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20 Cards in this Set
- Front
- Back
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What do you do to treat suspected bacterial meningitis (two things)?
Which drugs for pen-resistant pneumococcus? Which for Listeria? Which for herpes virus? Which for rickettsia, RMSF? |
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Drug user, petechial hemorrhages, meningitis-like symptoms? What's the diagnosis? |
Bacterial endocarditis (infectious vegetations on the heart valves) |
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Infection of the heart valves usually occurs with what class of bacteria (gram + or gram -)? what is the presentation?
What three thing can septic emboli to the brain cause? |
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What can a septic embolism to a distal cerebral artery cause?
What bacteria is responsible for 50% of bacterial endocarditis? What are two other common agents? |
Focal inflammatory erosion of the vessel wall => mycotic aneurysm
Streptococcus viridans Staphylococcus aureus and enterococcus |
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What should you always due prior to an LP if you suspect intracranial pressure?
Why does lying on your back cause worsening headache? |
Get a CT!
Lost effect of gravity => back pressure => increase in blood volume of venous system => rise in ICP
TUMOR HEADACHE similar => improves with upright posture in the morning |
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What four signs do septic emboli cause? How do you treat subacute bacterial endocarditis?
What would a urinalysis show in someone with splinter hemorrhages?
Which are painful nodes or pustules on the pad of the fingers and toes and which are painless red macular areas on the palms of the hand and soles of the feet (Osler and Janeway)? |
Blood
Osler's nodes are painful “nodes” or pustules on the pads of the fingers and the toes. In contrast, Janeway lesions are painless red macular areas on the palms of the hand and soles of the feet. |
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What do all of these help in the clinical diagnosis of?
Why is vision affected by a pressure wave? |
Cerebral abscess
Posterior circulation is lower pressure system compared to anterior circulation => more susceptive to CSF pressure effects. |
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How do you treat brain abscesses? Which antibiotics cover most of the pathogens (and anaerobes)? What bacteria do they not affect? |
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The leg weakness, umbilical sensory level, urinary incontinence, reduced rectal tone and bilateral extensor plantar responses suggest a spinal cord lesion at T10. The mild fever suggests a subacute infectious process. The periodontal surgery could certainly have provided a bacteremia. |
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How will white count, EST, and "pain" be affected or present in patient with epidural mass lesion?
How does tumor affect bone and the nucleus pulposus? What does infection affect and spare? |
Point tenderness Elevated white count Elevated ESR (non-specific)
Tumor destroys the bone but spares the intervertebral disc (nucleus pulposus) while infection often involves the disc (discitis) and relatively spares the surrounding bone, albeit not completely. |
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What could all these signs and symptoms be used to make a CLINICAL diagnosis of? |
Spinal epidural abscess |
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What will be absent (what sensation) below the level of involvement in spinal epidural abscess?
How will sed rate be affected? How will WBC count be affected? What two imaging techniques can you use? Cultures? |
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If a spinal epidural abscess if compressing the cauda equina, what additional signs might you see? |
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What are these all risk factors for? |
Spinal epidural abscesses |
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What are the three treatment options for spinal epidural abscesses? |
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Diagnosis? Also has petechial rash. |
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What disease?
CSF is benign or will show a modest increased in cells and protein
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RMSF |
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Where is the lesion located? |
It appears to be multifocal and multi-systemic affecting the nervous system, the large joints and the skin. The nervous system is affected at the cranial nerve level and in one of the cognitive domains. The blood-brain barrier may be disrupted to allow protein to seep into the CSF from the vasculature. It is the skin lesion that is classic and most helpful in the diagnosis |
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What is the diagnosis? How would you treat it? |
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What is lyme disease caused by? How long does it have to stay in the host? When will the skin rash appear? What will the patient experience a few weeks after the bite?
What type of facial nerve paralysis? |
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