CNS Infections

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Author:
giddyupp
ID:
63936
Filename:
CNS Infections
Updated:
2011-02-04 11:47:00
Tags:
CNS Infections PHPR523 Test2
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CNS Infections
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  1. What are the most likely pathogens for meningitis in newborns?
    • E. coli
    • Klebsiella spp
    • S. agalactiae
    • Enterobacter spp
  2. What are the most likely pathogens for meningitis in 1mo - 29yo?
    • N. meningitidis
    • S. pneumoniae
    • H. influenzae
  3. What are the most likely pathogens for meningitis in 30-72yo?
    • S. pneumoniae
    • N. mengitidis
  4. What causes problems with drug concentrations in the CSF?
    • age dependent volume
    • constantly produced
    • constant flow
  5. What considerations should be applied to selection of antibiotic therapy for meningitis?
    • Low protein binding
    • lipid soluble
    • small molecular weight
    • unionized at physiologic pH
    • Absence or presence of meningeal inflammation
  6. Which antibiotics do not rely on inflammation of the meninges to treat meningitis?
    • Bactrim
    • Chloramphenicol
    • Isoniazid
    • Rifampin
    • Linezolid
  7. Which antibiotics rely on inflammation of the meninges to treat meningitis?
    • Ampicillin
    • Aztreonam
    • Cefotaxime
    • Ceftazidime
    • Cedftriaxone
    • Cefuroxime
    • Ciprofloxacin
    • Levofloxacin
    • Imipenem/Meropenem
    • Pen G
    • Piperacillin
    • Ticarcillin
    • Doxycycline
    • Vancomycin (and still not very good penetration)
    • TCNs
    • Tigecycline
  8. What is the empiric therapy for meningitis in neonates?
    Ampicillin + 3rd gen ceph + Vancomycin
  9. What is the empiric therapy for meningitis in 3mo - 50yo?
    3rd gen ceph +/- Vancomycin
  10. What is the empiric therapy for meningitis in >50yo?
    Ampicillin + 3rd gen ceph +/- Vancomycin
  11. What is the treatment for meningitis caused by S. pneumoniae?
    • Pen G (DOC)
    • Ceftriaxone (used more often than Pen G d/t convenience)
    • Cefuroxime
    • Chloramphenicol (almost never used)
    • Vancomycin
  12. What is the treatment for meningitis caused by Pen-resistant S. pneumoniae (PRSP)?
    Vancomycin + Rifampin, FQ, or Linezolid
  13. What is the treatment for meningitis caused by H. influenzae?
    • Ampicillin (DOC if B-Lactamase neg.)
    • Ceftriaxone (DOC if B-lactamase pos.)
    • Chloramphenicol
    • FQ
    • Bactrim
  14. What is the treatment for meningitis caused by N. meningitidis?
    • Pen G (DOC)
    • Ceftriaxone (used more than Pen G d/t convenience)
    • Chloramphenicol
    • FQ
  15. What is the treatment for meningitis caused by S. agalactiae?
    • Pen G (DOC)
    • Ceftriaxone
    • Chloramphenicol
    • Bactrim
  16. What is the treatment for meningitis caused by L. monocytogenes?
    • Ampicillin (DOC)
    • Bactrim
    • Linezolid
  17. What are the risks and benefits of using adjunctive corticosteroid therapy in meningitis?
    • significantly less hearing loss and other neurologic sequelae in some children receiving Dexamethasone
    • may decrease antibiotic penetration
  18. When should corticosteroid adjunctive therapy be given for meningitis?
    before or at the same time as the first dose of antibiotics (prevents increased inflammation d/t toxin release from cell lysis of first dose of ABX)
  19. What is the prophylaxis for S. pneumoniae meningitis?
    • Vaccination
    • NO chemoprophylaxis
  20. What is the prophylaxis for H. influenzae meningitis?
    • Chemoprophylaxis:
    • Rifampin
    • FQ + Ceftriaxone
    • Vaccination
  21. What is the prophylaxis for N. meningitidis meningitis?
    • Chemoprophylaxis:
    • Rifampin
    • FQ + Ceftriaxone
    • Vaccination
  22. What are the possible causes of aseptic meningitis?
    • viral meningitis/encephalitis
    • Mycobacterial meningitis
    • Fungal meningitis
    • Helminth diseases
    • Chemically induced (NSAIDs - Ibuprofen #1, various chemotherapeutics)
  23. What is the treatment for brain abscess?
    • surgery
    • Metronidazole
    • Chloramphenicol

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