Term
| Infection/inflammation of the dura, arachnoid, and pia mater and of the CSF. |
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Definition
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Term
| What is the reason for the decreased incidence of meningitis in peds and adults? |
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Definition
| Peds - Hib vaccine, Adults - pneumococcal vaccine used more in >65yo |
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Term
| What is the MC cause of CA-Meningitis in the US? |
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Definition
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Term
| What cause of meningitis is MC in the winter months and infects the nasopharynx causing sore throat? |
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Definition
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Term
| What cause of meningitis primarily affects pregnant women, neonates, pts on immunosuppression, HIV pts, and >50yo? |
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Definition
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Term
| How is listeria monocytogenes contracted? |
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Definition
| Eating foods (unpasteurized milk, soft cheese) - enters GI tract |
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Term
| MC organism to cause meningitis in neonates? Second MC? |
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Definition
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Term
| MC organisms to cause nosocomial meningitis? If ventricular shunt placement? |
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Definition
| Klebsiella or E. coli (gram -). S. aureus. |
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Term
| What is the classic triad of sx in bacterial meningitis? |
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Definition
| Fever, nuchal rigidity, and AMS |
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Term
| Describe the nuchal rigidity present in bacterial meningitis. |
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Definition
| Problem of forward flexion only |
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Term
| Name 2 diagnostic signs present in bacterial meningitis. |
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Definition
| Kernig's and Brudzinski's sign |
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Term
| What is the likely pathogen of bacterial meningitis if the ear exam is abn? |
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Definition
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Term
| What is the likely pathogen in bacterial meningitis with pharyngeal erythema? |
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Definition
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Term
| What are the likely pathogens of bacterial meningitis if petechiae or purpura is present? |
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Definition
| N. meningitidis, Ricketssia, echovirus, or S. aureus |
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Term
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Definition
| Vancomycin + cephalosporin + ampicillin |
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Term
| Abx for meningitis if significant immunosuppression, h/o CSF leak, recent neurosurgery, head trauma, or potential sepsis? |
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Definition
| Add cefepime or meropenem |
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Term
| Tx for bacterial meningitis if coma or inc. CSF pressure? |
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Definition
| Dexamethasone (consider Mannitol for inc. CSF pressure) |
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Term
| Name 3 types of chronic bacterial meningitis. |
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Definition
| Tuberculosis, syphilitic, or cryptococcal meningitis |
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Term
| MC etiology of aseptic meningitis? |
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Definition
| Enterovirus, coxsackievirus, and echovirus |
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Term
| How do viruses that cause viral meningitis spread? What time of the year are they MC? |
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Definition
| Fecal-oral route. Spring and summer |
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Term
| What is the MC c/o in a pt w/ viral meningitis? What are other common presenting sx? |
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Definition
| HA. Photophobia, neck stiffness, diffuse myalgia, and fever. |
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Term
| What is the likely virus causing conjunctivitis in a pt w/ viral meningitis? |
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Definition
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Term
| What is the tx for viral meningitis? |
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Definition
| Usually self-limiting and tx symptomatically |
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Term
| Inflammation of the brain. |
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Definition
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Term
| Name the 3 MC etiologies of encephalitis. |
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Definition
| 1)HSV 1 2)Western equine (arbovirus) 3)West Nile (flavivirus) |
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Term
| HSV encephalitis is associated with profound _______ and changes in ______. |
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Definition
| Memory impairment, personality |
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Term
| How is western equine encephalitis transmitted? |
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Definition
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Term
| Who does western equine encephalitis MC affect? |
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Definition
| Very young and > 50yo during the summer months |
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|
Term
| How is west nile encephalitis transmitted? |
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Definition
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Term
| What is a RF for severe dz in west nile encephalitis? What are signs of severe dz? |
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Definition
| Advanced age. Fever, muscle weakness/paralysis, and AMS. |
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Term
| A localized collection of pus w/i the brain parenchyma. |
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Definition
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Term
| MC location of brain abscess? |
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Definition
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Term
| What is the etiology of brain abscess? |
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Definition
| Polymicrobial (S. aureus, gram - bacilli, strep, and anaerobes) |
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Term
| Finding on CT scan of brain abscess? |
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Definition
| Outer ring surrounding a low-density core |
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Term
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Definition
| 6-8 wks PCN, metronidazole, ceftriaxone, Nafcillin or oxacillin |
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Term
| Med for brain abscess if mass effect and AMS? |
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Definition
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Term
| Clinical findings in brain abscess of temporal lobe? |
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Definition
| Wernicke aphasia, homonymous superior quadranopsia, mild contralateral facial muscle weakness |
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|
Term
| Clinical findings in brain abscess in frontal lobe? |
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Definition
| Drowsiness, inattentiveness, disturbed judgement, grasp/suck reflex |
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|
Term
| Clinical findings in brain abscess in parietal lobe? |
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Definition
| Impaired position sense, focal sensory and motor sz, homonymous hemianopsia |
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Term
| Clinical findings in brain abscess of cerebellum? |
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Definition
| Ataxia, nystagmus, ipsilateral incoordination of arm and leg movement w/ intention tremor |
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Term
| Clinical findings of brain abscess in brain stem? |
|
Definition
| Facial weakness and dysphagia, cranial nerve palsies, contralateral hemiparesis |
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