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42 Cards in this Set

  • Front
  • Back
Infections involving meninges or membranes surrounding brain & spinal cord.
Meningitis
What is the term for a generalized infection of the brain parenchyma?
Encephalitis
Infectious involvement of both meninges & brain parenchyma
Meningoencephalitis
What do we call a localized infection with necrosis of brain parenchyma?
Brain abscess
Localized collections of purulence in epidural or subdural space
Epidural/subdural empyema
What disease damages the anterior horn cells of the spinal cord?
Poliomyelitis
Condition that affects the posterior columns of the spinal cord
Syphilitic tabes dorsalis
What CNS infection affects the temporoparietal lobes of the brain?
HSV encephalitis
The primary mechanism for microbes to invade the CNS is....
Blood-borne seeding of the meninges from a distant site of infection or from a site of asymptomatic mucosal colonization.
The fact that the CNS is a protected system influences our choice of antimicrobial in that.......
The use of microbiocidal rather than microbistatic antibiotic therapy in management is critical.
What bacteria cause CNS infection?
Streptococcus pneumoniae
Neisseria meningitidis
Listeria monocytogenes
Staphylococcus aureus
Enteric GNRs
Which viruses cause CNS infections?
Enteroviruses
HSV
Arboviruses
Other agents causing CNS infection.
Mycobacterium tuberculosis
Cryptococcus neoformans
Coccidioides immitis
Toxoplasma gondii
Treponema pallidum
Bacterial pathogens causing CNS infection in neonates?
Group B streptococci (S.agalacitae)
E.Coli
Kelbsiella
Bacterial pathogens causing CNS infection in children?
N. meningitidis
S. pneumoniae
The three main bacteria that cause CNS infections in adults are....
Streptococcus pneumoniae
Neisseria meningitidis
Listeria monocytogenes
Classic findings of a CNS infection
Fever
Headache
Altered mental status
Meningismus (Stiff neck)
Patients in which CNS infection signs and symptoms are likely to be atypical
Very young
Very old
Immunocompromised
Cotraindications for lumbar puncture
Cellulitis overlying LP site
Increased ICP (Stupor/coma, papilledema)
CSF from LP can be assesed for..
Color/clarity
Cellcounts/ WBC diff
Chemistries (protein, glucose)
Stains/smears (gram)
Routine cultures
Antigen screens
Other specialized studies
Percentage of positive gram stain in patients with untreated bacterial meningitis
60-90%
Percentage of positive gram stain in patients with previous antibiotics for bacterial meningitis
40-60%
+ GmS (gram stain) in CSF
Heavy organism burden & worse prognosis
Neutrophilic/Low glucose CSF profile
Bacterial meningitis
Lymphocytic/Normal glucose
CSF profile
Viral meningitis or encephalitis

Post-infectious encephalomyelitis
The most common cause of bacterial meningitis in the US is....
Streptococcus pneumoniae
(G+)
2nd most Common cause of bacterial meningitis in U.S
N.Meningitidis
G-
Low glucose CSF profile with lots of lymphocytes indicates....
Tuberculous meningitis
Fungal meningitis
Primary causative agent of viral meningitis.
Enterovirus
HSV meningitis likes to target what brain area?
Temporoparietal region
Freud contributions
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)
Freuds structural model
ID (drives)
Ego
Superego (inhibitions)
Freud's topographical model
Unconscious
Preconscious
Conscious
What are Ego defense mechanisms?
The ego shapes desires of the ID through these mechanisms.
Oral stage (Freud)
0-2 years (dependancy)
According to Freud, the anal stage occurs at age... and has to do with issues of...
Age 2-3
Control
Phallic stage
Related to Narcissism, egocentrism
Genital phase
Healthy end point of psychosexual development
Behaviours Freud would consider defense mechanisms include....
Repression
Denial
Regression
Reaction formation
Undoing
Projection
Splitting
Sublimation
Humor
Altruism
Normal CSF glucose level
>40% of concurrent serum value
>34mg/dL
Why has meningitis moved out of the realm of the pediatrician?
The eradication of H. influenza and the rise of S. pneumoniae as the primary causative agent.
Based on the season, what is the primary diagnostic concern for a mild non-focal encephalitis that occurs in July?
Enteroviruses like west nile