CNS

Question 1

Meningitis likely pathogens in neonates

Answer 1

listeria
GBS
E.coli

Question 2

Meningitis likely pathogens age 10-21

Answer 2

Neisseria meningitidis

Question 3

Meningitis likely pathogens age >21

Answer 3

Strep pneumoniae

Neisseria meningitidis

Question 4

Meningitis likely pathogens >65

Answer 4

Strep pneumoniae

Listeria

Question 5

Groups of patients likely to get Listeria meningitis

Answer 5

Neonates
Elderly (>60)
Immunocompromised

Question 6

Likely pathogen in meningitis following fracture of cribriform plate

Answer 6

Strep pneumoniae

Question 7

Encephalitis likely pathogen

Answer 7

Herpes simplex

Question 8

Empirical treatment of meningitis

Answer 8

IV Ceftriaxone 2g bd + IV Dexamethasone

Question 9

Treatment in encephalitis suspected

Answer 9

IV Aciclovir

Question 10

Treatment if Listeria suspected

Answer 10

Add IV Amoxicillin/Ampicillin

resistant to cefriaxone

Question 11

Describe the typical CSF findings in a viral meningitis including cell type, protein and glucose:

Answer 11

Lymphocytes
Protein normal or slightly raised
Glucose usually normal

Question 12

Describe the typical CSF findings in a bacterial meningitis including cell type, protein and glucose:

Answer 12

Neutrophils
Protein high
Glucose < 70% of blood glucose

Question 13

Describe the typical CSF findings in a TB meningitis including cell type, protein and glucose:

Answer 13

Predominantly lymphocytes
Protein high or very high
Glucose < 60% of blood glucose

Question 14

Which patients should have a CT prior to lumbar puncture?

Answer 14

Immunocompromised
History of CNS disease
New onset seizure
Papilloedema
Reduced GCS
Focal neurological deficit

Question 15

Which antibiotic is given as contact prophylaxis for meningitis?

Answer 15

Single dose ciprofloxacin