Unit 6 Case 1: Meningitis Flashcards

Question

most common side effects of benzylpenicillin

Answer 1

nausea diarrhoea headaches abdominal pain

Answer 2

allergic reactions seizures neurological problems GI disturbances

Answer 3

kidney problems hearing loss, either partial or total so given hearing test a few weeks later epilepsy memory and concentration difficulties coordination, movement and balance issues learning difficulties and behavioural problems vision loss loss of limbs, amputation bone and joint problems

Answer 4

fatigue not being able to return to normal life immediately disturbed sleep bedwetting fear of doctors or hospitals personality changes: aggression, anxiety mood swings depression isolation low self-esteem

Answer 5

disease spreading: guilt, shame and embarrassment isolation stigma sick pay, SSP: £99.35 for up to 28 weeks, single parents may struggle family/ relationships: sick parent can't care for the child so may need family support

Answer 6

supportive framework for vasculature act with CSF to protect CNS from mechanical damage

Answer 7

dura mater arachnoid mater pia mater

Answer 8

outermost layer between skull and vertebral column thick, tough and inextensible 2 layers: periostea and meningeal and between are dural venous sinuses vasculature: middle meningeal artery and vein innervation: trigeminal nerve 4 dural reflections

Answer 9

responsible for venous drainage of cranium and empty into the internal jugular veins

Answer 10

middle layer avascular, no innervation underneath is the subarachnoid space arachnoid granulations leptomeninges

Answer 11

contains CSF cerebral arteries and veins

Answer 12

allow CSF to re-enter circulation via dural sinuses

Answer 13

inner layer under the subarachnoid space very thin follows contours of the brain highly vascularised: blood vessels to neural tissue leptomeninges

Answer 14

falx cerebri tentorium cerebelli falx cerebelli diaphragmatic sellae

Answer 15

projects down to separate right and left cerebral hemispheres

Answer 16

separates occipital lobes from cerebellum

Answer 17

separates right and left cerebellar hemispheres

Answer 18

covers hypophysical fossa of the sphenoid bone

Answer 19

epidural subdural subarachnoid

Answer 20

between superficial layer of dura mater and bone of skull

Answer 21

between dura mater and arachnoid mater

Answer 22

between arachnoid and Pia mater contains CSF and major blood vessels provides expansions, cisterns subarachnoid spaces of cranium and vertebral column are continuous with each other creates closed route for CSF circulation

Answer 23

cerebrospinal fluid clear and colourless located in the subarachnoid space and central canal of the spinal cord produced by choroid plexus 500ml produced daily 150ml in body at a given time

Answer 24

invagination of Pia mater to ventricles of brain covers 2 lateral ventricles, roof of 3rd and 4th ventricles forms selectively permeable BBB, controls movement of water and solutes into the CSF

Answer 25

choroid ependymal cells and their tight junctions pia mater endothelial cells of capillaries basal membrane of endothelial capillary cells

Answer 26

lateral ventricle 3rd ventricle 4th ventricle through 2 lateral foramina of Luschka and medial foramen of Magendie subarachnoid space and/or central canal of spinal cord arachnoid villi (small protrusions of arachnoid mater) drain to superior sagittal venous sinus to venous sinus

Answer 27

protection homeostasis clearing waste clinical diagnosis buoyancy

Answer 28

acts as a shock absorber prevents damage caused by brain hitting the cranium

Answer 29

regulates distribution of metabolites that surround the brain

Answer 30

waste products created by brain cells are excreted into CSF which then drains to blood stream

Answer 31

lumbar punctures to obtain samples from subarachnoid space

Answer 32

viral bacterial fungal parasitic amoebic non-infectious

Answer 33

babies, E coli young children teens adults, N.men

Answer 34

N meniningitidis has 12 subtypes transmitted via droplets, must pass the submucosal layer incubation period is 4 days 10% population carries in bac of throat with no infection notifiable disease

Answer 35

gram negative, capsulated, diplococcus type 4 plus involved in mucosal colonisation (host adhesion) capsule helps to avoid phagocytes major toxin: lipo-oligosaccharide (LOS) endotoxin found inside pathogen and released when pathogen is degraded

Answer 36

paracellular leukocyte-facilitated/ trojan horse transcellular

Answer 37

bind to the endothelial cells deplete tight junctions (zona occludens) between endothelial cells in the BBB creates signalling pathways, allows pathogens to travel through gaps in cells

Answer 38

once phagocytose in bloodstream they're not degraded due to capsules due to depletion of tight junctions by bacterial cells they canc squeeze between gaps in the BBB

Answer 39

pilus mediated adhesion induces formation of micro-villi like structures triggers bacterial internalisation pill-induced signalling= reorganisation of actin cytoskeleton= formation of membrane protrusions= engulfing bacterial pathogens travel intracellular vacuoles then exocytosed to CSF by transcytosis

Answer 40

gram negative K1 capsule rod shaped

Answer 41

protected form host immune response by K1 capsule can prevent fusion of lysosomes and lysosomal degradation of bacteria once engulfed by phagocytes bacteria across BBB into the CSF attachment: type 1 pili bind to CD48 and ompA (outer membrane protein A) CNF1 binds to 67LR (67kDa laminin receptor) as well as type 1 pili and IbeA inducing rearrangement of actin cytoskeleton in target cells for transcytosis across BBB

Answer 42

pro-inflammatory cytokines secreted in response to pathogens in the CSF MMP's from pathogens and tissues can degrade tight junctions and increase endothelial permeability, changes CSF composition altered cerebral blood flow due to thrombosis asa result fo clotting around pathogens and damaged blood vessels induced by DAMPs can cause schema and decreased perfusion pressure of blocked vessels may result in increased inter cranial pressure and cerebral edema proteolytic enzymes and reactive oxygen species: released from granulocytes causes damage to endothelial cells aswell as neural damage and increased BBB permeability toxins and endotoxins: released by Bacteria when degraded can also cause tissue damage

Answer 43

lack of oxygen to tissue

Answer 44

less pressure required for substances to leave blood vessels