Neuro

Question 1

BM neonates

Answer 1

listeria, group b strep, EColi

Question 2

BM elderly

Answer 2

pneumococcal >listeria

Question 3

BM children

Answer 3

HI

Question 4

BM 10-21

Answer 4

meningococcal

Question 5

BM 21>

Answer 5

pneumococcal >meningococcal

Question 6

meningococcus meningitis treatment

Answer 6

IV ceftriaxone 2g bd (chloramphenicol IV 25mg/kg qds) for 5-7 days and stop dexa

Question 7

pneumococcal meningitis

Answer 7

ceftriaxone 10 days or 14 if not responding

4 days of dexa

Question 8

penicillin/cephalasporin resistant meningitis

Answer 8

ceftriaxone 14 days and vancomycin and 4 days of dexa

Question 9

listeria meningitis

Answer 9

21 days amoxacillin IV 2g 4 hourly (PA co tramox IV 120mg/kg qds)
stop dexa

Question 10

meningitis post op

Answer 10

IV ceft 2g 8 hourly and IV flucoxacillin and IV vancomycin

Question 11

Early in patient management of meningitis bacterial

Answer 11

IV ceftriaxone 2g bd and IV amox 2g qds if listeria suspected or >55yo
vancomycin +/- rifampicin if pneumococcal penicillin resistance suspected
steroid (dexa) 10mg IV 15-20 mins before or with first AB dose and then every 6 hourly for 4 days

Question 12

who is dexa contra indicated in

Answer 12

post surgical meningits
severe immunocompromised
meningococcal/septic shock
hypersensitivity to steroids

Question 13

viral meningitis cells
colour
protein
glucose

Answer 13

lymphocytes
gin clear
normal/slightly high
normal

Question 14

bacterial meningitis cells
colour
protein
glucose

Answer 14

polymorphs / neutrophils
cloudy
high
<70% of BG

Question 15

normal glucose

Answer 15

2.3-4.5

Question 16

normal protein

Answer 16

0.1-0.4

Question 17

TB cells
colour
protein
glucose

Answer 17

lymphocytes
cloudy/yellow
high/very high
<60%

Question 18

close contacts of people with meningitis have a increased risk for how long

Answer 18

6 months

Question 19

prophylaxis regimes for bacteria mengingitis

Answer 19

600mg rifampicin PO 12 hourly 4 doses for adults and >12
10mg/kg PO 12 hourly 4 doses for 3-11m

500mg ciprofloxacin PO single dose in adults and over 12 yo

250 mg IM ceftriaxone single dose in adults
125mg IV single dose in under 12s

Question 20

adverse effects of rifampicin

Answer 20

decreased efficacy of oral contraception, red discolouration of urine, contact lenses are stained

Question 21

Hib
pneumococcal vaccine and conjugate
travel vaccine, group c conjugate

Answer 21

HI
strep pneumonia
nesisseira meningits

Question 22

viral menignis who
when
cause

Answer 22

infants, young, elderly
late summer/autumn
enterovirsuses

Question 23

ix for viral

Answer 23

viral stool culture, throat swab and CSF PCR

Question 24

aseptic meningitis CSF

which kind of patients can it occur

Answer 24

low WBC, minimally elevated protein, normal glucose

HIV px

Question 25

causes of viral encephalitis

Answer 25

``` herpes simplex varicella zoster CMV HIV measles west nile Jab b encephalitis tick borne encephalitis rabies ```

Question 26

extreme lethargy

Answer 26

west nile

Question 27

delay in ix for encephalitis

Answer 27

start high dose IV aciclovir anyways

Question 28

aciclovir in encephalitis dose

Answer 28

neonates -3m 20mg/kg 3m-12yo 500mg/m2 >12 - 10mg/kg adjust for renal failure

Question 29

how long is aciclovir given for

Answer 29

given for 14 days | 21 if immunocompromised or 3m-12yrs

Question 30

