CNS

Question 1

Common SX

Answer 1

-Fever
-Photophobia
-AMS
-Neck stiffness
-Rash, NV
-Seizures
SPRANF

Question 2

Bacterial Pathogens

Answer 2

Community:
-Strep. pneumoniae
-Neisseria meningitides
-Listeria mono

Nosocomial:
-Gram neg bacilli
-Streps
-Staph aureus

Question 3

Empiric: < 1 month

Answer 3

Ampicillin + cefotaxime or AG
ACA

Question 4

Empiric: 1-23 months

Answer 4

Vancomycin + ceftriaxone or cefotaxime

Ceftriaxone is Q12 for all meningitis tx

Question 5

Empiric: 2-50 y/o

Answer 5

Vancomycin + ceftriaxone or cefotaxime

Question 6

Empiric: > 50 y/o or Immunocompromised

Answer 6

Vancomycin + ampicillin + ceftriaxone/cefotaxime

Question 7

Empiric: Hospital/Surgical Acquired

Answer 7

Vancomycin + Cefepime/Mero/Ceftazidime

Question 8

Dexamethasone

Answer 8

For adults with suspected or proven pneumococcal meningitis

-0.15 mg/kg Q6

10-20 min prior to abx, or at least concomitant

DC if negative for Gram + diplococci or negative CSF blood cultures for S. pneumoniae

Question 9

Encephalitis

Answer 9

Difference
-AMS, movement/speech disorder

Empiric
-Acyclovir 10 mg/kg IV Q8H IV
-IBW, Renal adj

Question 10

Syphilis

Answer 10

Sexually transmitted
-PCN G 18-24 mil
-Pro PCN 2.4 mil + probenecid

Desensitization to PCN preferred over alternative

Allergy:
-Ceftriaxone 2 g