Infectious Disease Flashcards
(29 cards)
Meningismus
Patient cant touch chin to chest
Communicating hydrocephalus
Normal CSF flow, but abnormal absorption into dural sinuses leads to dilation of ALL ventricles.
Kernig’s Sign
Pt thigh is flexed at the hip with knee at 90 degrees. A positive sign is if pain is caused by extending the knee from this position.
Brudzinski sign
Involuntary lifting of the legs from a supine position if the patients head is lifted.
Acute meningitis is usually due to ____ or ____
Bacterial or viral
Chronic meningitis is usually due to _____ or _____
Atypical bacteria (TB) or fungal
Organisms that usually cause meningitis in newborns (3):
Group B strep
E. Coli
Listeria Monocytogenes
Organisms that usually cause meningitis in kids (3):
Niesseria Meninigitis
Strep Pneumoniae
H. Influenzae (before vaccine)
Organisms that usually cause meningitis in elderly (2):
Strep pneumoniae
L. Monocytogenes
Clinical signs of bacterial meningitis:
H/a, fever, meningismus, confsion -> stupor, elevated ICP
CSF of bacterial meningitis:
WBC - (# and predominant cell type)
Protein -
Glucose -
WBCs - greater than 1000, mostly PMNs
protein HIGH
Glucose LOW
hazy Color and high pressure also seen
If bacterial meningitis is suspected…Tx?
Start 3rd gen cephalosporin (Ceftriaxone - broad spec) immediately with Vancomycin (especially for Nsurg pts, for S. Aureus.
Add ampicillin if over 55 or immunocompromised (for possible Listeria)
Steroids (dexamethasone) to reduce vasogenic swelling.
If pt has H/a, fever, neck stiffness and CSF shows <500 WBCs with PMNs early but mostly lymphocytes…suspect?
Viral meningitis
The Tx for viral meningitis is:
Rest, fluids, pain management. it is self limiting.
CN palsies are common in atypical bacterial meningitis due to:
Skull base granulomas
A CSF showing <200 WBCs with mostly lymphocytes due to a chronic meningitis with have _____ protein and _____ glucose.
HIGH protein
LOW gluose
Altered consciousness, seizures, focal Neuro symptoms and normal CSF might indicate:
Viral Encephalitis
The most common cause of viral encephalitis is ______ ____ __.
The classic sign is ___________________________.
Herpes Simplex I due to reactivation of virions in Trigeminal nerve.
The classic finding is MEDIAL TEMPORAL LOBE inflammation on MRI.
The treatment for a herpes simplex viral encephalitis is:
Acyclovir
A cause of encephalitis that has a variable time course due to retrograde transport and results in hydrophobia is:
Rabies
Two common causes of bacterial encephalitis are:
Neurosyphillis
Lyme disease
The VDRL test would be used to check the CSF if ____ was suspected in a pt with meningitis, cranial nueritis, sensory ataxia, and dementia.
The VDRL test checks the patients serum for the presence of anti-cardiolipin antibodies, which are porduced in response to syphillis infection. This is the test for treponema pallidum, syphillus.
T/F:
A brain abscess will cause fever
A brain abscess will cause increased ICP
F
F
brain abscess will not cause fever or ICP
An AIDS patients CT shows multiple ring-enhancing lesions. His CD4 count is low.
Dx?
Tx?
Cerebral Toxoplasmosis.
Treat with Pyrimethamin + Sulfadiazim
