Flashcards in CNS Deck (48):
Summary of CNS infections
-Bacterial/ Viral/ TB/ Cryptococcus/ Neonatal
VPS & EVD infections
Which CNS infection is called by Viral (HSV1), Bacteria or autoimmune?
What are the 3 components of meningism?
Which CNS infection presents as meningism, acute fever, +/- rash and no focal neurology?
Which CNS infection presents as +/- meningism, acute fever, CHANGE IN MENTAL STATE, +/- focal neurology?
What type of fever do you get with a brain abscess?
+/- neck stiffness/ focal neurology
Causes of brain abcesses?
Which CNS infections have altered conciousness?
State the 4 causes of meningitis
What test would you do to analysis a patient's CSF?
Patient in foetal position - L3-L4
What type of infection does the following CSF analysis suggest:
Cell count > 200
Bacterial meningitis can be caused by which 3 organisms?
How would you treat Bacterial meningitis?
Would you give prophylaxis to the contacts of the bacterial meningitis patient?
Neonatal meningitis is caused by E.Coli, Listeria monocytogenes, Group B strep.
How were they exposed?
How would you treat neonatal meningitis?
Ampicillin + Gentamicin
Which type of meningitis is a MEDICAL EMERGENCY + NOFTIABLE?
Viral meningitis is common in which age group?
State 5 common causes of viral meningitis.
HSV - diff= Mollarets M..
"V" for Viral Meningitis
Kernig's and Brudzinski's sign would be found on examination of a patient with bacterial meningitis.
+ve in patient with VIRAL meningitis
Describe Kernig's sign.
When hip & knee flexed --> pain/stiff in hamstrings, when EXTEND knee
Describe Brudzinski's sign.
Flexing neck causes hip & knee to flex
(patient lying down)
What investigations would you do in a case of suspected viral meningitis?
Blood tests - esp Clotting
Throat/stool - enterovirus
Serology - Mumps, HSV, EBV, HIV
Treatment for Viral meningitis?
What test do you need to do before performing a Lumbar puncture?
In order to compare the glucose CSF: blood, what should be taken simultaneously?
TB meningitis is gradual onset. (Bacteria slow to grow). What are the risk factors?
Same as TB
What cell type would you see in a LP confirming TB meningitis?
Treatment of TB meningitis?
12 month standard TB treatment
Cryptococcus meningitis is seen especially in whom?
Cryptococcus meningitis has the same CSF findings as TB M. What is the treatment?
List the complications of Meningitis
Which CNS infection should you treat on clinical suspicion?
With suspected Meningitis/Encephalitis, What should you alwyas ask the patient?
90% of Encephalitis is caused by...?
Presentation of Encephalitis?
CHANGE IN MENTAL STATE
+/- focal neurology (weakeness, ataxia, dysphagia, CN palsy..)
Investigations of Encephalitis?
FULL NEUROLOGICAL EXAM
MRI - typical changes
EEG - abnormal tempora activity
How do the LP results of Encephalitis compare to Viral Meningitis?
Treatment of Encephalitis?
IV Aciclovir (14-21 days)
Which autoimmune CNS demyelination condition presents the same and has same CSF fidnings as encephalitis?
Acute disseminated Encephalomyopathy
Are brain abscess monomicrobial or polymicrobial?
How do brain abscesses occur?
Direct spread (ear, sinus, teeth)
Blood- Endocarditis, Bronchiectasis
Clinical presentation of brain abcesses?
State 2 complications of brain abscesses.
Increased ICP --> mass effect
Rupture --> Ventriculitis
What is the main way of managing brain abscesses?
What is an example of a brain abscess
Neurosurgical patients have a VP shunt/EVD shunt to treat hydrocephalus/monitor CSF respectively. How does infection occur?
Tubes become colonised