CNS infections

Question 1

Meningitis definition

Answer 1

Inflammation of membranes surrounding the brain

Question 2

Encephalitis definition

Answer 2

Inflammation of brain matter

Question 3

Define a brain abcess

Answer 3

Defined and localised lesion

Question 4

Are viral or bacterial infections more dangerous

Answer 4

Bacterial, less common too

Question 5

What viruses mostly cause miningitis

Answer 5

ECHO
Coxsackie viruses
HSV

Question 6

What three bacteria mainly cause meningitis

Answer 6

H. influenzae, Neisseria meningitidis, Streptococcus pneumoniae cause over 80per of these.

Question 7

What other bacteria cause meningitis

Answer 7

• Cryptococcus neoformans
• M. tuberculosis
• Naegleria fowleri
• Treponema pallidum
• CoNS

Question 8

Main causative agents of neonatal meningitis

Answer 8

• Group B strep like S. agalactiae – high mortality depending on onset
• L. monocytogenes – cause spontaneous abortion, sepsis
• Members of Enterobacteriaceae- E. coli, S. enterica (common serovars) due to proximity with mother’s birth canal and anus.

Question 9

Symptoms of neonatal meningitis

Answer 9

Fever and also hypothermia

Question 10

Mothers with known streptococcus B in vaginal microbiota are treated with what antibiotic

Answer 10

Benzylpenicillin

Question 11

In 1985 that what vaccine was introduced to infants to protect from what bacteria

Answer 11

Hib vaccine , haemophilus

Question 12

Morphology of s. pneuomiae

Answer 12

G+ve diplococcus, lanceolate and encapsulated

Question 14

What bacteria is the most common agent of bacterial meningitis

Answer 14

S. pneumoniae

Question 15

Do S. pneunomiae has what type of india ink stain and why

Answer 15

Negative because capsule

Question 16

What shape is Neisseria meningitidis , found in what cell

Answer 16

Gram neg diplococcus, found intracelluary in neutrophils

Question 17

Is N. meningitidis capnophilic

Answer 17

YES

Question 18

What antibiotic is used to treat N. mengitidis

Answer 18

Rifampicin

Question 19

What type of rash is caused by N. mengitidits

Answer 19

Non-blanching

Question 20

What structure is needed for H. influenzae mengitidis

Answer 20

Capsule infection

Question 21

What ages are more vulnerable to H. influenzae meningitidis

Answer 21

4 months - 3 years old
Infants 3-4months old, protected by maternal antibodies.
Children 3-4 years old- protected by own antibodies via vaccination.

Question 22

What meningitidis is hard to diagnose which can’t be visualised with gram-stain

Answer 22

M. tuberculosis

Question 23

Symptoms of M. tuberculosis mengintis

Answer 23

• Fever
• Severe headache
• Neck stiffness (Kernig’s sign)
• Photophobia

Question 24

How to diagnose the causative agent of meningitis

Answer 24

Spinal tap and examining CSF

Question 25

How does the CSF appear of a virally infected patient, and why?

Answer 25

If a virus causes meningitis the CSF appears opalescent in part due to presence of lymphocytes, protein raised, glucose normal.

Question 26

Acute bacterial meningitis is characterised by what CSF traits

Answer 26

Acute bacterial meningitis is characterised by turbid CSF with high value for protein and low glucose, neutrophils predominant in CSF out of all lymphocytes

Question 27

What can be used to extract DNA from blood and CSF

Answer 27

Qiagen MDX kit

Question 28

Why is NAAT better for diagnostics than CSF examination

Answer 28

When a patient comes in with suspected bacterial meningitis, the CSF will be contaminated with antibiotic inhibiting growth on culture, DNA is present whether or not the bacteria is alive. ///

Question 29

Brain abscess is defined by what symptoms

Answer 29

Defined suppurative (pus-filled) lesions in brain parenchyma (functional tissue of brain neurones, glial cells). Increased intercranial pressure, upon lumbar puncture the pressure is released, the brain is pulled into the spinal column and so the patient dies, this is coning.

Question 30

Brain abscess is polymicrobial/monomicrobial

Answer 30

Polymicrobial

Question 31

What pathogens often contribute to brain absess

Answer 31

* Streptococci * S. aureus * Bacteroides spp. * G-ve enteric bacteria

Question 32

Symptoms of brain abscess

Answer 32

Fever Headache Seizures Focal neurological deficit

Question 33

Danger of brain abcess during diagnostics

Answer 33

Coning durign lumbar puncture

Question 34

What doe empyema mean

Answer 34

Collection of pus

Question 35

Symptoms subdural empyema

Answer 35

* Fever * Confusion * Headache * Seizure * Coma

Question 36

How is high intercranial pressure relased

Answer 36

Ventriculoperitoneal shunt infection- one way valve behind ear into the CSF allowing pressure release, push into GI tract.