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51 Cards in this Set
- Front
- Back
How do most microorganisms get to CNS?
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Through blood
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Name 3 mechanisms of meningitis
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- Infect cells lining barrier
- Passively transported across barrier in vacuoles - Carried across barrier in infected leukocytes |
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Organisms causing meningitis in neonates
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Strep B - Strep. agalactiae
E.coli Listeria monocytogenes |
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Organisms causing meningitis in infants and children
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S. pneumoniae
N. meningitidis H. influenzae |
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What is the most important virulence factor of organisms causing acute meningitis?
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CAPSULE - antiphagocytic, allows to escape immune system
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What are the symptoms of clinical infant meningitis
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Nuchal rigidity, opisthotonos, bulging fontanelle, convulsions, photophobia, lethargy, irritability, seizures, coma
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What are the cardinal signs of meningitis
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Fever
Nuchal rigidity Vomitting |
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What are two physical signs that could be performed and are indicative of presence of meningitis
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Kernigs sign + Brudzinskis sign
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If patient has maculopapular or petechial rash with the signs of meningitis, it is indicative of what type of meningitis
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Meningococcal
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Shape + Stain STREP PNEUMONIAE
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Gram positive diplococci
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Pneumococcal meningitis usually follows _
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Bacteremia, sinusitis or otitis media
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Which patients are in higher risk of pneumococcal meningitis
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Sickle cell patients
Patients with asplenia Elderly |
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Are cardinal signs of meningitis present in pneumococcal meningitis
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YES
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How do you diagnose pneumococcal meningitis
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Culture (CSF and blood) + Gram stain CSF
INCREASED NEUTROPHILS IN CSF, BACTERIA PRESENT IN CSF |
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What is the best treatment for pneumococcal meningitis
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Third generation cephalosporins
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Which drugs for treatment of pneumococcal meningitis is contraindicated in children
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FLuoroquinolones
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Name vaccine against pneumococcal meningitis
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Heptavalent pneumococcal vaccine - 2-23 months + for older children at high risk 2-5 years old
After 5 years old - 23 valent vaccine |
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NEISSERIA MENINGITIDIS
Shape + Stain |
Gram negative diplococcus
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Which serotype of Neisseria Meningitidis is responsible for meningitis epidemics in developing countries
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A
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Which serotypes of N. meningitidis are common in US
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B, C, Y and W-135
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20% of population are carriers of N. meningitidis - where is it located?
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Attached to epithelial cells in nasopharynx
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Epidemics of meningitis in overcrowded areas - schools, military bases, prisons are caused by which organism?
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N. meningitidis
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How do you diagnose meningococcal meningitis
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Primarily by clinical signs - also culture CSF and blood, Gram stain of CSF, increased WBC count in CSF
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What is a treatment of meningococcal meningitis
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Penicillin or ampicillin, chloramphenicol - after acute infection 1 dose rifampin
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As chemoprophylaxis for family members of patient with meningococcal meningitis - what drug is used and why
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Rifampin - clears nasopharyngeal carriages (penicillin does not)
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What is preferred vaccine for N. meningitidis for 2-10 year olds and over 55 year old
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Meningococcal polysaccharide vaccine (MPSV4 or Menomune)
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What is preferred vaccine for N. meningitidis in people 11-55 year old + people at high risk (college freshmen, military recruits, etc)
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Meningococcal conjugate vaccine (MCV4 or Menactra)
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Which serotype of N. meningitidis is NOT included in the vaccine and is most commonly seen in US
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B
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H. INFLUENZAE B - shape + stain
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Gram negative pleomorphic coccobacilli
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Which organism used to be primary cause of pediatric meningitis but now only seen in unvaccinated children
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H. influenzae
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How long do maternal antibodies protect infant from H. influenzae
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3-4 months
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Meningitis caused by H. influenzae usually follows _
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Upper respiratory infection followed by fever and severe headache
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What are the sequelae of meningitis caused by H. influenzae
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Hearing loss
Retardation Seizures |
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H. influenzae does NOT grow on which medium
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MacKonkeys or Blood agar
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What two factors does H. influenzae need for growth
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X (hemin) and V (NAD) factors
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H. parainfluenzae only needs one factor -
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V factor
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H. influenzae can only be cultured on which medium
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Chocolate agar
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How do you treat meningitis caused by H. influenzae
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Broad spectrum cephalosporins
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Serratia, Pseudomonas, Proteus are NOT common causes of neonatal meningitis but occur in _
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Premature infants -respiratory equipment
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Are cardinal signs of meningitis present in neonatal meningitis
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NO
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Which serotype of Group B strep causes most cases of meningitis
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III
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LISTERIA MONOCYTOGENES - shape + stain
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Gram positive rods
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Which organism grows on most media in cold selection (4 degrees C)
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Listeria monocytogenes
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C. BOTULINUM and C. TETANI - Shape + Stain
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Gram positive rods, anaerobic, spore forming
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Botulinum toxin causes what in infants?
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Flaccid paralysis
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MOA botulinum neurotoxin
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Inhibits release of Ach
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How would infant suffering from botulism present
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Failure to thrive
Constipation Flaccid paralysis |
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MOA tetanus toxin
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Prevents release of inhibitory NT
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What do you see in 75% of patients with tetanus
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Strismus - lock jaw
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What is appropriate treatment of tetanus
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Antimicrobial therapy first followed by tetanus immunoglobulin
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What distinguishes Brucella bacteria
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INTRACELLULAR
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