Micro 1-Liners Nervous System

Front 1

392. Hx: fever, headache, neck stiffness, and altered mental status; Kernig's/Brudzinski's sign other focal neurologic findings, rash, headache, seizures + myalgia; CSF: WBC > 2000 or PMNs > 1200; glucose < 34, protein > 220

Back 1

Acute bacterial meningitis (ABM)

Front 2

CSF gram stain of the most likely pathogen of ABM in a 6 mos-6yr old (or adults > 50 years) should reveal

Back 2

Gram-positive diplococci

Front 3

CSF gram stain of the most likely pathogen of ABM in an older child or young adult should reveal

Back 3

Gram-negative diplococci

Front 4

393. Most common cause of sepsis/meningitis in newborns/neonates?

Back 4

Streptococcus agalactiae

Front 5

394. Cause of fever, headache, photophobia, nausea/vomiting, rash, diarrhea, meningeal signs, in older children in the summer months; CSF with 10-<1,000 WBC typical, mostly monos, moderately elevated protein?

Back 5

Aseptic meningitis caused by enteroviruses

Front 6

395. Cause of aseptic meningitis in men with exposure to rodents?

Back 6

Leptospira interrogans

Front 7

396. Cause of aseptic meningitis with hx of tick bite and erythema migrans?

Back 7

Borrelia burgdorferi

Front 8

397. Cause of aseptic meningitis with hx of sex with multiple partners; CSF PCR(+)?

Back 8

HSV-2 > 1

Front 9

398. Cause of fever, headache, photophobia, meningismus, in pts w/ solid organ transplant, malignancy, corticosteroid use. CSF glucose < 2/3 serum glucose, elevated protein, WBC > 5 with PMNs?

Back 9

Listeria monocyotgenes

Front 10

399. How does Listeria monocytogenes differ from other β-hemolytic bacteria?

Back 10

Gram-positive rods; tumbling motility

Front 11

400. Cause of chronic meningoencephalitis in a pt, who uses infliximab or native from endemic region; PE: papilledema. CXR (+). Lab: elevated monocytes on differential, low CSF glucose?

Back 11

Mycobacterium tuberculosis

Front 12

401. Test to confirm subacute mengoencephalitis in a, immunocompromised pt (CD4 <100); vesicular skin lesions [CSF profile: protein 30-150mg/dl, monos 10-100]?

Back 12

CSF India ink

Front 13

402. Cause of meningoencephalitis after a hx of respiratory illness after travel to SW USA?

Back 13

Coccidioides immitis

Front 14

403. Test to confirm CNS pathology with fever, cognitive deficits, focal neurologic signs, seizures; temporal lobe involvement on MRI. Lab: no papilledema, CT (no brain lesion)?

Back 14

CSF PCR (+)

Front 15

404. Cause of fever, cognitive deficits, focal neurologic signs, seizures, abnormal mental status with ataxia, hemi-paresis, in a pt w/ AIDS?

Back 15

JC virus > HHV-6

Front 16

405. Cause of fever, cognitive deficits, focal neurologic signs, seizures or abnormal mental status with ataxia in an adult during outdoor activity?

Back 16

West-Nile virus > SLE

Front 17

406. Hx of fever, cognitive deficits, focal neurologic signs, seizures, in a pt w/ AIDS (CD4 < 50). MRI: multifocal (ring-enhancing) lesions in basal ganglia. Rule out?

Back 17

Toxoplasma encephalitis (TE)

Front 18

407. HIV-infected Pt with TE should receive (for life)

Back 18

pyrimethamine + leucovorin + sulfadiazine

Front 19

408. Folinic acid (leucovorin) prevents bone marrow suppressive effect of

Back 19

pyrimethamine.

Front 20

409. Cause of confusion, stiff neck, irritability over wks to months, in immunocompromised pts; CT/MRI = multifocal lesions in midbrain, brain stem, & cerebellum; wet mount CSF = motile macrophage-like organisms

Back 20

Acanthamoeba spp. (GAE)

Front 21

410. Cause of severe headache and other meningeal signs, fever, vomiting, and focal neurologic deficits, frequently progressing to coma, in a healthy boy (summer diving activity)?

Back 21

Naegleria fowleri (PAM)

Front 22

411. Cause of seizures, chronic headache, symptomatic hydrocephalus, in immigrants; pt. successfully responds to praziquantel + anti-convulsant drug?

Back 22

Taenia solium (neurocysticercosis)

Front 23

412. Pt from Africa had fever, lymphadenopathy, chancre, and pruritus weeks ago; now has headaches, somnolence, neuro Sns; slowly responds to pentamidine isothionate or suramin. TOW?

Back 23

Sleeping sickness caused by Trypanosoma brucei

Front 24

413. Hx of rigidity, muscle spasm, and autonomic dysfunction. Trismus due to masseter spasm in an infant w/ umbilical stump infection. Neurotoxin interferes w/

Back 24

GABA and glycine

Front 25

414. Hx of afebrile illness w/ diplopia, dysarthria, dysphoria, dysphagia, in a pt w/ IDU skin poppers with black tar heroin. Neurotoxin blocks the release of

Back 25

Acetylcholine

Front 26

415. Immediate treatment of a male infant w/ constipation, a weak cry, and drooling, hypotonea and cranial neuropathy, after ingestion of home-processed honey.

Back 26

Equine immune globulin (infant botulism)