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INSTRUCTIONS

INSTRUCTIONS

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INSTRUCTIONS

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  1. INSTRUCTIONS READ EACH QUESTION GIVE IT YOUR BEST SHOT GO TO THE NEXT SLIDE OR SLIDES FOR CLUES THEN, GO ON TO THE NEXT SLIDE FOR THE CORRECT ANSWER GOOD LUCK! Israel Alfonso, MD

  2. 1. WHAT PERCENT OF BRAIN ABSCESSES ARE MULTIPLE? • A. 30% • B. 50% • C. 75% • D. 100%

  3. RIGHT! SHOW ME THE QUESTION AGAIN I WANT TO SEE A CLUE, ANYWAY GO TO THE NEXT QUESTION

  4. WRONG! I WANT TO TRY AGAIN GIVE ME A CLUE JUST GIVE ME THE ANSWER

  5. BRAIN ABSCESS MULTIPLE SINGLE

  6. 1. WHAT PERCENT OF BRAIN ABSCESSES ARE MULTIPLE? • A. 30% • B. 50% • C. 75% • D. 100%

  7. 2. FRONTAL ABSCESS IS USUALLY DUE TO: • A. MASTOIDITIS • B. HEAD TRAUMA • C. ORBITAL SINUSITIS • D. PENETRATING HEAD INJURY

  8. RIGHT! SHOW ME THE QUESTION AGAIN I WANT TO SEE A CLUE, ANYWAY GO TO THE NEXT QUESTION

  9. WRONG! I WANT TO TRY AGAIN GIVE ME A CLUE JUST GIVE ME THE ANSWER

  10. LOCATION OF BRAIN ABSCESS FRONTAL SINUSITIS

  11. FRONTAL BRAIN ABSCESS ABSCESS (CEREBRITIS) SINUSITIS

  12. 2. FRONTAL ABSCESS IS USUALLY DUE TO: • A. MASTOIDITIS • B. HEAD TRAUMA • C. ORBITAL SINUSITIS • D. PENETRATING HEAD INJURY

  13. 3. THE FOLLOWING CONDITIONS ARE PREDISPOSING FACTORS FOR BRAIN ABSCESS: • A. DENTAL INFECTIONS • B. VENTRICULOPERITONEAL SHUNTS • C. SCALP INFECTIONS • D. ALL OF THE ABOVE

  14. RIGHT! SHOW ME THE QUESTION AGAIN I WANT TO SEE A CLUE, ANYWAY GO TO THE NEXT QUESTION

  15. WRONG! I WANT TO TRY AGAIN GIVE ME A CLUE JUST GIVE ME THE ANSWER

  16. PREDISPOSING FACTORS FOR BRAIN ABSCESS ANY FOCAL INFECTIONS AROUND THE CRANIUM RIGHT-TO-LEFT CARDIAC SHUNTS VENTRICULOPERITONEAL SHUNTS IMMUNODEFICIENT STATES

  17. 3. THE FOLLOWING CONDITIONS ARE PREDISPOSING FACTORS FOR BRAIN ABSCESS: • A. DENTAL INFECTIONS • B. VENTRICULOPERITONEAL SHUNTS • C. SCALP INFECTIONS • D. ALL OF THE ABOVE

  18. 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

  19. RIGHT! SHOW ME THE QUESTION AGAIN I WANT TO SEE A CLUE, ANYWAY GO TO THE NEXT QUESTION

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  21. CHILDREN YOUNGER THAN 2 YEARS CHILDREN OLDER THAN 2 YEARS MIDDLE CEREBRAL ARTERY THROMBOSIS BRAIN ABSCESS

  22. 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

  23. 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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  26. EARLY SIGNS OF BRAIN ABSCESS LOW-GRADE FEVER HEADACHE LETHARGY

  27. 5. ALL OF THE FOLLOWING ARE EARLY SIGNS OF BRAIN ABSCESS IN CHILDREN , EXCEPT: • A. LOW-GRADE FEVER • B. VOMITING • C. LETHARGY • D. HEADACHE

  28. 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

  29. RIGHT! SHOW ME THE QUESTION AGAIN I WANT TO SEE A CLUE, ANYWAY GO TO THE NEXT QUESTION

  30. WRONG! I WANT TO TRY AGAIN GIVE ME A CLUE JUST GIVE ME THE ANSWER

  31. BRAIN ABSCESS DO NOT TRUST NEGATIVE BLOOD OR CSF CULTURES DO NOT TAP

  32. 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

  33. 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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  36. IF CAUSE IS UNKNOWN THIRD GENERATION CEPHALOSPORIN METRONIDAZOLE

  37. IF CYANOTIC HEART DISEASE PENICILLIN METRONIDAZOLE

  38. IF VENTRICULOPERITOENAL SHUNT THIRD GENERATION CEPHALOSPORIN VANCOMYCIN

  39. IF HEAD TRAUMA OR NEUROSURGICAL PROCEDURE THIRD GENERATION CEPHALOSPORIN METRONIDAZOLE VANCOMYCIN OR NAFCILLIN

  40. IF IMMUNOCOMPROMISE THIRD GENERATION CEPHALOSPORIN METRONIDAZOLE VANCOMYCIN OR NAFCILLIN AMPHOTERICIN

  41. WHEN TREATING CONFIRMED OR SUSPECTED ABSCESS IN THE BRAIN WITH ANTIBIOTICS: MORE IS BETTER THAN LESS, LONGER IS BETTER THAN SHORTER

  42. 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

  43. 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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  46. SURGICAL INDICATIONS ARE: GAS IN THE ABSCESS MULTILOCULATED ABSCESS FUNGAL ABSCESS POSTERIOR FOSSA LOCATION NELSON’S 16th EDITION

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

  48. 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

  49. 9. LONG-TERM SEQUELAE, INCLUDING SEIZURES AND LEARNING DISABILITY OCCUR IN AT LEAST ____ OF CASES. • A. 25% • B. 50% • C. 70% • D. 90%

  50. RIGHT! SHOW ME THE QUESTION AGAIN I WANT TO SEE A CLUE, ANYWAY