Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

paediatrics > 1: Infections - Meningitis > Flashcards

1: Infections - Meningitis Flashcards

1
Q

What is the main cause of meningitis in children

A

Viral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What proportion of meningitis in children is viral

A

2/3 cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most-common cause of bacterial meningitis in children 0-3 months

A

Group B Streptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are 3 organisms that cause meningitis in children 0-3 months

A
  1. Group B Streptococcus
  2. S. Pneumonia
  3. N. Meningitides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is most common cause of meningitis in children 3-6 years

A

N. Meningitides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 3 organisms that cause meningitis in children 3-6 years

A
  1. N. Meningitides
  2. S. Pneumonia
  3. H.Influenza
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the main cause of bacterial meningitis in 6-60 year-olds

A

N. Meningitides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are two causes of bacterial meningitis in 6-60 year-olds

A

N. Meningitides

S. Pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is Listeria Monocytogenes are more common cause of meningitis

A
  • 0-3 months
  • > 60 years
  • Immunocompromised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can cause meningitis in immunocompromised patients

A

Cryptococcus Neoformans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 5 risk factors for Meningitis

A
  • Sinusitis
  • Otitis media
  • Immunocompromised
  • Maternal Group B Infection
  • Crowded Living Conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain order of septic signs to meningitis signs

A

Septic signs typically precede meningitis signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the septic signs of meningococcal septicaemia

A
  • Fever
  • Abnormal skin colour
  • Rash
  • Shock: tachycardia, low RR, low BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When does a non-blanching petechial rash occur

A

If caused by N. meningitides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 5 meningeal signs of meningitis

A
  • Photophobia
  • Neck stiffness
  • Kernig’s
  • Brundinzki’s sign
  • Opisthotonus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is neck stiffness absent

A

Under 18-months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Kernig’s sign

A

Resistance to knee extension, when hips are flexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Brudzinski’s sign

A

When neck is bent, hips will flex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is opisthotonus

A

Spasm muscles - causing backward arching of head, neck and spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is problem with meningitis in children

A

Often quite non-specific symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When should meningitis be suspected in infants

A

Any unwell infant with fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are 5 early symptoms of meningitis in infants

A 
Lethargy 
Vomiting 
Irritable 
Poor appetite 
Dyspneoa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are 3 late-symptoms of meningitis in infants

A

Bulging fontanelle
Seizures
High-pitch cry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are symptoms of meningitis in young children

A

Fever
Poor Feeding
Lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How do older children with meningitis present

A

Triad:

  • Headache
  • Neck Stiffness
  • Photophobia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

If in the community and suspect meningitis, what should be given

A

IM (of IV) Benzylpenicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If in hospital, what 4 investigations are ordered for neonates (under 1 -month) with meningitis

A
  1. FBC
  2. CRP
  3. Blood Culture
  4. LP - send for culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is given to manage neonates under 1-month

A

Cefotaxime and Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why is amoxicillin given

A

To cover for listeria - which is more common in younger patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When is vancomycin added

A

If known MRSA

If from an area of known pneumococcal cephalosporin resistance

31
Q

In an infant or child over 1-month with suspected meningitis, what 4 investigations are ordered

A
  • FBC
  • CRP
  • LP
  • Blood Culture
32
Q

What is first-line management for meningitis in children over 1-month

A

Ceftiraxone and IV Vancomycin

33
Q

When is IV Vancomycin indicated

A

MRSA positive patients or from an area with known pneumococcal-cephalosporin resistance

34
Q

What 3 medications are given for meningitis in children over 1-months

A

Ceftriaxone
Amoxicillin
Dexamethasone

35
Q

What are the indications for dexamethasone

A

Child over 3-months with:

  • Cloudy CSF
  • Gram stain positive
  • WCC >100
  • Protein >1
36
Q

What age must a child be for dexamethasone to be given

A

> 3-months

37
Q

List 6 contraindications for LP

A
  1. Raised ICP
    - Low HR, Raised BP
    - Papilloedema
    - Significant bulge in fontanelle
  2. Meningococcal septicaemia (Petechial rash)
  3. DIC
  4. Focal Neurological Signs
  5. Shock
  6. Infection at LP Site
38
Q

