CNS

Question 1

The most common form of suppurative CNS infection

Answer 1

Bacterial meningitis

Question 2

Cause recurring epidemics of meningitis

Answer 2

N meningitidis

Question 3

90% of patients with meningitis will have opening pressure CSF of

Answer 3

> 180

Question 4

Most common. Cause of meningitis adults > 20

Answer 4

S pneumoniae

Question 5

Abx used in the empirical therapy bacterial meningitis

Answer 5

Cefotaxime or Ceftriaxone or cefepime + vancomycin

Question 6

Role of dexamethasone in meningitis

Answer 6

Dec CSF outflow resistance

Inhibits TNFa and IL1B

Question 7

Rationale for giving dexamethasone prior to antibiotic therapy

Answer 7

It exerts production of TNFa by macrophages and microclimate only b fore the cells are activated by endotoxins

Question 8

Most likely agents in viral meningitis

Answer 8

Enteroviruses

Question 9

Causes of subacute meningitis

Answer 9

MTb
C neoformNs 
T pallid in
H capsulatum
C immitis

Question 10

CSF abnormalities in fungal infection

Answer 10

Mono or lymphocytic oleo cytosine
Increased protein concentration
Decreased glucose concentration

Question 11

Rx tuberculous meningitis

Answer 11

hRZE and pyridoxine

Treat 10 months

Question 12

Multifocal areas of demyelination of varying size sparing spinal cord and optic nerves

Answer 12

PML

Question 13

Most common localizing sign of frontal lobe abscess

Answer 13

Hemiparesis

Question 14

Classic triad of abscess

Found in <50%

Answer 14

Fever headache

FND

Question 15

The most common parasitic disease of the CNS

Answer 15

Neurocysticercosis

Question 16

Treatment CST toxoplasmosis

Answer 16

Sulfadiazine

Pyrimethamine

Question 17

MC predisposing condition to subdural empyema

Answer 17

Sinusitis

FRONTAL SINUS!!!

Question 18

Classic CSF abnormalities in Tb meningitis

Answer 18

Elev opening pressure
Lymphocytic pleocytosis
Elevated protein concentration
Decreased glucose concentration

Question 19

Combination that is HIGHLY SUSPICIOUS for TB meningitis

Answer 19

Stiff neck
Fatigue
Night defeats 
Fever
CSF lymphocytic pleocytosis
Mildly decreased glucose concentration is highly suspicious for TB meningiti

Question 20

Phases of brain abscess formation

Answer 20

Early cerebritis
Late cerebritis
Early capsule formation
Late capsule formation

Question 21

Empiric therapy of brain abscess

Answer 21

3rd or 4th generation cephalosporin and metronidazole

Question 22

Until when should patient with brain abscess receive seizure prophylaxis?

Answer 22

3 months after the resolution of the abscess

Question 23

Most common symptom in patients with brain abscess

Answer 23

Headache

Question 24

Rx for progressive multifocal leukoencephalopathy

Answer 24

Mirtazipine 15 mg/tab OD

Question 25

Treatment of | CNS toxoplasmosis

Answer 25

Sulfadiazine Pyrimethamine Folinic acid

Question 26

Most common predisposing condition of subdural empyema

Answer 26

Sinusitis

Question 27

Transverse sinus thrombosis presenting with otitis media Sixth nerve palsy Retro orbital or facial pain

Answer 27

Gradinego syndrome

Question 28

Chronic demyelinating disease of the CND associated with no permission infection of brain tissue with measles virus

Answer 28

SSPE

Question 29

Rx SSPE

Answer 29

Is inspire

Question 30

Rx syphilitic meningitis

Answer 30

Aqueous penicillin G

Question 31

Rx meningitis C neoformans

Answer 31

AMPHOTERICIN B + flucytosine Consolidation with fluconazole

Question 32

Test for gram negative meningitis

Answer 32

Limmulus lysate

Question 33

A CSF culture is positive in __ cases of meningitis

Answer 33

80%

Question 34

Remains the drug of choice for meningococcal meningitis

Answer 34

Penicillin G 7 days in uncomplicated course

Question 35

Regimen of meningococcal prophylaxis in close contacts

Answer 35

Rifampin 600 mg BID x 2 days Alternative: Azithromycin 500 OD x 1 dose Ceftriaxone 250 mg 1 IM dose

Question 36

Rx pneumococcal meningitis

Answer 36

Cephalosporin | Vancomycin

Question 37

How to treat meningitis caused by Listeria monocytogenes

Answer 37

Ampicillin x 3 weeks (Add gentamicin to critically ill patients) Alternative TMP-SMX

Question 38

Dose of Pen G for pneumococcal meningitis

Answer 38

300,000 U/kg

Question 39

Bactericidal agent with antistaphylococcal activity. Novel mechanism of action: disrupts the cytoplasmic membrane

Answer 39

Daptomycin