Intro To Infectious Diseases

Question 0

What is a bacteria associated with meningitis?

Answer 0

Neisseria meningitidis

Question 1

What side effect does prednisone do to the body?

Answer 1

Immunosuppression

Question 2

What can cause encephalitis?

Answer 2

Herpes
Abscesses (tumor) (strep and staph)
Ammonia build up tumor
Lupus
Hemmorhage 
Drugs

Question 3

What area does meningitis involve?

Answer 3

The subarachnoid space

Question 4

What area does encephalitis involve?

Answer 4

Diffuse parenchyma

Question 5

What are does an abscess involve?

Answer 5

Some focus point

Question 6

What are the four common symptoms of meningitis and how often does a Px have them?

Answer 6

95% of Pxs have 2 out of:
Headache
Fever
Nuchal (neck) rigidity
Altered mentality

Question 7

What is the most common cause of meningitis?

Answer 7

Viral

Question 8

What is the most life threatening cause of meningitis?

Answer 8

Bacterial

Question 9

What causes of meningitis usually only happen when the Px is immunocompromized?

Answer 9

Fungal and protozoan

Question 10

What is one of the most important virulence factors that allow organisms to survive?

Answer 10

Capsule virulence factors so they can stay in the blood stream longer

Question 11

What are the main symptoms of encephalitis?

Answer 11

Fever, headache, and altered mental status
Motor and sensory deficits not seen in meningitis

Progression leads to seizures, speech disturbances, lethargy, and coma

Question 12

What percentage of cases of encephalitis have an unknown etiology?

Answer 12

33% - 66%

Question 13

What are some none viral causes of encephalitis?

Answer 13

Entrovirus
Arbovirus
Herpes virus
Rabies virus

Question 14

What are some none viral causes of encephalitis?

Answer 14

Rickettsia
Mycoplasma
Acute disseminated encephalomyelitis (ADEM)

Question 15

What are symptoms of an abscess?

Answer 15

More focal neurological symptoms
Fever
Headache
Seizure

Question 16

What is the most common cause of encephalitis?

Answer 16

Streptococci

Question 17

What are some other bacteria that can cause a brain abscess?

Answer 17

Pseudomonas
Haemophilus
Staph
Bacteriodes

Question 18

When do mycobacterium, fungi, or parasites cause abscesses?

Answer 18

When the Px is immunocompromized

Question 19

How do you distinguish between

Encephalitis vs. Encephalopathy?

Answer 19

-itis -pathy
Headache common. Uncommon
Fever common. Uncommon
Inflammation. No inflammation
High WBC. Normal WBC

Question 20

What are some causes of encephalopathy?

Answer 20

Build up of a drug or some metabolic product

Question 21

Are infections of the CNS common?

Answer 21

No

Question 22

What are important innate immune cells in the CNS?

Answer 22

Astrocytes and Microglia

Question 23

How does the rabies virus get into the brain?

Answer 23

Retrograde axonal transport

Question 24

What bacteria can be passed from a mother to a fetus through food?

Answer 24

Listeria

Question 25

What is the mortality rate for Listeria?

Answer 25

25%

Question 26

What diagnostic test do you do if you want to confirm Listeria infection?

Answer 26

Blood culture before treatment Lumbar puncture Imaging for abscess to avoid herniation

Question 27

How do you identify an organism?

Answer 27

Gram stain | PCR

Question 28

What properties of an antibiotic for Listeria would be good?

Answer 28

Gets into the brain (small) | Bacteriocidal

Question 29

What class is primarily used for brain infections?

Answer 29

3rd generation cephalosporins Small lipophilic Low affinity for plasma binding proteins Include dexamethasone for decreasing inflammation

Question 30

What is the treatment for Listeria?

Answer 30

Ceftriaxone + ampicillin | By inhibiting Transpeptidation of peptidogylcan

Question 31

What is the spectrum for 3rd generation cephalosporin ceftriaxone?

Answer 31

For streptococci and more serious gram - infections. Can cross BBB Also gram + Worried about allergies Inactivation by beta-lactamases

Question 32

What are major side effects of beta lactams?

Answer 32

Seizures since it crosses the BBB

Question 33

Why would you do neuroimaging?

Answer 33

Look for an abscess, herniation

Question 34

Where is a lumbar puncture done?

Answer 34

Between L3/4

Question 35

What are routine tests done on a lumbar puncture?

Answer 35

``` WBC with diff RBC Glu concentration Protein concentration Gram stain Bacterial culture ```

Question 36

What percent of CSF and blood cultures are positive?

Answer 36

40 and 60 respectively

Question 37

What levels help differentiate between viral and bacterial meningitis?

Answer 37

Elevated protein, decreased glucose, and increase polymorphonuclear leukocytes

Question 38

What stain is Listeria?

Answer 38

Gram positive Intracellular

Question 39

What is the normal WBC for CSF?

Answer 39

0-5

Question 40

What's is a typical WBC for someone with bacterial meningitis?

Answer 40

100-20000 | Average is about 800

Question 41

What is PMN?

Answer 41

Polymorphonuclear leukocytes-Granulocytes

Question 42

What is a normal PMN for bacterial meningitis?

Answer 42

>80% PMN

Question 43

What is the typical WBC for someone with viral meningitis?

Answer 43

5-500 | Average 50

Question 44

What is the typical PMN for viral meningitis?

Answer 44

Greater than 50 L | Less than 20 PMN

Question 45

What does a very high CSF protein indicate?

Answer 45

Bacterial meningitis while viral is lower but still high

Question 46

What do you see in CSF glucose for bacterial meningitis?

Answer 46

Low glucose because bacteria use glucose while viruses don't

Question 47

What type of bacteria is Listeria?

Answer 47

Rod (gram positive)

Question 48

What are some virulence factors for Listeria?

Answer 48

Internalin - induces phagocytosis (intracellular) Phospholipase - escape from vacuole Listeriolysin - escape from vacuole Actin tail - facilitate pseudopod

Question 49

Why do you use gentamicin and what does it do?

Answer 49

It is an aminoglyacide and inhibited ribosomes Ampicillin helps it get into the cell Gentimicin is added once listeria is found