correct answers
Route to CNS - correct answer ✔✔ -Blood to BBB to brain (most freq./penetration of BBB difficult)
-Direct (trauma, surgery) Most bacterial meningitis is nosocomial, not community-acquired.
- Via the nerves (rabies virus)
Anatomy - correct answer ✔✔ cranium - skull
Meninges
- 3 membranes that surround the brain
brain
-cerebrum
-cerebellum
-brain stem
Blood brain barrier at vascular endothelium
ventricles
spinal cord
Diseases - correct answer ✔✔ -Meningitis: infect. of the meninges
-Encephalitis: infect. of the brain parenchyma
-Brain abscess
-Myelitis: infect. of the spinal cord
Meningitis Clinical Presentation - correct answer ✔✔ -acute (bact. some viruses)
-subacute (slower org's)
-chronic (fungi, Mycobacterium)
Epidemiology
, - community-acquired vs. nosocomial
-sporadic vs. epidemic
Meningitis symptoms - correct answer ✔✔ - headache
- stiff neck
- neurologic dysfunction: lethargy, confusion
- vomiting
Diagnosis of bacterial meningitis - correct answer ✔✔ - cerebrospinal fluid analysis (by lumbar puncture)
- gram stain, presence of/elevated leuk's, predominant PMN, decreased glucose, elevated protein
Treatment for Meningitis - correct answer ✔✔ -prompt abx. treatment
- anti-inflammatory agents
-reduce intracranial pressure
Defenses of the CNS (meningitis) - correct answer ✔✔ -low complement in CSF
- microglia - phagocytes
Meningitis damage - correct answer ✔✔ - inflammation
- PMNS
- vasogenic edema (leakage of fluid out of capillaries into the brain)
- impaired blood flow
- ischemia (lack of oxygen and blood in parts of the body)
- cell death
Acute bacterial meningitis signs - correct answer ✔✔ - elevated leukocytes (>1,000) norm: 0-6
predominant/increase in PMN (neutrophils >50) norm: 0
- decreased glucose (<40mg/dL) norm: 40 - 80
- elevated protein (>100) norm: 20 - 50