Infectious Disease Flashcards Preview

MS2 - Nervous System > Infectious Disease > Flashcards

Flashcards in Infectious Disease Deck (41):
1

What three vaccines have led to a decrease in incidence of meningitis?

Hemophilus Influenza B
Pneumococcus
Meningococcus

2

Meningitis is an infection of the __________ space.

subarachnoid

3

Infection of the subarachnoid space leads to __________.

cerebral edema

4

The classic signs and symptoms of meningitis are ___________.

fever, headache, nuchal rigidity, and depressed consciousness (100% have at least 2 of these; 40% have three)

5

What is the mortality of bacterial meningitis?

20%

6

The first step in managing suspected meningitis is ___________.

starting antibiotics (preferably within 60 minutes)

7

The definitive diagnostic procedure for diagnosing meningitis is __________.

lumbar puncture

8

CSF signs of meningitis are ___________.

pleocytosis, neutrophils greater than 80%, glucose less than 40 mg/dL, high protein, and culture/Gram stain

9

What is papilledema?

Bulging of the optic disk in the eye (a sign of increased ICP)

10

What are the most common bacterial species that cause neonatal meningitis?

- Group B Streptococcus (50%)
- Escherichia coli (14%)
- Streptococcus pneumoniae
- Neisseria meningitidis

11

What are the most common bacterial species that cause infant-toddler meningitis?

Strep pneumo
N meningitidis
Group B Strep

12

What are the most common bacterial species that cause adult meningitis?

2-35:
- Neisseria meningitidis (50% - 60%)
- Streptococcus pneumoniae

Older than 35:
- Streptococcus pneumoniae

13

Research indicates that, in addition to antibiotics, _________ should also be given with or before the first antibiotics.

Corticosteroids (to decrease inflammation-related injuries)

14

Altered conscious happens in ________ bacterial meningitis.

advanced

15

What patients have atypical presentations of meningitis?

Infants and the elderly

16

What is the most common mechanism that bacteria enter the meninges?

Hematogenously (less common are through adjacent infections and penetrating trauma)

17

When should you not do an LP immediately?

Focal neurologic deficit
Papilledema
Prior CNS issues
Seizures
Decreased level of consciousness
Immunocompromised

18

What is the normal CSF protein for adults and children?

Less than 50 for adults and 150 for children

19

True or false: those with brain abscesses present with high CSF WBC.

False (because the white blood cells stay in the abscess)

20

What antibiotics should be given to neonates with suspected meningitis?

Ampicillin
Cefotaxime / aminoglycoside

21

What antibiotics should be given to people in the 3 month to 50 year age group?

Ceftriaxone or cefotaxime
Vancomycin

22

What antibiotic should be given to the elderly with suspected meningitis?

Ampicillin
Vancomycin
Ceftriaxone

23

What antibiotics should be given to immunocompromised patients with suspected meningitis?

Ampicillin
Meropenem / cefepime
Vancomycin

24

Which bacterial species require the longest treatment plans?

Gram-negative bacteria and listeria

25

Which strain of bacterial meningitis has been shown to benefit the most from steroid treatment?

Strep pneumo

26

The three most common viruses that cause meningitis are ______________.

HSV-2
WNV (seasonal fall/summer)
Enterovirus (seasonal fall/summer) (80%)

27

What CSF finding can indicate arbovirus (besides PCR)?

elevated IgM

28

What clinical feature distinguishes encephalitis?

Neurologic impairment

29

What two viruses cause the most mortality from encephalitis?

HSV-2 and WNV

30

If a patient has hyperglycemia and suspected meningitis, what formula should be used to calculate their CSF glucose?

CSF:serum should be greater than 0.4 (if it is less, suspect bacterial meningitis)

31

Listeria is Gram ___________.

positive

32

What big outcome has steroid treatment been shown to prevent in developed countries?

Hearing loss (CN VIII palsy)

33

HSV-1 is more likely to cause ____________.

encephalitis

34

What is a non-cerebral sign of enterovirus infection?

Pharyngitis with macular rash

35

Having antibodies to NMDA can mimic ______________.

viral encephalitis (so test the CSF for the antibody; if positive, immunosuppression is the treatment)

36

True or false: most HSV encephalitis is primary.

False – most results from reactivation

37

What is the etymology of arbovirus?

ARthropod-BOrne virus

38

Most people with WNV display what symptoms?

Trick question... None! 80% are asymptomatic

39

What is the MRI pattern of WNV?

Early: normal
Late: deep-brain nuclei affected

40

Toxoplasmosis can lead to __________ in the brain.

cysts

41

Describe the findings associated with cryptococcal meningitis infection.

Few lymphocytes
Elevated protein

Decks in MS2 - Nervous System Class (111):