Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neurology_Clinical Medicine > CNS Infections > Flashcards

CNS Infections Flashcards

(59 cards)

Start Studying
1
Q

What does the Pia and the Arachnoid make up?

A

Leptomeninges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is infected with meningitis?

A

Leptomeninges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the Pia matter create?

A

Is the inner layer that is tightly adhered to the brain parenchyma which forms the Choroid Plexus, which makes CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is important to do immediately after giving an epidural?

A

Optimize patient positioning to appropriately numb targeted area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is bacterial meningitis a can not miss diagnosis?

A

Without treatment within 24 hours can be fatal 70-100% of the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who is more likely to get bacterial meningitis?

A

Children < 2 months (but median age is 42- so really anyone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some predisposing factors for bacterial meningitis?

A

Prior viral infection
Household crowding (college kids or military)
Active and passive smoking
Occupation risks (us and microbiologists)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the top three bacteria to cause bacterial meningitis?

A

S. pneumonia, N. meningitis, L. monocytogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common bacterial cause of meningitis in newborns?

A

Group B Strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most common bacterial cause of meningitis in teenagers?

A

N. meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a common place of entry for bacterial organisms that go on to cause bacterial meningitis?

A

Nasopharynx up to optic chiasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the the top three infections that lead to meningitis?

A

Otitis media, sinusitis, or dental infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common place of BBB cross over in bacterial meningitis?

A

Choroid plexus and postcapillary veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the inflammatory response for bacterial meningitis?

A

Further breakdown of the BBB, cerebral edema and increased ICP which can lead to herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the two N. meningitidis vaccines?

A

Meningococcal conjugate vaccine and MenB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the antibiotic of choice to treat bacterial meningitis caused by N. meningitidis?

A

Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the antibiotic of choice to treat bacterial meningitis caused by S. pneumoniae?

A

Vancomycin plus ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of bacterial meningitis is most likely to have seizures?

A

Meningitis caused by Listeria Monocytogenes (older patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the antibiotic of choice to treat bacterial meningitis caused by listeria?

A

Ampicillin or Penicillin (if allergic, Bactrim)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What symptom (neurological deficit) seen in listeria meningitis?

A

Ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What type of meningitis is most common in those that arn’t vaccinated?

A

Haemophilus Influenzae (most common in kids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why are neonates more susceptible to meningitis?

A

Have increased permeability of the BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the classic triad of presentation for bacterial meningitis?

A

Fever, stiff neck (nuchal cord rigidity), change in mental status (more lethargy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How can babies present with meningitis?

Study These Flashcards
A

Poor feeding, irritable, moaning cry, abnormal tone (abnormal posturing), vacant staring, lethargic, tense fontanelle, cyanosis

25
What two tests can you do as part of your physical exam to diagnose meningitis?
Brudzinski and Kernig signs
26
What is the rash that will classically present in N. meningitidis meningitis?
Petechiae and palpable purpura rash
27
What will you see on your CBC in meningitis?
Leukocytosis with Left Shift May have thrombocytopenia
28
What labs are you going to order for working up bacterial meningitis?
CBC Coagulation studies CMP (elevated anion gap) 2 sets of blood cultures Head CT LP ?MRI (may show enhancements of the leptomeninges)
29
In real life (not textbook) are you ordering a CT when diagnosing meningitis?
YES! You need to rule out the other stuff that is going to be bad (abscess that would be contraindicated for an LP)
30
How does the patient need to be lying for a lumbar puncture?
Lateral decubitus
31
What are the contraindications for an LP in working up meningitis?
Anticoagulated Concern for herniation (elevated ICP) If platelets < 50,000
32
What is the normal glucose level of CSF?
45-85
33
What is the glucose in bacterial meningitis?
< 40 (low)
34
What is the color of bacterial meningitis vs. viral meningitis?
Turbid/cloudy in bacterial meningitis and clear with viral
35
What WBC is going to be elevated in viral meningitis?
Lymphocytes
36
What is the order of treatment for meningitis?
ABC's Start antibiotics and antivirals Head CT LP Treat Shock Start steroids (dexamethasone) Exposure prophylaxis
37
What is the classic antibiotic (broad spectrum) regimen for antibiotics?
Ceftriaxone, Vancomycin, Ampicillin
38
Who else do you need to treat when someone is diagnosed with meningitis?
Anyone in close contact with patient for more than 8 hours of contact
39
How long does chronic meningitis last prior to presentation?
> 30 days
40
How does chronic meningitis present?
Often have cranial nerve findings and mental status change
41
What is aseptic meningitis most typically associated with?
Enterovirus
42
When is viral meningitis more common?
Summer and fall, enteroviruses most commonly peak in summer and fall
43
What viruses cause viral meningitis?
Enterovirus Herpes Virus Acute HIV
44
What two presenting symptoms are more common in bacterial meningitis than viral meningitis?
Photophobia and seizures are more common in bacterial
45
What is the treatment for viral meningitis?
Depends on virus (acyclovir) Support patient with dark and quite room Tylenol for HA, fever, pain
46
What can direct you to bacterial meningitis over aseptic meningitis or encephalitis?
CSF lactate >3.5mmol/L
47
What is encephalitis?
Inflammation of the brain parenchyma
48
What are the 6 V's of encephalitis?
Vacation Vaccination Vectors Viruses Veterinary sources Vital statistics (is there an outbreak)
49
Beside the overlapping symptoms with meningitis, how is a patient with encephalitis going to present?
Altered mental status (truly confused, agitated, obtunded, personality change) Focal neurologic abnormalities
50
What is a major criteria diagnostic criteria for encephalitis?
AMS + 2 minor criteria (fever, seizure, neuro findings, CSF pleocytosis, parenchyma on MRI, EEG abnormality)
51
What imaging are you going to order for viral meningitis?
MRI, CT may look normal initially
52
What lobe is going to be typically involved in viral meningitis?
Temporal lobe
53
What is the treatment for viral meningitis?
Acyclovir all day long!
54
How is a brain abscess defined?
Focal collection of infection in the brain parenchyma
55
What are the typical infections of spread leading to a brain abscess?
Otitis media Mastoiditis Dental infection
56
What cranial nerve palsy is usually present in a brain abscess?
CN VI due to elevated ICP
57
Do you use contrast when looking for an abscess?
Yes
58
What broad spectrum coverage is used in treating a brain abscess?
IV Vancomycin IV Metronidazole (anerobes) IV Ceftriaxone for 4-8 weeks
59
When is surgery indicated in a brain abscess?
Secondary to a TBI and material in the abscess Fungal Loculated (walls within the abscess) No improvement after a week Elevated ICP Increased size

Neurology_Clinical Medicine (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions