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Flashcards in Micro Deck (47):
1

LCMV Name
Genome?
Enveloped/Naked?
Causes what?

Lymphocytic Choriomeningitis Virus
Arenavirus: ambisense, RNA, enveloped
Causes febrile, aseptic choriomeningitis

2

Groups of bacteria causing meningitis:

Pneumococcus
Group B Strep
Meningococcus
H. influenzae

3

4 Classic Symptoms of Meningitis:

-Headache
-Stiff Neck
-Fever
-Photophobia

4

Neisseria meningitidis:
gram ___
____cellular
Oxidase ___
Catalyse ___
Ferments___

Gram (-)
Facultative intracellular
Oxidase (+)
Catalyse (+)
Ferments Glucose and Maltose

5

Difference of pathogenic vs. non-pathogenic N. meningitidis strains:

Pathogenic = Encapsulated (polysaccharide)

6

Neisseria needs ___ agar to grow

Chocolate agar

7

N. meningitidis is:
Transmitted by ____
Colonizes ____

Airbone droplets
Nasopharynx (asymptomatic carriage)

8

Most common N. meningitidis age range:

2-18 years

9

3 major N. meningitidis virulence factors

-Polysaccharide Capsule
-IgA Protease
-LOS

10

Lack of what complement proteins increases risk for N. meningitidis

C5-9

11

Waterhouse-Friderichen Syndrome:

-Bilateral destruction of adrenal glands
-DIC

12

What can't you give for N. meningitides?

Glucocorticosteroids

13

Group B Strep
Capsule?
Gram ___
___ Hemolytic

-Encapsulated
-Gram (+)
-Beta-hemolytic

14

Major risk group for GBS+ meningitis?
Why?

-Neonates
-GBS is natural flora in the vagina

15

CAMP test:

B-hemolysin of S. aureus interacts w/ GBS to cause enhanced hemolysis

16

Hippurase test turns what color?

Purple

17

2 Ways to differentiate GBS and Listeria in a CSF sample

-Morphology on gram stain (cocci vs rod)
-Motility on wet mount

18

Pneumococcus:
Gram ___
Catalase ___
___ Hemolytic

-Gram (+)
-Catalase (-)
-Alpha-hemolytic

19

Strep pneumonia is most common cause of community-acquired: (4 things)

-Pneumonia
-Bacterial meningitis
-Bacteremia
-Otitis media

20

Pnemococcus causes a (low/high) inflammation meningitis

High

-Strong inflammatory response
-All pathogenic strains produce a pneumolysin

21

Pneumococcal disease also requires what kind of testing?

Antibiotic-sensitivity testing

22

1st line Pneumococcus meningitis treatment is ___
If resistant, add ___

Vancomycin + ceftriaxone or cefotaxime

Resistant: add rifampin, meropenem or chloramphenicol

23

For which septic meningitises can you use corticosteroids?

Pneumococcal

24

3 routes of viral entry into CNS

1. Neural
2. Olfactory
3. Hematogenous

25

80% of viral meningitis caused by:

Enterovirus

26

Brudzinski's sign is:

-Guarding due to nuchal rigidity
-Neck raise --> leg raise

27

Distinguishing feature of encephalitis not found in meningitis

Encephalitis: intracerebral hemorrhage

28

What is ADEM?
When?
What causes?

-Acute Disseminated Encephalomyelitis
-postinfectious encephalitis (after VIRAL infection)
-1-2 weeks later
-Autoimmune disorder

29

Herpes simple encephalitis usually affects what part of the brain?

-Temporal lobe
-Unilateral

30

When do you immunize someone for rabies?

-Post-exposure
-Prevents spread up into the brain

31

What is Pachymeninges
What is Leptomeninges

Pachy: outer layer, dura
Lepto: inner layer, arachnoid, dura

32

Lumbar Puncture CSF Findings in Bacterial vs Virus vs Fungal meningitis

Bacterial: high Neutrophils, low glucose

Viral: high Lymphocytes, normal glucose

Fungus: high Lymphocytes, low glucose

33

What do you have to worry about in terms of meningitis post-surgery?

Anaerobic bacteria

34

Clinical feature that distinguishes Meningitis vs Encephalitis

MENTAL STATE

confusion and/or decreased level of consciousness -->encephalitis

35

Pus in ____ (space) in acute bacterial meningitis

Subarachnoid space

36

3 Complications of Bacterial meningitis:

1. Spreading to infect Virchow-Robbins (perivascular) space
2. Thrombosis of leptomeningeal vessels
3. Hydrocephalus (communicating or obstructive)

37

What kind of cell makes the BBB?

Astrocyte glial cells

38

"Worst headache in my life"

DDx: ruptured aneurysm

39

What kind of meningitis is usually self-limiting?

Aseptic (viral) meningitis

40

What is PML?
What causes it?
What can it be confused for

-Progressive Multifocal Leukoencephalopathy
-Viral by JC polyomavirus
-Can mimic MS

41

3 Major Patterns of Fungal Meningoencephalitis:

1. Chronic Meningitis
2. Vasculitis
3. Parenchymal invasion

42

What 2 fungi are usually associated w/ vasculitis

Mucor (especially diabetics)
Aspergillus

43

What 2 fung are usually associated w/ brain invasion?

Candida
Cryptococcus

44

Rabies asociated w/ this animal

BATS!

45

Rabies encephalopathy pathopnemonic finding:

Negri bodies in brain

46

HIV encephalopathy has what finding:

Giant cells

47

Vasculitis meningitis can cause what superficial finding?

Petechial hemorrhages