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Neurology > 1(E): Meningitis > Flashcards

1(E): Meningitis Flashcards

1
Q

What is meningitis

A

Inflammation meninges

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2
Q

When is meningitis incidence at it’s highest

A

Infants and children

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3
Q

Why is epidemiology of meningitis reduced

A

Introduction haemophillus Influenza and Men B into immunisation schedule

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4
Q

During first three-months of life, what causes meningitis

A

Group B Strep
E.Coli
Listeria

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5
Q

During three-six months, what is most common organisms

A
  • N Meningitides
  • S Pneumonia
  • H Influenza
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6
Q

During 6 months - 60 years what can cause meningitis

A

N Meningitides

S Pneumonia

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7
Q

Over 60-years what are common causes of meningitis

A

S Pneumonia
N Meningitides
Listeria

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8
Q

If diabetic, what is a common cause of meningitis

A

S. Pneumonia

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9
Q

If penetrating skull injury, what can cause meningitis

A

S. Aureus

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10
Q

What can cause meningitis in hyposplenism (eg. sickle cell)

A

S. Pneumonia

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11
Q

If immunosuppressed what may cause meningitis

A

Cryptococcus

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12
Q

What are four RF for meningitis

A
  • Maternal group B strep
  • Sinusitis
  • OM
  • Immunocompromised
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13
Q

In a child or adult, what are common initial symptoms of meningitis

A
  • Cold peripheries
  • Myalgia
  • Fever
  • Headache
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14
Q

What are late features of meningitis

A

Meningism:

  • Headache
  • Photophobia
  • Nausea, Vomiting
  • Kernig
  • Brudzinski’s sign
  • Drop in GCS
  • Non-blanching petechial rash
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15
Q

What is not present in meningitis in neonates

A

Meningism

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16
Q

What are features of meningitis in neonates

A
  • Lethargy, Hypotonia
  • High-Pitch crying
  • Vomiting
  • Poor Feeding
  • Bulging fontanelle
  • Seizures
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17
Q

In primary care, if someone has non-blanching rash what should they be given

A

IM Benzylpenicillin

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18
Q

How should a patient in meningitis be approached

A

A-E

  • Resuscitation
  • IV access
  • Glucose if required
19
Q

If meningococcal septicaemia how should the patient be managed

A

Initiate sepsis 6

Blood culture 
Urine output 
Fluid 
Antibiotics 
Lactate, FBC, ABG 
Oxygen
20
Q

If meningitis without shock, what should be done

A

Blood cultures

Assess ICP

21
Q

If signs of raised ICP, what should be done

A

Contact ITU

  • Nurse at 30’
  • Antibiotics
  • Dexamethasone
22
Q

If patient does not have raised ICP what should be done

A

Contact senior

  • LP in 1h
  • Antibiotics
  • Dexamethasone
23
Q

What is a way to remember CI of LP

A

PIICCS

24
Q

What are CI of LP

A 
Purpura 
Infection at LP site 
ICP raised 
Coagulation: platelets <100 
Convulsions 
Shock
25
Q

What are symptoms of raised ICP

A
  • Reduce GCS (by 3, or less than 9)
  • Bulging Fontanelle
  • Focal Neurological Sign
  • Bradycardia
26
Q

What platelet count should individuals not have LP

A

<100

27
Q

If patient has meningococcal septicaemia what is ordered

A

do NOT perform LP

- Order PCR and BC

28
Q

Explain the following in bacterial LP

a. Appearance
b. Glucose
c. Protein
d. WCC

A

a. Cloudy
b. Low
c. High
d. High polymorph count

29
Q

Explain the following in TB LP

a. Appearance
b. Glucose
c. Protein
d. WCC

A

a. Fibrin web
b. Low
c. High
d. High lymphocytes

30
Q

Explain following in viral LP

a. Appearance
b. Glucose
c. Protein
d. WCC

A

a. Clear
b. Normal (More than half of serum)
c. Normal
d. High lymphocytes

31
Q

What is used to test CSF for TB and why

A

PCR , as ziehl-neelsen is only positive in 20%

32
Q

What antibiotics are given for meningitis

A

IV Ceftriaxone

33
Q

If suspecting viral meningitis, what is given

A

Acyclovir

34
Q

When is amoxicillin given and why

A

Infants, Immunocompromised, Elderly

35
Q

When is dexamethasone NOT given

A

To infants under 3-months

36
Q

What should all household contacts of those with meningitis be given

A

Ciprofloxacin, Meningococcal Vaccine

37
Q

What is used to prevent meningitis

A

Men B: 3,4 and 12 months

Pneumococcal vaccine given to those with asplenism

38
Q

What is most common complication of meningitis

A

SNHL

39
Q

What are 3 neurological complications of meningitis

A

SNHL
Epilepsy
Cognitive Impairment
Hemiparesis

40
Q

What are 2 infective complications of meningitis

A

Sepsis

Cerebral abscess

41
Q

What are pressure consequences of meningitis

A

Herniation

42
Q

What is a metabolic complication of meningitis

A

Waterhouse Freiderichson Syndrome

43
Q

When is waterhouse-freiderichson syndrome more common

A

Children

Asplenism

44
Q

What is water friederichson syndrome

A

Haemorrhagic necrosis of the adrenal glands due to endotoxin release. Presents with non-blanching rash petechial rash and myalgia

Neurology (26 decks)

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