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35 Cards in this Set
- Front
- Back
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What are the basic symptoms of an infection of the CNS?
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Headache, fever, stiff neck, altered mental status
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When do CNS infections occur?
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When body resistance is low.
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75% of acute bacterial meningitis cases occur before what age?
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15
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What bacterium causes acute bacterial meningitis?
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H. influenzae
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What is the best antibiotic for H. flu?
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Amoxacillin
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What type of infection most often precedes acute bacterial meningitis?
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Sinus infection caused by bacteria in the nasopharynx
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What is the most common cause of aseptic meningitis?
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viral infection
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What age group is most commonly affected by aseptic meningitis?
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children and young adults
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What is the difference between viral and bacterial meningitis?
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CSF:
Bacterial - neutrophils Viral - macrophages and lymphocytes Mortality: Bacterial - will kill you Viral - will not kill you |
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Encephalitis is infection of what tissue?
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Parenchymal tissue
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What is the most common cause?
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Viral infection (HSV)
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What causes Multiple Sclerosis?
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Misdirected immune response. T-cells are switched on and directed toward the patient's own myelin.
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What is a characteristic pathological finding in the brains of patients with MS?
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Multiple scars (plaques) in the brain due to inflammation.
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Is the father or mother more likely to pass on MS?
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father
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Which gender and age range is most affected by MS?
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Women 20-40
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What is the common presentation of MS at first?
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Attacks - rapid appearance of new symptoms over a week or two.
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What is the average length of attack?
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1-3 months (up to 6 months)
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During a remission of MS do the plaques go away?
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No, but they do behave differently
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What are all of the ocular symptoms of MS?!
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UNILATERAL VISION LOSS also called Uhtoff's symptom (if the loss is made worse by heat)
Optic neuritis Diplopia Nystagmus INO |
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What are the general signs associated with MS?
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Muscle weakness and fatigue
Ataxia Dysmetria Lhermitte's sign |
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What is Lhermitte's sign?
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Shooting pain up the spine when the patient brings their chin down to their chest.
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What are the 4 presentation patterns for MS?
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1. Relapsing-Remitting (RRMS)
2. Secondary Progressive (SPMS) 3. Primary Progressive (PPMS) 4. Progressive-Relapsing (PRMS) |
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Which is the most common presentation pattern?
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Relapsing-Remitting MS
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How do you define Relapsing-Remitting MS?
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Unpredictable exacerbations with partial or total remission.
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How do you define Secondary-Progressive MS?
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RRMS followed by gradual clinical decline with no or minor distinct remissions.
Even during remissions they continue to decline in neurological function. |
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How do you define Primary-Progressive MS?
Who usually has this presentation? |
Gradual decline with no remission
Patients who are diagnosed with MS at an older age. |
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How is PPMS different from RRMS?
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It is progressive from the start.
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How do you define Progressive-Relapsing MS?
How common? |
Disease takes progressive path punctuated by ACUTE attacks and remissions.
Rare |
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How do you Dx MS?
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Hx of otherwise healthy patient experiencing relapsing and remitting neurological function over a long period of time.
Elevated Ab in CSF MRI with FLAIR |
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How do you Tx?
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Treat symptoms (fatigue, muscle spasm, depression, constipation)
Treat MS |
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How do you treat relapsing-remitting MS?
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ABCs:
Interferon beta 1A - subQ daily Interferon beta 1B - IM or subQ weekly Copaxone (Glatiramer) - subQ daily Natalizumab (Tysabri) IV q5weeks |
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How does Glatiramer (copaxone) work against MS?
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Tricks immune cells into attacking it rather than myelin - it resembles myelin basic protein.
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How does Natalizumab work against MS?
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It blocks inflammatory cells from entering the brain and spinal cord.
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Other MS drugs?
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Mitoxantrone - an immunosuppresor
IV q3months Cyclophosphamide - high dose Statin drugs - reduces inflammation, delays progression Oral and cheap |
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Future therapies for MS?
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Neurovax - vaccine to generate immune response against harmful T-cells
Recombinant T-cell receptor ligand (RTL) - tailored drug that attaches to pathogenic T-cell and renders it non-inflammatory. Hyaluronic acid inhibition - high levels of HA interferes with myelin producing cells Monthly steroids Testosterone gel for men Nicotinaminde |
