Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

DTMH Block 3 > Bacterial Meningitis > Flashcards

Bacterial Meningitis Flashcards

1
Q

In SA which populations have the highest rate of bacterial meningitis?

A

<1yo
Follow by 1-4yo

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

Which causes of bacterial meningitis are vaccine-preventable?

A

S. pneumo
Haeif B
Neime
Strag

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

Which organisms have the highest risk for morbidity?

A

STRPN -> HAEIF -> NEIME

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

What are the risk factors for bacterial meningitis?

A
  1. Immunodeficiencies
    - hereditary
    - asplenia
    - malignancies
    - HIV
    - medications
    - CKD, DM, alcoholism, liver disease
  2. Anatomical defects
    - cranium
    - sinuses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the definition of meningitis?

A

Meningeal inflammation with abnormal WBCs in CSF (>5 WBC OR any lymphocytes)

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

How is bacterial meningitis transmitted?

A

Droplet spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Discuss the routes of meningitis

A
  1. Haematogenous (BBB, BCB)
  2. Direct invasion
  3. Neural centripetally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Discuss the pathogenesis of bacterial meningitis

A
  1. Nasopharyngeal colonisation -> invasion -> bacteremia
  2. Meningeal invasion -> replication in subarachnoid space -> release of bacterial components (LPS, cell wall)
  3. Damage to microvascular endothelium -> increased BBB permeability -> vasogenic edema
  4. Cerebral vasculitis
  5. Subarachnoid space inflammation -> CSF outflow resistance -> incensed ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the bacterial and host factors regarding mucosal colonisation that attribute to bacterial meningitis pathogenesis?

A

Bacterial
- fimbriae
- IgA protease
Host
- mucosal colonisation
- secretory IgA
- cilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the bacterial and host factors regarding intravascular survival that attribute to bacterial meningitis pathogenesis?

A

Bacteria
- polysaccharide capsule (antiphagocytic)
Host
- complement activation
- specific antibodies

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

What are the bacterial and host factors regarding meningeal invasion that attribute to bacterial meningitis pathogenesis?

A

Bacteria
- fimbriae
- lipoteichoic acid
Host
- BBB
- BCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the bacterial and host factors regarding survival in subarachnoid space that attribute to bacterial meningitis pathogenesis?

A

Bacteria
- polysaccharide capsule
Host
- poor opsonic activity

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

What are the clinical features of acute bacterial meningitis in adults?

A

Fever
Headache
Neck stiffness
Altered GCS
Vomiting
Photophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the clinical features of acute bacterial meningitis in infants?

A

Irritability
Poor feeding
Bulging fontanelles
Hypothermia

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

What is aseptic meningitis?

A

Lymphocytic pleocytosis without an apparent cause on CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some causes of aseptic meningitis

A

Drugs
Autoimmune
Vaccines
Malignancies

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

What is the hallmark of acute encephalitis?

A

Diffuse involvement of cerebral cortex

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

What are the common bacterial meningitis pathogens in neonates?

A

S. agalctiae
E. coli
L. monocytogenes

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

What are the common bacterial meningitis pathogens in 1-23m?

A

S. agalactiae
E. coli
H. influenzae
S. pneumo
N. meningitidis

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

What are the common bacterial meningitis pathogens in 2-50y?

A

S. pneumo
N. meningitidis

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

What are the common bacterial meningitis pathogens in >50y?

A

S. pneumo
N. meningitidis
H. influenza (some)
L. monocytogenes
Aerobic GNBs

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

What are the common bacterial meningitis pathogens in immunocompromised patients?

A

S. pneumo
N. meningitidis
L. monocytogenes
Aerobic GNBs (including pseudo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the common bacterial meningitis pathogens in basilar skull fractures?

A

S. pneumo
H. influenza
S. pyogenes

Exposure to the nasopharynx

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

What are the common bacterial meningitis pathogens in head trauma?

