Head & Neck Labs / Neuro infections

Question 1

What is included in a CSF analysis?

Answer 1

• color
• cells
• protein
• glucose
• graim stain/culture
• syphilis testing

Question 2

What does red CSF indicated

Answer 2

presence of blood = likely traumatic tap or SAH

Question 3

What does xanthochromia indicate?

Answer 3

presence of blood = SAH

Question 4

What does turbid CSF indicate?

Answer 4

increased WBC or protein

Question 5

CSF with elevated WBC and elevated neutrophils indicates…

Answer 5

bacterial meningitis

Question 6

CSF with elevated WBCs and lymphocytic cells indicates…

Answer 6

viral meningitis

Question 7

CSF with elevated protein levels could indicate…

Answer 7

• bacterial meningitis
• viral encephalitits
• can be mildly elevated in MS

Question 8

CSF with low level of glucose indicates…

Answer 8

bacteria or tumor present

Question 9

CSF cultures:

____ is gram positive cocci in chains and has a higher mortality rate

Answer 9

Streptococcus pneumoniae

Question 10

CSF cultures:

____ is gram negative diplococci and is commonly seen among adolescents and college students

Answer 10

Neisseria meningitides

Question 11

CSF cultures:

____ are gram negatives rods, commonly seen in 1-4 y/o

Answer 11

Haemophilus influenzae

Question 12

What is contained in a cell wall and is a potent inducer of cytokines associated with fever and septic shock?

Answer 12

Lipopolysaccharides

gram negative

Question 13

True or False: Viral meningitis is more lethal than bacterial

Answer 13

FALSE

Question 14

The finding of oligoclonal banding in CSF is highly suspicious for ___

Answer 14

multiple sclerosis

Question 15

What are common tests to order to try to find reversible cause of dementia?

Answer 15

• CBC (anemia, infection, thrombocytopenia)
• CMP (glu, BUN/Crt, electrolytes)
• UA (UTI)
• Vitamin B12
• Folate
• RPR
• TSH

Question 16

potential complications from untreated strep throat?

Answer 16

• rheumatic fever
• PTA
• post-streptococcal glomerulonephritis

Question 17

common Tx for influenza?

Answer 17

• Oseltamivir (Tamiflu)
• Baloxavir (Zofluza)
• Zanamivir (Relenza)

Question 18

Epstein Barr Virus is transmissible through what

Answer 18

respiratory, saliva

Question 19

Where is pt with mono (EBV) likely to have lymphadenopathy?

Answer 19

posterior cervical chain

Question 20

____ is treating with Abx covering for organisms that could cause infection as you wait for culture results to return

Answer 20

Empiric Tx

Question 21

What type of rash can be associated with meningitis?

Answer 21

petechial rash

Question 22

Who is at risk for meningitis?

Answer 22

• Newborns/babies
• college campus/military barracks
• underlying medical conditions
• working in a meningitis lab
• travel to sub-saharan Africa & Haaj

Question 23

Which bacteria is commonly passed from mother to child during birth and can cause meningitis?

• how is this prevented?

Answer 23

Group B Strep (beta-hemolytic)

• screening during week 35-37 of pregnancy

Question 24

Who is most at risk for meningitis secondary to H. influenzae?

Answer 24

• <4 y/o
• unvaccinated
• Hx of splenectomy

Question 25

What should someone do if they are in contact with someone with Hib meningitis?

Answer 25

Prophylactic Tx with Rifampin

Question 26

What should someone do if they are in contact with someone with meningitis caused by N. meningitides?

Answer 26

Prophylactic Tx with Ciprofloxacin

Question 27

Who is most at risk for meningitis caused by Strep pneumoniae?

Answer 27

- age >50 | - Hx of splenectomy (need immunization against strep pneumo)

Question 28

What should someone do if they are in contact with someone with meningitis caused by Strep pneumoniae?

Answer 28

Nothing (no prohylaxis Tx since mode of transmission less risky -- not resp droplets)

Question 29

What groups are high risk for Listeria monocytogenes meningitis?

Answer 29

- pregnant women - elderly - pts with comorbidities/weakened immunities

Question 30

What Abx is used to treat Listeria monocytogenes meningitis

Answer 30

Ampicillin

Question 31

What foods have high risk for listeria monocytogenes

Answer 31

- soft cheeses - unpasteurized milk - contamination at food plants

Question 32

True or False: Aseptic meningitis has similar symptoms to bacterial but is shorter lasting

Answer 32

FALSE - Aseptic meningitis is longer lasting

Question 33

True or False: Aseptic meningitis is less likely to be life threatening

Answer 33

True

Question 34

West nile Virus is _____ borne and includes what symptoms

Answer 34

- mosquito borne | - fever, neck stiffness, diffuse MP rash may even be asymptomatic

Question 35

Pt presents with GAS strep throat but has a beta-lactam allergy. What would you treat with?

Answer 35

- azithromycin, clindamycin, clarithromycin | macrolides and lincosamide - clinda