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Neurology > CNS Infxn > Flashcards

Flashcards in CNS Infxn Deck (63):
1

Who are at risk for CNS infxn?

immunocompromised
young
old

2

How is the brain protected?

skull
dura
BBB

3

Who is at HIGHEST risk for CNS infxn?

infants b/c they do not have a fully developed BBB

4

How can bacteria be spread?

hematogenously
thin bone (sinus)
veins (facial infxn)

5

What is baceterial meningitis?

bacterial infxn of the arachnoid, subarachnoid, CSF

6

Bacterial meningitis - sx?

stiff neck
headache
fever

7

Bacterial meningitis - PE?

Kernigs
Burdzinski
*anything that stretches the dura

8

Why is there a stiff neck with bacterial meningitis?

they cannot move the neck b/c of dura inflammed

9

Who is at risk of getting bacterial meningitis?

YA who live in close areas (colleges students dorming)

10

Vacciniation for bacterial meningitis?

Neisseria menigitidis
H influ

11

Bacterial meningitis - dx?

CSF!!

12

Bacterial meningitis - CSF labs?

+ neutrophils
high CSF protein
low glucose
*bacteria eats glucose, poops proteins
CSF culture

13

Bacterial meningitis - CSF culture? infants, children, adults?

infants- E coli, B strep
Children and adults: s. pneumonia, neisseria meningitisis*, H influ* (vaccine)

14

Bacterial meningitis - tx?

ASAP W/ BROAD ABX!!

15

Epidural abscess - cx?

surgical procedure
infxn from neighboring areas

16

Epidural abscess - leads to?

osteomyelitis
TCB of vertebral column

17

Subdural abscess/subdural empyema - cx?

spread of bacterial infxn from sinuses/middle ear

18

Spinal empymea - leads to?

compression of spinal cord - permenant damage

19

Intracranial subdural/epidural empyema - leads to?

increase in ICP
(vomiting, diplopia, papilledema)

20

Subdural abscess/empyema- tx?

1) surgical 2) abx IV
*b/c of compression, there is low blood circulation, so abx cannot get there

21

Brain abscess - cx?

bacterial spread from sinus/middle ear infxn

22

Brain abscess - sx?

headache
increased ICP - vomit, nausea, papilledema
seizures
mental status changes

23

Brain abscess - dx?

CT/MRI - DO NOT DO LP!! (CAN CX HEMORRHAGE)

24

Brain abscess - tx?

1) surgical 2) IV abx

25

CNS spirochete infection?

syphillis
lyme dz

26

CNS spirochete infxn - syphilis result?

Tabes dorsalis

27

CNS spirochete infxn -syphilis sx?

General paresis of the insane
tabes dorsalis

28

Tabes dorsalis?

result of untreated syphilis
infects the posterior dorsal column - affects vibration and propioception
pain of the sensory

29

General paresis of the insane?

behavior mood changes in syphilis infxted pts
encepahlitis

30

Lyme dz - bug?

tick borne illness d/t borrelia burgodferi

31

Lyme dz - leads to?

neurologic manifestions (neuropathy, meningitis)

32

How to tx syphilis?

PCN

33

CNS viral - cx?

vectors
GI tract
respiratory tract
animal bites

34

CNS viral pathophys?

immune response to viral infxn can lead to tissue damage
more damage from T cell and potent cytokines

35

Aseptic meningitis - sx?

HA
stiff neck

36

Aseptic meningitis - cx?

unknown
maybe theratpuetic drug

37

Aseptic meningitis vs bacterial meningitis - CSF labs?

CSF culture: negative
CSF: incr WBC/pleocytosis (same), elevated protein (same) but normal glucose

38

Encephalitis?

infxn of CNS neurons and glial cells

39

Viral encephalitis - cx?

secondary (common): viral infxn (pneumonia, enteritis)
primary (rare): rabies

40

Viral encephalitis - results?

confusion --> stupor --> seizures --> focal neurological defects --> coma --> death

41

Herpes simplex encephalitis - cx?

HSV I (cold sores)
HSV II (herpes)
primary infxn or viral reactivation in trigeminal ganglion that travels to the brain

42

Herpes simplex encephalitis - most common cx?

HSV I

43

Herpes simplex encephalitis - sx?

fever
confusion
seizures
coma

44

Herpes simplex encephalitis - what lobe is affected, role in sx?

frontal: personality changes, dementia, hallucination
temporal lobe

45

Herpes simplex encephalitis - cx in infants?

HSV II
to avoid: C section instead of vaginal birth (infants can get it easier b/c no BBB)

46

Herpes simplex encephalitis - CSF?

pleocytosis
increase protein

47

Herpes simplex encephalitis - dx?

PCR

48

CMV encephalitis?

rare in adults

49

CMV encephalitis - population?

immunocompromised (HIV pts)

50

HIV?

directly infects the CNS

51

CNS arthropod borne virus?

vectors

52

Prion dz?

abnormal form of neuron glycoprotein --> amyloid (neuron degeneration)
confined to gray matter --> spongiform encephalopathy

53

Prion dz - sx?

prominent personality changes
dementia
hallucination
gait abnormalities
seizures

54

Prion dz types?

Creutzfeldt Jakob (CJD)
Kuru
Bonvein Spoinform encephalopathy (mad cow)

55

Prion dz - dx?

brain bx postmortem - r/o other dz

56

CNS fungal infxn - popuatoin?

immunocomporomied
AIDs (loss of normla T cells)
low WBC

57

CNS fungal infxn - bugs?

candid
aspergillus mucormycosis
cryptococcus

58

Mycobacterial infxn?

TB meningitis

59

Mycobacterial infxn - sx?

HA
confusion
CN defects

60

Primary ameobic meningoencephalitis infxn?

rare
HIGH MORTALITY RATE

61

PAM - cx?

free-living ameoba (naegleria flowerir) - lives in freshwater and hot springs

62

PAM - population?

young men playing in American SW waters

63

CSF testing includes?

CBC and diff
protein
glucose
gram stain, C&S