Neuro Infections + sequalae
description
Transcript of Neuro Infections + sequalae
![Page 1: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/1.jpg)
Neuro Infections + sequalae
Quiz
![Page 2: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/2.jpg)
What are the most common organisms implicated in bacterial
meningitis in children?
![Page 3: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/3.jpg)
What are the most common organisms implicated in bacterial meningitis in children?
a) N. meningitidis, H. influenzae b) S. pneumoniae, L. monocytogenes c) E. coli, group B streptococcid) N. meningitidis, S. pneumoniae
![Page 4: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/4.jpg)
What CSF findings would be most suggestive of bacterial meningitis?
![Page 5: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/5.jpg)
What CSF findings would be most suggestive of bacterial meningitis?
a) Low turbidity, positive latex agglutination test, CSF/ serum glucose ratio = 0.5
b) PMN leukocytosis (400/mm3), CSF/ serum glucose ratio = 0.3, increased protein, negative culture
c) CSF opening pressure = 130mmH2O, CSF/ serum glucose ratio = 0.7, mononuclear leukocytosis (200/mm3)
d) CSF/ serum glucose ratio = 0.4, high protein, cells (PMN and mono) = 150/mm3
![Page 6: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/6.jpg)
What are the 3 components of meningismus?
![Page 7: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/7.jpg)
What are the 3 components of meningismus?
a) nuchal rigidity, meningeal irritation, headache
b) photophobia, nuchal rigidity, headachec) headache, nuchal rigidity, feverd) fever, photophobia, nuchal rigidity
![Page 8: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/8.jpg)
Describe Kernig’s and Brudzinski’s signs.
![Page 9: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/9.jpg)
Describe Kernig’s and Brudzinski’s signs.
Kernigs - leg is bent at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance)
Brudzinski’s - appearance of involuntary lifting of the legs in meningeal irritation when lifting a patient's head off the examining couch, with the patient lying supine
![Page 10: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/10.jpg)
Aciclovir’s mechanism of action is:
![Page 11: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/11.jpg)
Aciclovir’s mechanism of action is:
a) Prodrug nucleoside analogue that inhibits viral DNA polymerase after phosphorylation, resulting in chain termination.
b) Inhibition of viral protease used to cleave nascent proteins for assembly of new virions.
c) Binding to viral neuraminidase, rendering the influenza virus unable to escape its host cell and infect others.
d) interference with a viral M2 ion channel which is required for the viral particle to become "uncoated" once taken inside a cell by endocytosis.
![Page 12: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/12.jpg)
SPOT DIAGNOSIS! A 45 year old female from nimbin presents with loss of coordination
(with high stepping gait), urinary incontinance, impaired pupil reaction to light, lower limb areflexia and lower back pain that shoots down her legs sometimes. There has been no recent illness or infections, but she says that 5 years ago she did have a ‘sore’
down there.
![Page 13: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/13.jpg)
SPOT DIAGNOSIS! A 45 year old female from nimbin presents with loss of coordination (with high stepping gait), urinary incontinance, impaired pupil reaction to light, lower limb areflexia and lower back pain that shoots down
her legs sometimes. There has been no recent illness or infections, but she says that 5 years ago she did have a ‘sore’ down there.
a) Guillain Barre Syndromeb) Myasthenia gravis c) Tabes dorsalisd) HIV/ AIDS
![Page 14: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/14.jpg)
VZV reactivation involving the facial and auditory nerves is known as:
![Page 15: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/15.jpg)
VZV reactivation involving the facial and auditory nerves is known as:
a) Bell’s palsyb) Ramsay Hunt Syndromec) Trigeminal neuralgiad) Postherpetic neuralgia
![Page 16: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/16.jpg)
What is the most helpful ‘clinical triad’ for diagnosis of GBS?
![Page 17: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/17.jpg)
What is the most helpful ‘clinical triad’ for diagnosis of GBS?
a) Areflexia, lower back pain radiating to legs, fever
b) Ascending flaccid paralysis, areflexia, respiratory distress or autonomic dysfunction
c) Respiratory distress, positive Campylobacter jejuni serum Ig, areflexia
d) Cytoalbumin dissociation, areflexia, ascending flaccid paralysis
![Page 18: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/18.jpg)
SPOT DIAGNOSIS! A new patient, a 40 year old man presents with left sided
ptosis and diplopia. He also has dysphagia and his wife adds that he is slurring his speech (you just thought it
was normal for him). All other examinations are normal.
![Page 19: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/19.jpg)
SPOT DIAGNOSIS! A new patient, a 40 year old man presents with left sided ptosis and diplopia. He also has dysphagia and his wife adds that he is slurring
his speech (you just thought it was normal for him). All other examinations are normal.
a) Eaton-Lambert syndromeb) Multiple Sclerosisc) Stroked) Myasthenia gravis
![Page 20: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/20.jpg)
Why does thymectomy help some patients with myasthenia gravis?
![Page 21: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/21.jpg)
Why does thymectomy help some patients with myasthenia gravis?
Something about knocking out the activation of T-helper cells that activate B-cells to plasma cells which then throw out the Ig against the Ach receptor….?
![Page 22: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/22.jpg)
What drugs are used to treat Myasthenia gravis? Why?
![Page 23: Neuro Infections + sequalae](https://reader036.fdocuments.net/reader036/viewer/2022062314/56813e07550346895da7e786/html5/thumbnails/23.jpg)
What drugs are used to treat Myasthenia gravis? Why?
a) Atropineb) Penicillinc) Pyridostigmined) Oxybutinin