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42 Cards in this Set
- Front
- Back
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Infections involving meninges or membranes surrounding brain & spinal cord.
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Meningitis
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What is the term for a generalized infection of the brain parenchyma?
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Encephalitis
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Infectious involvement of both meninges & brain parenchyma
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Meningoencephalitis
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What do we call a localized infection with necrosis of brain parenchyma?
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Brain abscess
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Localized collections of purulence in epidural or subdural space
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Epidural/subdural empyema
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What disease damages the anterior horn cells of the spinal cord?
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Poliomyelitis
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Condition that affects the posterior columns of the spinal cord
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Syphilitic tabes dorsalis
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What CNS infection affects the temporoparietal lobes of the brain?
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HSV encephalitis
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The primary mechanism for microbes to invade the CNS is....
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Blood-borne seeding of the meninges from a distant site of infection or from a site of asymptomatic mucosal colonization.
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The fact that the CNS is a protected system influences our choice of antimicrobial in that.......
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The use of microbiocidal rather than microbistatic antibiotic therapy in management is critical.
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What bacteria cause CNS infection?
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Streptococcus pneumoniae
Neisseria meningitidis Listeria monocytogenes Staphylococcus aureus Enteric GNRs |
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Which viruses cause CNS infections?
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Enteroviruses
HSV Arboviruses |
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Other agents causing CNS infection.
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Mycobacterium tuberculosis
Cryptococcus neoformans Coccidioides immitis Toxoplasma gondii Treponema pallidum |
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Bacterial pathogens causing CNS infection in neonates?
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Group B streptococci (S.agalacitae)
E.Coli Kelbsiella |
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Bacterial pathogens causing CNS infection in children?
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N. meningitidis
S. pneumoniae |
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The three main bacteria that cause CNS infections in adults are....
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Streptococcus pneumoniae
Neisseria meningitidis Listeria monocytogenes |
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Classic findings of a CNS infection
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Fever
Headache Altered mental status Meningismus (Stiff neck) |
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Patients in which CNS infection signs and symptoms are likely to be atypical
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Very young
Very old Immunocompromised |
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Cotraindications for lumbar puncture
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Cellulitis overlying LP site
Increased ICP (Stupor/coma, papilledema) |
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CSF from LP can be assesed for..
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Color/clarity
Cellcounts/ WBC diff Chemistries (protein, glucose) Stains/smears (gram) Routine cultures Antigen screens Other specialized studies |
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Percentage of positive gram stain in patients with untreated bacterial meningitis
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60-90%
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Percentage of positive gram stain in patients with previous antibiotics for bacterial meningitis
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40-60%
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+ GmS (gram stain) in CSF
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Heavy organism burden & worse prognosis
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Neutrophilic/Low glucose CSF profile
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Bacterial meningitis
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Lymphocytic/Normal glucose
CSF profile |
Viral meningitis or encephalitis
Post-infectious encephalomyelitis |
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The most common cause of bacterial meningitis in the US is....
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Streptococcus pneumoniae
(G+) |
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2nd most Common cause of bacterial meningitis in U.S
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N.Meningitidis
G- |
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Low glucose CSF profile with lots of lymphocytes indicates....
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Tuberculous meningitis
Fungal meningitis |
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Primary causative agent of viral meningitis.
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Enterovirus
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HSV meningitis likes to target what brain area?
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Temporoparietal region
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Freud contributions
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Conscious Vs. Unconscious
Psychic determinism Psychoanalysis Free assocation interpretation Dream analysis Transference (projection of feelings onto therapist) Countertransference (projection of feelings onto the patient by the therapist) |
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Freuds structural model
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ID (drives)
Ego Superego (inhibitions) |
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Freud's topographical model
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Unconscious
Preconscious Conscious |
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What are Ego defense mechanisms?
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The ego shapes desires of the ID through these mechanisms.
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Oral stage (Freud)
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0-2 years (dependancy)
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According to Freud, the anal stage occurs at age... and has to do with issues of...
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Age 2-3
Control |
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Phallic stage
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Related to Narcissism, egocentrism
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Genital phase
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Healthy end point of psychosexual development
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Behaviours Freud would consider defense mechanisms include....
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Repression
Denial Regression Reaction formation Undoing Projection Splitting Sublimation Humor Altruism |
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Normal CSF glucose level
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>40% of concurrent serum value
>34mg/dL |
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Why has meningitis moved out of the realm of the pediatrician?
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The eradication of H. influenza and the rise of S. pneumoniae as the primary causative agent.
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Based on the season, what is the primary diagnostic concern for a mild non-focal encephalitis that occurs in July?
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Enteroviruses like west nile
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