``` fungal opening pressure colour cells CSF/glucose protein ```

Answer 30

``` high/very high clear/cloudy lymphocytes normal/low 0.2-5 ```

Question 31

normal opening pressure of CSF

Answer 31

10-20cm

Question 32

cerebral abscess spread from brain

Answer 32

mastoiditis, otitis media, sinusitis

Question 33

cerberal abscess blood borne

Answer 33

cyanotic heart disease, dental abscess, lung infection, pelvic infection, skin infection, abd infection

Question 34

organisms in cerebral abscess immunocomp

Answer 34

fungal, toxoplasmic gondii

Question 35

ix for cerebral abscess

Answer 35

contrast enhanced CT/MRI - ring enhancing lesion | if dx in doubt do stereotaxic biopsy

Question 36

treatment for cerebral abscess normal if staph infection suspected if PA or MRSA infec suspected/proven how long

Answer 36

IV ceftriaxone 2g qds and IV metro 500mg 8 hourly IV flucox 2g qds IV vancomycin 4w

Question 37

what is the highest cause of deaths in under 40s

Answer 37

glioblastomas

Question 38

tumour headache

Answer 38

worse in mornings and increases with coughing, leaning forward

Question 39

increased ICP symptoms

Answer 39

headache vom - pressure on medula mental changes - pressure on frontal lobe seizures

Question 40

meningiomas are typically what

Answer 40

benign

Question 41

having what increases the chance of getting meningiomas

Answer 41

NF2

Question 42

meningiomas 1 type who symp

Answer 42

arachnoid cap cells, extraxial F>M asymp

Question 43

meningiomas 2 symp

Answer 43

headache, CN neuropathies, regional anatomical disturbances

Question 44

meningiomas 3

Answer 44

benign slow growing can have mets

Question 45

meningiomas aggressors who are these most common in and where

Answer 45

childhood leukaemia in midline

Question 46

treatment for meningiomas

Answer 46

pre op embolisation surgery radio

Question 47

astrocytic tumours grade 1

Answer 47

truly benign slow growing children and young adults

Question 48

astrocytic tumours grade 1 symp ix rx

Answer 48

child - blind in 1 eye, extreme hunger enhance on contrast surgery curative

Question 49

grade 2 (low grade) astrocytic tumour symp

Answer 49

seizures, temp lobe in adults, post frontal, ant parietal

Question 50

what happens to grade 2

Answer 50

eventually becomes grade 3/4

Question 51

poor prognostic factors of astrocytoma 2

Answer 51

>50, seizures, short duration of symp, increased ICP, altered consciousness, enhancement on contrast studies

Question 52

grade 3 astrocytic tumours

Answer 52

can arise de novo | av survival 2y

Question 53

grade 4 astrocytic tumours is what mean survival spread

Answer 53

glioblastoma multiforme most common primary tumour 12-14m white matter tract, CSF pathways

Question 54

poor prognostic factors of muktiforme

Answer 54

>45 crossing midline >6cm incomplete resection

Question 55

treatment of grades 3 and 4

Answer 55

surgery post op radio temozolomide

Question 56

better prognosis if what

Answer 56

MGMT methylated tumour

Question 57

oligodendrogal tumours grade 1 who symp

Answer 57

24-45s and 6-12yo | seizures

Question 58

oligo type 2

Answer 58

difficult to extinguish from astrocytomas

Question 59

treatment of oligo

Answer 59

chemo-sensitive. surgery | radio contraversion but reduces incidence of seizures

Question 60

gamma knife for treatment of schwannoma

Answer 60

hearing decreases over time

Question 61

pineal tumours in who | symp

Answer 61

children | hydrocephalus. symp of increased ICP

Question 62

GCT who

Answer 62

<20s esp 10-12yo

Question 63

most common CNS GCT

Answer 63

germinomous | radiosensitive

Question 64

non germatus CNS GCT

Answer 64

teratoma, yolk sac, choriocarcinoma, embryonic carcinoma