1.37 Meningitis Casse Flashcards
What are the initial symptoms of meningitis?
Malaise, myalgia, pyrexia, fluish, headache, nausea, photophobia and rash
What are the causes of a headache?
Primary - tension type due to high BP, and dehydration; Migraine
Secondary - non infectious - sub arachnoid heamorrhage
Non CNS - flu, colds etc.
What kind of headache is presented with meningitis?
All over, neck stiffness, increased with any movement
What types of meningitis are there?
Bacterial, Fingal, Viral and Opportunistic
What is Kerning’s sign?
Positive - an indication usually present in meningitis that consists of pain and resistance on attempting to extend the leg at the knee with the thigh flexed at the hip - stretches the meninges
what does a meningococcal septicaemia lead to?
immune respone to the liposaccharides of the bacteria release TNF-alpha and IL-1 toxic mediators released leaky capillaries low BP and neutrophil release which release NO
How does a meningococcal infection affect blood clotting?
release TNF-alpha and IL1 tissue factors, activates thrombin activates thrombodulin inactivates protein c increases clotting and reduce inhibition of clotting
What is the treatment for meningitis?
Antibiotics, circulatory support
Why is a CT necessary before lumbar puncture?
To prevent the possibility of a herniation in the brain
What are the contraindications of Lumbar Puncture?
no imaging: Seizures, GCS, Brainstem compression, ocular palsies and pupillary dilation, raised pressure,
imaging:low anticoagulation, purpuric rash, uncontrolled hypertension
What are the difference in CSF you can get?
Viral - turbid, high lymphocytes, nil polymorphs (granulocytes), low protein, low glucose
Pyogenic - turbid/purulent, high lymphocytes, high polymorphs, high protein, low glucose
TB - turbid/viscous, high lymphocytes, high polymorphs, high protein, extremely low glucose
