1. 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

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

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5. BRAIN ABSCESS SINGLE MULTIPLE

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

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10. FRONTAL SINUSITIS LOCATION OF BRAIN ABSCESS

11. FRONTAL BRAIN ABSCESS SINUSITIS ABSCESS (CEREBRITIS)

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

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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

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21. CHILDREN YOUNGER THAN 2 YEARS MIDDLE CEREBRAL ARTERY THROMBOSIS CHILDREN OLDER THAN 2 YEARS 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. LOW-GRADE FEVER HEADACHE LETHARGY EARLY SIGNS OF BRAIN ABSCESS

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

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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. THIRD GENERATION CEPHALOSPORIN METRONIDAZOLE

37. PENICILLIN METRONIDAZOLE

38. THIRD GENERATION CEPHALOSPORIN VANCOMYCIN

39. THIRD GENERATION CEPHALOSPORIN METRONIDAZOLE VANCOMYCIN OR NAFCILLIN

40. 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 16 th 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%

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52. MORTALITY IS 5% TO 10%

53. SEQUELAE OCCUR IN AT LEAST 50% OF CASES

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

55. THE END I HOPE YOU LEARNED SOMETHING! Israel Alfonso, MD