A

S. aureus
CNS
Aerobic GNBs (pseudo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Which vaccines are given at birth according to the SA EPI schedule?
BCG OPV - 0
26
Which vaccines are given at birth according to the SA EPI schedule?
27
Which vaccines are given at 6w according to the SA EPI schedule?
Rotavirus - 1 PCV - 1 Hexavalent - 1
28
Which vaccines are given at 10w according to the SA EPI schedule?
Hexavalent - 2
29
Which vaccines are given at 14w according to the SA EPI schedule?
Rotavirus - 2 PCV - 2 Hexavalent - 3
30
Which vaccines are given at 6m according to the SA EPI schedule?
MMR - 1
31
Which vaccines are given at 9m according to the SA EPI schedule?
PCV - 3
32
Which vaccines are given at 12m according to the SA EPI schedule?
MMR - 2
33
Which vaccines are given at 18m according to the SA EPI schedule?
Hexavalent - 4
34
Which vaccines are given at 6y according to the SA EPI schedule?
TdaP - 1
35
Which vaccines are given at grade 5 according to the SA EPI schedule?
TdaP (campaign only)
36
Which vaccines are given at 9y according to the SA EPI schedule?
HPV (campaign only)
37
Which vaccines are given at 12y according to the SA EPI schedule?
TdaP - 2
38
At which ages is rotavirus vaccine given?
6w 14w
39
At which ages is hexavalent vaccine given?
6w 10w 14w 18m
40
At which ages is PCV vaccine given?
6w 14w 9m
41
At which ages if MMR given?
6m 12m
42
What is the most common cause of bacterial meningitis?
S. pneumo
43
What are the SA PCV vaccines available?
PCV 7 (2009) PCV 13 (2011)
44
What is the rate of CTX non-susceptibility for s.pneumo in SA?
8-10%
45
What are risk factors for mortality with s. pneumo meningitis?
HIV Smoking Chronic lung disease
46
In which age group is haemophilus influenzae most common?
Infants Low incidence overall
47
What is the rate of ampicillin non-susceptibility to haemophilus influenza?
8%
48
In which population does n. meningitides occur?
Healthy, young patients Highest incidence is in infants
49
What are risk factors for n. meningitidis meningitis?
Terminal complement deficiency Lack of MAC formation
50
What was the usual outbreak season of n. meningitidis?
Dry season in the sub Saharan "meningitis belt"
51
Which serotype is not included in the n. meningitidis vaccine?
B
52
What is the rate of penicillin non-susceptibility in n.meningitidis in SA?
55% 2 cipro resistant isolates which has consequences for PEP
53
What is the difference between early and late neonatal meningitis
Early - <7d Late - >7d
54
When is the s. agalactiae conjugate vaccine given in pregnancy?
3rd trimester
55
What are risk factors for l. monocytogenes meningitis?
Extremes of age Cell-mediated immunity defects
56
What is the clinical presentation of l. monocytogenes?
Gastroenteritis
57
What is the clinical presentation of l. monocytogenes specific to pregnancy?
Malaise Transient bacteremia Placentitis Amnionitis
58
What is the clinical presentation of l. monocytogenes specific to neonates?
Acute bacterial meningitis Septicemia Encephalitis
59
Which antibiotics is l. monocytogenes intrinsically resistant to?
Cephalosporins (the first line for acute bacterial meningitis) Ampicillin is the drug of choice
60
Name other causative organisms of meningitis
Enterovirus VZV Mumps HSV HIV Rickettsia Treponema pallidum
61
What is the normal CSF WCC?
0-5
62
What is the normal CSF protein?
0.15-0.45
63
What is the normal CSF glucose?
2.5 - 3.5 (>60% serum glucose)
64
What is the normal CSF pressure?
50-150
65
What are the CSF parameters in bacterial meningitis?
++ WCC >50% PMN Protein >1 Glucose <2.2 Pressure increased
66
What are the CSF parameters in viral meningitis?
++WCC >50% lymphocytes Protein normal Glucose normal Pressure normal
67
What are the CSF parameters in fungal meningitis?
+WCC >50% lymphocytes Protein normal Glucose normal/low Pressure increased
68
What are the CSF parameters in TB meningitis?
++WCC >50% lymphocytes Protein 1-5 Glucose normal/low Pressure normal/increased
69
How much CSF must be included for culture?
>1ml
70
Which biomarkers have good NPV for bacterial meningitis?
CRP<20 with NBO and normal CSF
71
When is PCR multiplex assay performed?
If - viral suspected - previous antibiotics - pleocytosis but gram NBO
72
Which bacteria are included on the BioFire?
E.coli Haemophilus L. mono N. meningitidis S. agalactiae S. pneumo
73
Which viruses are included on the BioFire?
CMV EV HSV1+2 HHV-6 HPeV (human parechovirus) VZV
74
Which fungi are included on the BioFire>
Crypto neoformans Crypto gattiii
75
In which patients should you add ampicillin for?
<1m >50y Immunocompromised
76
In studies in high income countries, meningitis with which organism had decreased hearing loss?
H. influenzae
77
In studies in high income countries, meningitis with which organism had decreased mortality?
S.pneumo
78
Which risk factors must you exclude in recurrent meningitis?
Anatomical defects Asplenia Immunodeficiency
79
Which bacterial meningitis organisms are notifiable?
Neisseria Haemophilus L. monocytogenes
80
Which bacterial meningitis organisms require PEP?
Neisseria - single dose cipro H. influenza - rif daily for 4d
81
Which HCWs are considered close contacts requiring PEP?
Any exposure to nasopharyngeal secretions
82
When does an index cause need PEP?
If not treated with 3rd gen cephalosporin (for nasopharyngeal colonisation)
83
When does an index meningococcal need droplet infection precautions?
Until 24h post treatment initiation with 3rd gen cephalosporin
84
What antibiotic should you add if the s.pneumo is CTX resistant or non-responsive?
Vancomycin
85

DTMH Block 3 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions