Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

systems- neuro- oc > Infections of the Nervous System > Flashcards

Infections of the Nervous System Flashcards

(65 cards)

Start Studying
1
Q

definition of meningitis

A

inflammation / infection of meninges

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

definition of encephalitis

A

inflammation / infection of brain substance

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

definition of myelitis

A

inflammation / infection of spinal cord

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

clinical features of meningitis

A

“classical triad” – fever, neck stiffness and altered mental status

Present with a short history of progressive headache associated with
Fever (>38º) and
Meningism (neck stiffness, photophobia, nausea and vomiting)
Neck stiffness is examined by passively bending the neck forward

Cerebral dysfunction (confusion, delirium, declining conscious level) is common and GCS is <14 in 69%

Cranial nerve palsy (30%), seizures (30%), focal neurological deficits (10-20%) may also occur

Look for a petechial skin rash (Tumbler test)
hallmark of meningococcal meningitis, but can also occur in viral meningitis

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

what are differential diagnosis of meningitis?

A

Infective: Bacterial, Viral, Fungal

Inflammatory: Sarcoidosis

Drug induced: NSAIDs, IVIG

Malignant: Metastatic
Haematological
e.g. Leukaemia, Lymphoma, Myeloma

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

what are the bacterial causes of meningitis?

A 
Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the viral causes of meningitis?

A

enteroviruses

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

what are clinical features of encephalitis?

A

Flu-like prodrome (4-10days)

Progressive Headache associated with fever 
\+/- meningism
Progressive cerebral dysfunction
Confusion
Abnormal behaviour
Memory disturbance
Depressed conscious level
Seizures
Focal symptoms / signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the differential diagnosis of encephalitis?

A

Infective:Viral (most common is HSV)

Inflammatory: Limbic encephalitis (Anti VGKC Anti NMDA receptor)
ADEM

Metabolic: Hepatic, Uraemic, Hyperglycaemic

Malignant: Metastatic, Paraneoplastic

Migraine

Post ictal (after seizure)

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

what are the two antibodies involved in auto-immune encephalitis?

A

Anti-VGKC (Voltage Gated Potassium Channel)
Frequent seizures
amnesia (not able to retain new memories)
Altered mental state

Anti-NMDA receptor
Flue like prodrome
Prominent psychiatric features
Altered mental state and seizures
Progressing to a movement disorder and coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the investigations for meningitis?

A 
Blood cultures (bacteraemia)
Lumbar puncture (CSF culture/microscopy)
No need for imaging if no contraindications to LP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the investigations for encephalitis?

A

Blood cultures
Imaging (CT scan +/- MRI)
Lumbar puncture
EEG

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

what are the indications for CT brain scanning before lumbar puncture?

A

focal neurological deficit, not including cranial nerve palsies

new onset seizures

papilloedema

abnormal level of consciousness, interfering with proper neurological examination

severe immunnocomprimised state

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

what do focal symptoms or signs suggest on a CT?

A

focal brain mass

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

what does reduced conscious level suggest on a CT?

A

raised intracranial pressure

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

what is the cell count in bacterial meningitis?

A

high, mainly neutrophils

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

what is the cell count in viral meningitis or encephalitis?

A

high, mainly lymphocytes

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

what is the levels of glucose in bacterial meningitis?

A

reduced

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

what are the glucose levels in viral meningitis and encephalitis?

A

normal 60% of blood glucose

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

what are the protein levels in bacterial meningitis?

A

high

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

what are the protein levels in viral meningitis and encephalitis

A

slightly increased

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

what would the result of a blood culture gram stain be?

A

gram positive cocci in chains- looks like streptococci

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

what is the commonest cause of encephalitis in europe?

A

herpes simplex (HSV) encephalitis

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

how would you treat HSV encephalitis?

A

aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are the results of HSV type 1 and 2?
cold sores and genital herpes
26
how are enteroviruses spread?
faecal-oral route
27
what can enteroviruses cause?
non-paralytic meningitis
28
do enteroviruses cause gastroenteritis?
no
29
how is arbovirus encephalitis transmitted?
to man by vector form non-human host
30
what part of a history is related to arbovirus encephalitedes?
travel history- can be prevented by immunisation
31
what is a subdural empyema?
thin layer of pus between the dura and arachnoid membranes over the surface of the brain
32
what are clinical features of brain abscess and empyema?
Fever, Headache Focal symptoms / signs Seizures, dysphasia, hemiparesis, etc Signs of raised intracranial pressure Papilloedema, false localizing signs, depressed conscious level Meningism may be present, particularly with empyema
33
differential diagnosis of brain abscess and empyema
Any focal lesion, but most commonly tumour | Subdural haematoma
34
what are the causes of brain abscess and empyema?
``` Penetrating head injury Spread from adjacent infection Dental, Sinusitis, Otitis media Blood borne infection e.g. Bacterial endocarditis Neurosurgical procedure ```
35
how would you diagnose brain abscess and empyema?
Imaging: CT or MRI investigate source blood cultures Biopsy (drainage of pus)
36
how do you manage brain abscess?
Surgical drainage if possible Penicillin or ceftriaxone to cover streps Metronidazole for anaerobes High doses required for penetration Culture and sensitivity tests on aspirate provide useful guide High mortality without appropriate treatment
37
what are HIV indicators (brain)
``` Cerebral toxoplasmosis Aseptic meningitis /encephalitis Primary cerebral lymphoma Cerebral abscess Cryptococcal meningitis Space occupying lesion of unknown cause Dementia Leucoencephalopathy ```
38
diagnostics of brain infections in HIV
Cryptococcal antigen Toxoplasmosis serology CMV PCR HIV PCR
39
what are the spirochaetes in the CNS?
``` Lyme Disease (Borrelia burgdorferi) Syphilis (Trepomena pallidum) Leptospirosis (Leptospira interrogans) ```
40
what is the vector invoolved in lyme disease?
tick
41
what are the stage 1 signs of lyme disease?
Early localized infection (1-30d) Characteristic expanding rash at the site of the tick bite: erythema migrans 50% flu like symptoms (days – 1 week) Fatigue, myalgia, arthralgia, headache, fever, chills, neck stiffness
42
what are the stage 2 signs of lyme disease?
Early disseminated infection (weeks – months) One or more organ systems become involved Haematologic or lymphatic spread Musculoskeletal and neurologic involvement most common Neurologic involvement (10-15%) untreated patients
43
what are the stage 3 signs of lyme disease?
Chronic infection months to years occuring after a period of latency Musculoskeletal and neurologic involvement most common Neurologic involvement As described for stage 2 Subacute encephalopathy Encephalomyelitis
44
what are the investigations for lyme disease?
Complex range of serological tests CSF lymphocytosis MRI brain / spine (if CNS involvement) Nerve conduction studies / EMG (if PNS involvement) Prolonged antibiotic treatment intravenous ceftriaxone oral doxycycline
45
what are the three stages of syphillis?
primary, secondary, latent
46
what are the antibody tests involved in syphillis?
Treponema specific and non-treponemal specific antibody tests
47
what causes poliomyelitis?
poliovirus types 1, 2 or 3
48
how is rabies transmitted to a human?
by bite or salivary contamination of open lesion
49
how would you diagnosoe rabies encephalitis?
PCR and Serology
50
what is the tetanus infection?
Clostridium tetani
51
what type of bacillus is tetanus?
anaerobic Gram positive bacillus, spore forming
52
what does tetanus do?
blocks inhibition of motor neurones | rigidity and spasm (risus sardonicus)
53
how is tetanus preventable?
immunisation
54
what are the three modes of infection of botulism?
Infantile (intestinal colonization) Food-borne (outbreaks) Wound: Almost exclusively injecting or “popping” drug users
55
what is the botulism infection?
Clostridium botulinum
56
how does botulism (Neurotoxin) work?
Binds irreversibly to the presynaptic membranes of peripheral neuromuscular and autonomic nerve junctions Toxin binding blocks acetylcholine release Recovery is by sprouting new axons
57
what is the clinical presentation of botulism?
``` Incubation period 4-14 days Descending symmetrical flaccid paralysis Pure motor Respiratory failure Autonomic dysfunction Usually pupil dilation ```
58
how would you diagnose botulism?
Nerve conduction studies Mouse neutralisation bioassay for toxin in blood Culture from debrided wound
59
what is the treatment of botulism?
Anti-toxin (A,B,E) Penicillin / Metronidazole (prolonged treatment) Radical wound debridement
60
what are some post infective inflammatory syndromes?
“Molecular mimicry”Acute disseminated encephalomyelitis (ADEM) Guillain Barre Syndrome (GBS)
61
what is the aetiology of creutzfeldt-jakob disease?
``` Sporadic CJD New variant CJD Familial CJD (10-15%) Acquired CJD (<5%) Cadeveric Growth Hormone Dura matter grafts Blood transfusion ```
62
clinicl features of sporadic CJD?
Insidious onset (usually older than 60) Early behavioural abnormalities Rapidly progressive dementia Myoclonus Progressing to global neurological decline Motor abnormalities Cerebellar ataxia Extrapyramidal: tremor, rigidity, bradykinesis, dystonia Pyramidal: weakness, spacticity, hyper-refexia Cortical blindness Seizures may occur
63
what are differential diagnosis of sporadic CJD?
Alzheimer’s disease with myoclonus Usually more prolonged Subacute sclerosing panencephalitis (SSPE) Very rare, chronic infection with defective measles virus CNS vasculitis Inflammatory encephalopathies
64
what is the prognosis of sporadic CJD?
Rapid progression | Death often within 6 months
65
investigations of CJD?
MRI EEG CSF

systems- neuro- oc (51 decks)

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