CNS infections

Question 1

what is meningitis

Answer 1

infection of the meninges

Question 2

common bacteria in meningitis for neonates

Answer 2

listeria, group B strep, E.Coli

Question 3

common bacteria in meningitis for infants and young children

Answer 3

H.Influenzae

Question 4

common bacteria in meningitis for older children and adults

Answer 4

nisseiria meningitidis, strep pneumo

Question 5

common bacteria in meningitis for +65

Answer 5

strep pneumo, listeria

Question 6

common bacteria causing meningitis in immunocompromised patients

Answer 6

listeria monocytogenes

Question 7

what bacteria can cause meningitis in a patient who fracture their cribiform plate

Answer 7

strep pneumo

Question 8

what is the most common cause of meningitis

Answer 8

VIRAL

Question 9

what is the most common cause of meningitis in immunocompetent adults in the UK

Answer 9

enterovirus

Question 10

what is a definitive sign of acute bacterial meningitis

Answer 10

neutrophils in the subarachnoid space

Question 11

which type of meningitis causes cerebral oedema

Answer 11

bacterial

Question 12

what happens in viral meningitis

Answer 12

lymphocytic inflammatory CSF reaction
NO pus formation or adhesions

Question 13

classic triad for meningitis

Answer 13

headache, neck stiffness and fever

Question 14

what are some other common symptoms for meningtis

Answer 14

photophobia
vomiting

Question 15

what is a general presentation of a patient with acute bacterial meningitis

Answer 15

sudden onset with rigors and high fever
non-blanching rash with meningococcal septicaemia

Question 16

clinical presentation of meningoencephalitis

Answer 16

headache, fever and neck stiffness + features of encephalitis

Question 17

investigation for meningitis

Answer 17

lumbar puncture

Question 18

CSF in bacterial meningits

Answer 18

cloudy, high protein, low glucose, NEUTROPHILS

Question 19

CSF in viral meningitis

Answer 19

clear, LYMPHOCYTES

Question 20

management of viral meningitis

Answer 20

supportive
usually lasts 4-10 days

Question 21

management of bacterial meningitis in adults

Answer 21

ceftriaxone + dexamethasone

Question 22

what can be used as an alternative to ceftriaxone

Answer 22

chloramphenicol

Question 23

what is added in the management of bacterial meningitis in adults if the patient is >60 or immunocompromised

Answer 23

amoxicillin

Question 24

management of bacterial meningitis in <3 month olds

Answer 24

cefotaxime + amoxicillin

Question 25

management of bacterial meningitis in >3 month olds

Answer 25

dose cefotaxime + once daily ceftriaxone 6 hours later

Question 26

management of listeria

Answer 26

IV ampicillin/amoxicillin

Question 27

management in contact prophylaxis of meningitis

Answer 27

single dose ciprofloxacin orally or ceftriaxone IM

Question 28

name some complications of meningitis

Answer 28

purulence invasion cerebral oedema hydrocephalus

Question 29

what is encephalitis

Answer 29

acute inflammation of the brain parenchyma

Question 30

what is usually the cause of encephalitis

Answer 30

VIRAL - HSV, VSV, enteroviruses and adenovirus

Question 31

what might limbic encephalitis be associated with

Answer 31

underlying malignancy or autoimmunity

Question 32

clinical presentation of encephalitis

Answer 32

FEVER flu-like illness seizures focal neurological deficits behavioural changes

Question 33

what is limbic encephalitis

Answer 33

antibody-mediated encephalitis

Question 34

investigations for encephalitis and their findings

Answer 34

CSF - elevated lymphocytes MRI - bilateral medial temporal lobe involvement EEG

Question 35

management of suspected HSV or VZV encephalitis

Answer 35

IV acyclovir

Question 36

management of limbic encephalitis

Answer 36

treat cause e.g. tumour, immunosuppressive agent