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NMSP > CNS Infections part 1 > Flashcards

CNS Infections part 1 Flashcards

(50 cards)

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1
Q

What is the most common route for CNS infections to arise?

A

Hematogenous (via blood)

– usually arterial

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2
Q

What are the 4 ways that a CNS infection can reach the CNS?

A
  1. Hematogenous
  2. Direct Implantation
  3. Local extension
  4. Peripheral Nervous System
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3
Q

What are the only 2 organisms that reach the CNS via infecting the peripheral nervous system and moving to the CNS?

A

Rabies

Herpes Zoster

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4
Q

What is the importance of the CSF being completely exchanged in the brain every 3-4 hours with CNS infections?

A

Completely bathes the brain in the bacteria!

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5
Q

Which organism uses direct seeing from a subepidural or submeningeal granuloma to infect the CNS?

A

Tuberculus Meningitis

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6
Q

Describe how Rabies infects the CNS

A

Virus binds the Ach receptors at the NMJ and ascends motor neurons to the CNS

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7
Q

Describe how Herpes Zoster infects the CNS

A

Infects sensory ganglia and replicates in schwann cells and ascends to CNS via sensory nerves

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8
Q

Capillaries in the BBB are impermeable to what types of things?

A

Antibiotics
Complement
Immunoglobulins

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9
Q

How do molecules cross the BBB capillaries?

A

Active transport

Lipid soluble

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10
Q

Which populations are at the highest risk for Meningitis?

A

< 5
> 60
Diabetics
Immunosuppressed

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11
Q

A lumbar puncture is performed to diagnose Meningitis. What organism is commonly Gram (-) Diplococci in the CSF?

A

N. Meningitidis

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12
Q

A lumbar puncture is performed to diagnose Meningitis. What organism is commonly Gram (+) Diplococci in the CSF?

A

S. Pneumoniae

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13
Q

A lumbar puncture is performed to diagnose Meningitis. What organism is commonly Gram (-) pleomorphic in the CSF?

A

H. Influenzae

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14
Q

A lumbar puncture is performed to diagnose Meningitis. What organisms are commonly Gram (+) Cocci?

A

S. Aureus

Streptococci

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15
Q

A lumbar puncture is performed to diagnose Meningitis. What organism is commonly Gram (-) Bacilli in the CSF?

A

E. Coli

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16
Q

What are some symptoms of Meningitis?

A

Meningeal irritation - fever, headache, N/V, confusion, stiff neck

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17
Q

What is the CNS response to pyogenic (bacterial) meningitis?

A

Cerebral Edema (loss of BBB)

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18
Q

Cerebral edema is the CNS response to pyogenic meningitis. What accelerates it and what slows/resolves it?

A

Accelerated by = Bacteria

Slowed/Resolved by = Corticosteroids

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19
Q

CSF appearance for Bacterial vs Viral Meningitis?

A

Bacterial - cloudy/turbid

Viral - clear

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20
Q

CSF lab value of Neutrophils/Lymphs/Monos for Bacterial vs. Viral Meningitis?

A

Bacterial - NEUTROPHILS

Viral - Lymphs/Monos

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21
Q

CSF lab value of Glucose for Bacterial vs. Viral Meningitis?

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A

Bacterial - LOW glucose

Viral - normal glucose

22
Q

Protein may be increased in the CSF with Meningitis. Bacterial vs. Viral, which causes a greater increase?

23
Q

In the CSF, if the glucose is < 50, what is the likely cause of the Meningitis?

24
Q

In a neonate, what are the likely organisms causing pyogenic meningitis?

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A

E. Coli OR

Group B Streptococcus

25
In a child < 2 years old that is UNvaccinated, what is the likely organism causing pyogenic meningitis?
H. Influenzae type B
26
In a young adult, what is the likely organism causing the pyogenic meningitis?
N. Meningitidis
27
In the elderly, what is the likely organism causing pyogenic meningitis?
Strep. Pneumoniae
28
Waterhouse Friderichsen Syndrome can be a complication of Meningitis. What are the symptoms and what are 2 organisms that commonly cause it?
Rash, Adrenal Hemorrhage, death | - Meningococcemia and N. Meningitidis
29
Chemical Meningitis
NON-bacterial irritant in the subarachnoid space
30
Brain Abscesses arise via the same routes as Meningitis does. What are the symptoms of Brain Abscesses?
Progressive focal neuro deficits | Possible increase in intracranial pressure
31
What are the CSF values for WBC, protein and glucose for Brain Abscesses?
Increased WBC and protein | Normal glucose
32
What are 2 complications of a Brain Abscess?
Abscess rupture with infection | Venous sinus thrombosis and patient dies
33
What is a Subdural Empyema and what change in the dura is seen?
Infections of the skull bones or sinuses that spreads to the subdural space -- Thickened Dura
34
What is associated with an Extradural Abscess?
Osteomyelitis
35
Osteomyelitis is associated with? And what may it cause?
Extradural Abscess | -- may cause cord compression
36
Neisseria Meningitidis colonizes ____ and spreads via _____
Colonizes asymptomatic carries | Spreads via direct contact with respiratory secretions
37
Neisseria Meningitidis infections are common in what populations?
Dorms, military quarters all in close contact
38
What are the signs of infection with N. Meningitidis?
Fever, septicemia, DIC, petechial lesions and purpura fulminans
39
What is purpura fulminans and what infection is it seen with?
Hemorrhage skin lesions that turns into gangrene of the distal limbs -- N. Meningitidis
40
What classifies Chronic Meningitis and what CSF changes for protein, cell type and glucose levels are present?
CSF abnormalities and symptoms for > 4 weeks | Increased protein, lymphs and decreased glucose
41
What 3 organisms can cause Chronic Meningitis?
``` Tuberculosis Borellia Burgdorferi (lyme disease) Treponema Pallidum (syphilis) ```
42
With Chronic Meningitis, TB and Neurosphilis have a predilection to form exudates where in the brain?
BASE (arachnoiditis)
43
If Mycobacterium Tuberculosis is causing the Chronic Meningitis, what mass may be present and why could there be CN signs?
Tuberculoma - caseous necrosis mass | -- exudate at base of brain traps CN's and obliterates cisterns
44
If Borrelia Burgdorferi is causing the Chronic Meningitis, what are the symptoms?
Rash * 4 weeks pass* Cranial nerve palsies and peripheral neuropathies
45
With Borrelia Burgdorferi, what is in the CSF that can cross react?
Antibodies
46
What are the 3 types of Neurosyphilis (Treponema Pallidum)?
1. Meningovascular Neurosyphilis 2. Paretic Neurosyphilis 3. Tabes Dorsalis
47
What are the 3 types of Neurosyphilis?
1. Meningovascular Neurosyphilis 2. Paretic Neurosyphilis 3. Tabes Dorsalis
48
Meningovascular Neurosyphilis
Chronic meningitis involving the base of the brain | + communicating hydrocephalus
49
Paretic Neurosyphilis
Progressive mental deficits with mood alterations that terminate in severe dementia + iron deposits
50
Tabes Dorsalis
Damage to sensory nerves - Loss of pain sensation, DTRs, limb awareness - Joint damage and lightening pains

NMSP (28 decks)

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