbillirubinemia

Pathophysiology Of Infectious Diseases (4 decks)

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