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24 Cards in this Set

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433. Fever, headache, neck stiffness, and altered mental status; Kernig's/Brudzinski's sign, rash; CSF: WBC > 2000 or PMNs >1200; glucose < 34, protein > 220 CSF gram stain of the most likely pathogen of ABM in a 6 mos-6yr old (or adults > 50 years) should reveal CSF gram stain of the most likely pathogen of ABM in an older child or young adult should reveal

Acute bacterial meningitis (ABM) Gram-positive diplococci, Gram-negative diplococci

434. Most common cause of sepsis/meningitis in newborns/neonates?
Streptococcus agalactiae
435. 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?
Aseptic meningitis (enteroviruses)
436. Cause of aseptic meningitis in men with exposure to rodents?
Leptospira interrogans
437. Cause of aseptic meningitis with hx of tick bite and erythema migrans?
Borrelia burgdorferi
438. Cause of aseptic meningitis with hx of sex with multiple partners; CSF PCR(+):
HSV-2 > 1
439. 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
Listeria monocyotgenes
440. How does Listeria monocytogenes differ from other - hemolytic bacteria
Gram-positive rods; tumbling motility
441. 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?
Mycobacterium tuberculosis
442. Test to confirm subacute mengoencephalitis in a, immunocompromised pt (CD4 <100); vesicular skin lesions [CSF profile: protein 30-150mg/dl, monos 10-100]?
CSF India ink
443. Cause of meningoencephalitis after a hx of respiratory illness after travel to SW USA?
Coccidioides immitis
444. 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)?
CSF PCR (+)
445. Cause of fever, cognitive deficits, focal neurologic signs, seizures, abnormal mental status with ataxia, hemi-paresis, in a pt w/ AIDS?
JC virus > HHV-6
446. Cause of fever, cognitive deficits, focal neurologic signs, seizures or abnormal mental status with ataxia in an adult during outdoor activity?
West-Nile virus > SLE
447. Hx of fever, cognitive deficits, focal neurologic signs,seizures, in a pt w/ AIDS (CD4 < 50). MRI: multifocal (ringenhancing) lesions in basal ganglia. Rule out?
Toxoplasma encephalitis (TE)
448. HIV-infected Pt with Toxoplasma encephalitis should receive (for life)
pyrimethamine + leucovorin + sulfadiazine
449. Folinic acid (leucovorin) prevents bone marrow suppressive effect of
Pyrimethamine
450. 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
Acanthamoeba spp. (GAE)
451. 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)?
Naegleria fowleri (PAM)
452. Cause of seizures, chronic headache, symptomatic hydrocephalus, in immigrants; pt. successfully responds to praziquantel + anti-convulsant drug?
Taenia solium (neurocysticercosis)
453. 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?
Sleeping sickness caused by Trypanosoma brucei
454. Hx of rigidity, muscle spasm, and autonomic dysfunction Trismus due to masseter spasm in an infant w/ umbilical stump infection. Neurotoxin interferes w/
GABA and glycine
455. 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
Acetylcholine
456. Immediate treatment of a male infant w/ constipation, a weak cry, and drooling, hypotonea and cranial neuropathy, after ingestion of home-processed honey.
Equine immune globulin (infant botulism)