How can DIC and meningococcal septicaemia be excluded

A

Absence petechial rash

39
Q

What are the features of bacterial infection on LP

A
  1. Cloudy Fluid
  2. Low Glucose (Less than half of plasma)
  3. High Protein
  4. Polymorphs
40
Q

What are the features of viral infections on LP

A
  1. Clear Fluid
  2. Normal Glucose
  3. Normal Protein
  4. High Lymphocytes
41
Q

What are features of TB on LP

A
  1. Fibrin Web
  2. Low Glucose
  3. High Protein
  4. High Lymphocytes
42
Q

What is used to test for TB in CSF and why

A
  • PCR is preferred as Ziehl Neelsen Stain is only 20% accurate
43
Q

Is meningitis a notifiable disease

A

Yes

44
Q

What should all household contacts of someone with meningitis be given

A

Ciprofloxacin for all household contacts

45
Q

What should be offered 4W following meningitis in children and why

A

Audiology assessment - as SNHL is the greatest complication of meningitis

46
Q

If SNHL what is offered

A

Cochlear Implant

47
Q

What endocrinological complication can occur post-meningitis

A

Waterhourse - Freiderichson

48
Q

What is waterhourse - friederichson syndrome

A

Coagulopathy triggered by meningitis results in ischaemic necrosis of adrenal glands

49
Q

What are 3 neurological complications of meningitis

A

Seizures
SNHL
Paralysis

50
Q

What are 2 infective complications of meningitis

A

Sepsis

Brain abscess

51
Q

What can meningitis lead to

A

Raised ICP - brain herniation

52
Q

What do NICE state on using CT to check for raised ICP before lumbar puncture

A

Do not use CT to check for raised ICP prior to LP. ICP is a clinical diagnosis

53
Q

When may a CT performed in children

A
  • Fluctuating consciousness: GCS less than 9 or change of more than 3
54
Q

What is bacteraemia

A

Bacteria in the blood

55
Q

What is septicaemia and what does it lead to

A

Bacteria proliferating in the blood that release toxins which bind and causes vasodilation resulting in shock

56
Q

What is meningococcal septicaemia

A

Proliferation meningococcal bacteria in the blood stream, without meningitis

57
Q

What causes meningococcal septicaemia

A

N. meningitides

58
Q

Describe clinical presentation of meningococcal septicaemia

A

Non-Specific:

  • Malaise
  • Fever
  • Signs shock: poor urine output

Haematological:
- DIC

CNS:
- Meningitis (20-30%)

59
Q

When should someone be suspected of having meningococcal septicaemia

A

Unwell child with petechial or purpuric rash

60
Q

What is glass test used for

A

Determine if rash is non-blanching

61
Q

How is suspected meningococcal septicaemia managed

A

Community: IM benzylpenicillin

Hospital: IV Ceftriaxone

If in shock - manage with fluid resuscitation

62
Q

If individual with meningococcal septicaemia is in shock what may be required

A

Inotropes

63
Q

Name two inotropes

A

Dopamine

Dobutamine

64
Q

What is given as prophylaxis for contacts of patients with meningococcal septicaemia

A

Ceftriaxone

65
Q

How does meningococcal septicaemia lead to DIC

A

Proliferation of bacteria in the blood stream causes release of endotoxins - these trigger systemic DIC

66
Q

What is DIC

A

Systemic activation of coagulation cascade leading to formation or micro thrombi. Micro thrombi formation results in use of clotting factors causing bleeding

67
Q

What are 3 causes of DIC

A

Sepsis
Trauma
Malignancy

68
Q

How can presentation of DIC be divided

A

Clotting Symptoms

Bleeding Symptoms

69
Q

What are bleeding manifestations of DIC

A
  • Ecchymosis
  • Petechiae
  • Purpura
  • Haematuria
  • Haemtemesis
70
Q

What are clotting symptoms of DIC

A 
Oliguria: kidneys 
Jaundice: liver 
ARDS: lungs 
Pupura fulminans: skin 
Waterhouse-Friederichson
71
Q

What is purpura fulminans

A

DIC with skin necrosis

72
Q

How will DIC present on coagulation studies

A

Prolonged APTT, PT and Bleeding time

73
Q

How do d-dimers present in DIC

A

Raised

paediatrics (61 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions