INSTRUCTIONS

READ EACH QUESTION

GIVE IT YOUR BEST SHOT

THEN, GO ON TO THE NEXT SLIDE FOR THE CORRECT ANSWER

GO TO THE NEXT SLIDE OR SLIDES FOR CLUES

GOOD LUCK!

Israel Alfonso, MD

1. WHAT PERCENT OF BRAIN ABSCESSES ARE MULTIPLE?

A. 30%

B. 50%

C. 75%

D. 100%

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BRAIN ABSCESS

SINGLE

MULTIPLE

1. WHAT PERCENT OF BRAIN ABSCESSES ARE MULTIPLE?

A. 30%

B. 50%

C. 75%

D. 100%

2. FRONTAL ABSCESS IS USUALLY DUE TO:

A. MASTOIDITIS

B. HEAD TRAUMA

C. ORBITAL SINUSITIS

D. PENETRATING HEAD INJURY

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FRONTAL SINUSITIS

LOCATION OF BRAIN ABSCESS

FRONTAL BRAIN ABSCESS

SINUSITIS

ABSCESS (CEREBRITIS)

2. FRONTAL ABSCESS IS USUALLY DUE TO:

A. MASTOIDITIS

B. HEAD TRAUMA

C. ORBITAL SINUSITIS

D. PENETRATING HEAD INJURY

3. THE FOLLOWING CONDITIONS ARE PREDISPOSING FACTORS FOR BRAIN ABSCESS:

A. DENTAL INFECTIONS

B. VENTRICULOPERITONEAL SHUNTS

C. SCALP INFECTIONS

D. ALL OF THE ABOVE

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PREDISPOSING FACTORS FOR BRAIN ABSCESS

ANY FOCAL INFECTIONS AROUND THE CRANIUM

RIGHT-TO-LEFT CARDIAC SHUNTS

VENTRICULOPERITONEAL SHUNTS

IMMUNODEFICIENT STATES

3. THE FOLLOWING CONDITIONS ARE PREDISPOSING FACTORS FOR BRAIN ABSCESS:

A. DENTAL INFECTIONS

B. VENTRICULOPERITONEAL SHUNTS

C. SCALP INFECTIONS

D. ALL OF THE ABOVE

4. HEMIPARESIS IN A CHILD OLDER THAN 4 YEARS OF AGE WITH CYANOTIC CONGENITAL HEART DISEASE IS USUALLY ASSOCIATED WITH:

A. INTERNAL CAROTID THROMBOSIS

B. MIDDLE CEREBRAL ARTERY THROMBOSIS

C. BRAIN ABSCESS

D. RENAL STROKE

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CHILDREN YOUNGER THAN 2 YEARS

