Week 4 - Nervous system infections

Question 1

Two main infections of the NS

Answer 1

• Meningitis
• Encephalitis

Question 2

Patient with Herpes simplex can’t stop having seizures because it affects a specific lobe of the brain, which one is it?

Answer 2

Temporal lobe

Question 3

Encephalitis signs can be divided into 2

Answer 3

• Diffuse
• Focal

Question 4

Inflammatory process involving the brain parenchyma + evidence of neurologic dysfunction

Answer 4

Encephalitis

Question 5

Most common group affected by encephalitis

Answer 5

Infants younger than 1 year (< 5 years old)

Question 6

Causes of encephalitis

Answer 6

• Virus
• Bacteria
• Autoimmune disease

Question 7

Signs positive in meningitis

Answer 7

• Kering’s sign
• Brudzinski’s sign

Question 8

Flexion of the hips and knees resulting in a neck flexion is a sign of…

Answer 8

Brudzinski’s sign

Question 9

Resistance to extend the leg while the hip os flexed is a sign of…

Answer 9

Kering’s sign

Question 10

Most common cause of encephalitis

Answer 10

Enterovirus

Question 11

Most common bacterial cause of meningitis

Answer 11

Pneumococci

Question 12

How does Herpes simplex 1 and 2 get to the NS

Answer 12

Ascends though the Trigeminal nerve

Question 13

Clinical manifestations of encephalitis by Herpes simplex

Answer 13

• Acute
• Sporadic viral encephalitis

Question 14

Treatment for Herpes simplex

Answer 14

Acyclovir

Question 15

Pathogens infect meningeal layers

Answer 15

Meningitis

Question 16

Pathogens infect brain parenchyma

Answer 16

Encephalitis

Question 17

Infection starts @meninges and spreads to brain parenchyma

Answer 17

Meningiencephalitis

Question 18

Aseptic meningitis refers to meningitis where routine bacterial cultures of CSF are -, what are some pathogens that can cause this?

Answer 18

• Viruses
• Mycobacteria
• Fungi
• Parasites

Question 19

Most common cause of aseptic meningitis

Answer 19

Enterovirus: echovirus and coxsackie virus

Question 20

Babies < 3 months old are most susceptible to getting bacterial meningitis from

Answer 20

• Group B Streptococci
• Escherichia coli
• Listeria monocytogenes

Question 21

Teens between the ages of 13 and 17 years old get bacterial meningitis from

Answer 21

• Neisseria meningitidis
• Streptococcus pneumoniae
• Haemophilus influenzae

Question 22

Children between the ages of 3 + months and 12 years + adults get bacterial meningitis from

Answer 22

• Streptococcus pneumoniae
• Neisseria meningitidis
• Haemophilus influenzae

Question 23

Listeria monocytogenes can also cause bacterial meningitis @ another age group, which one?

Answer 23

> than 50 years and immunocompromised

Question 24

Pure encephalitis (without meningitis) is most commonly caused by

Answer 24

Virus

Question 25

Fungi that can cause encephalitis infections (only @ immunocompromised ppl)

Answer 25

- Cryptococcus neoformans - Coccidioides immitis

Question 26

Brain eating amoeba that can cause fatal meningoencephalitis

Answer 26

Naegleria Fowler

Question 27

Another parasite that can cause meningoencephalitis and is transmitted by the tsetse fly

Answer 27

Trypanosoma brucei

Question 28

Common triad of symptoms present in brain infections

Answer 28

- Headache - Fever - Neck rigidity

Question 29

Symptoms that accompany the triad are

Answer 29

- Photophobia - Nausea - Vomiting

Question 30

Petechiae are characteristic of

Answer 30

Neisseria meningitidis

Question 31

Sign to differentiate encephalitis from meningitis

Answer 31

Abnormal brain function

Question 32

Signs that differentiate meningitis from encephalitis

Answer 32

- Neck rigidity - Kering + - Brudzinski +

Question 33

HSV encephalitis has some characteristic signs since it affects the temporal lobe, which ones?

Answer 33

- Aphasia - Olfactory hallucinations - Personality changes

Question 34

Gold standard diagnosis for meningitis and encephalitis

Answer 34

Lumbar puncture to obtain CSF sample for analysis and culture

Question 35

Instant treatment for patients with suspected encephalitis or meningitis

Answer 35

- IV dexamethasone: to decrease inflammatory response - Empiric antibiotics - Sometimes steroids to reduce the risk of mortality

Question 36

If the patient has characteristic HSV encephalitis symptoms (confusion, change in personality, drowsiness, fussiness, lethargy and bulging fontanelle) start treatment with

Answer 36

IV acyclovir to treat HSV

Question 37

Patchy signs @ brain are characteristic of

Answer 37

HSV infection

Question 38

CSF with increased WBC count w/ neutrophil predominance

Answer 38

Bacterial

Question 39

CSF with mild leukocytosis and a lymphocyte predominance

Answer 39

- Viral - Fungal

Question 40

Protein levels @ CSF change depending on the pathogen, how so?

Answer 40

- High protein levels @ bacterial infections - Mild or normal protein levels @ viral and fungal infections

Question 41

Glucose levels @ CSF change depending on the pathogen, how so?

Answer 41

- Low glucose levels @ bacterial and fungal infections - Normal or slightly decreased @viral infections

Question 42

yay fin

Answer 42

yay