MIDDLE CEREBRAL ARTERY THROMBOSIS

CHILDREN OLDER THAN 2 YEARS

BRAIN ABSCESS

4. HEMIPARESIS IN A CHILD OLDER THAN 4 YEARS OF AGE WITH CYANOTIC CONGENITAL HEART DISEASE IS USUALLY ASSOCIATED WITH:

A. INTERNAL CAROTID THROMBOSIS

B. MIDDLE CEREBRAL ARTERY THROMBOSIS

C. BRAIN ABSCESS

D. RENAL STROKE

5. ALL OF THE FOLLOWING ARE EARLY SIGNS OF BRAIN ABSCESS IN CHILDREN, EXCEPT:

A. LOW-GRADE FEVER

B. VOMITING

C. LETHARGY

D. HEADACHE

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LOW-GRADE FEVER

HEADACHE

LETHARGY

EARLY SIGNS OF BRAIN ABSCESS

5. ALL OF THE FOLLOWING ARE EARLY SIGNS OF BRAIN ABSCESS IN CHILDREN , EXCEPT:

A. LOW-GRADE FEVER

B. VOMITING

C. LETHARGY

D. HEADACHE

6. WHICH OF THE FOLLOWING IS TRUE REGARDING BRAIN ABSCESS?

A. BLOOD CULTURES ARE OFTEN POSITIVE

B. CSF CULTURES ARE USUALLY POSITIVE

C. IF YOU SUSPECT BRAIN ABSCESS, TAP

D. MRI IS MOST SENSITIVE

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BRAIN ABSCESS

DO NOT TRUST NEGATIVE BLOOD OR CSF CULTURES

DO NOT TAP

6. WHICH OF THE FOLLOWING IS TRUE REGARDING BRAIN ABSCESS?

A. BLOOD CULTURES ARE OFTEN POSITIVE

B. CSF CULTURES ARE USUALLY POSITIVE

C. IF YOU SUSPECT BRAIN ABSCESS TAP

D. MRI IS MOST SENSITIVE

7. IN A CHILD WITH AN ABSCESS AND A HISTORY OF HEAD TRAUMA OR NEUROSURGICAL PROCEDURE, USE:

A. VANCOMYCIN

B. THIRD GENERATION CEPHALOSPORIN

C. METRONIDAZOLE

D. ALL OF THE ABOVE

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THIRD GENERATION CEPHALOSPORIN

METRONIDAZOLE

PENICILLIN

METRONIDAZOLE

THIRD GENERATION CEPHALOSPORIN

VANCOMYCIN

THIRD GENERATION CEPHALOSPORIN

METRONIDAZOLE

VANCOMYCIN OR NAFCILLIN

THIRD GENERATION CEPHALOSPORIN

METRONIDAZOLE

VANCOMYCIN OR NAFCILLIN

AMPHOTERICIN

WHEN TREATING CONFIRMED OR SUSPECTED ABSCESS IN THE BRAIN WITH ANTIBIOTICS: MORE IS BETTER

THAN LESS, LONGER IS BETTER THAN SHORTER

7. IN A CHILD WITH AN ABSCESS AND A HISTORY OF HEAD TRAUMA OR NEUROSURGICAL PROCEDURE, USE:

A. VANCOMYCIN

B. THIRD GENERATION CEPHALOSPORIN

C. METRONIDAZOLE

D. ALL OF THE ABOVE

8. THE FOLLOWING ARE INDICATIONS FOR SURGERY IN PATIENTS WITH INTRACRANIAL ABSCESS, EXCEPT:

A. GAS IN THE ABSCESS

B. MULTILOCULATED ABSCESS

C. POSTERIOR FOSSA LOCATION

D. MASTOIDITIS

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SURGICAL INDICATIONS ARE:

GAS IN THE ABSCESS

MULTILOCULATED ABSCESS

FUNGAL ABSCESS

POSTERIOR FOSSA LOCATION

NELSON’S 16th EDITION

PATIENTS WITH MASTOIDITIS, SINUSITIS OR PERIORBITAL ABSCESS MAY NEED SURGERY FOR THE PRIMARY CONDITION, BUT DO NOT AUTOMATICALLY NEED SURGERY FOR THE ABSCESS

8. THE FOLLOWING ARE INDICATIONS FOR SURGERY IN PATIENTS WITH INTRACRANIAL ABSCESS, EXCEPT:

A. GAS IN THE ABSCESS

B. MULTILOCULATED ABSCESS

C. POSTERIOR FOSSA LOCATION

D. MASTOIDITIS

9. LONG-TERM SEQUELAE, INCLUDING SEIZURES AND LEARNING DISABILITY OCCUR IN AT LEAST ____ OF CASES.

A. 25%

B. 50%

C. 70%

D. 90%

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MORTALITY IS 5% TO 10%MORTALITY IS 5% TO 10%

SEQUELAE OCCUR IN AT LEAST 50% OF

CASES

SEQUELAE OCCUR IN AT LEAST 50% OF

CASES

9. LONG-TERM SEQUELAE, INCLUDING SEIZURES AND LEARNING DISABILITY OCCUR IN AT LEAST ____ OF CASES.

A. 25%

B. 50%

C. 70%

D. 90%

THE END

I HOPE YOU LEARNED SOMETHING!

Israel Alfonso, MD