CNS infections Flashcards

1
Q

What trio of clinical features suggest pyogenic bacterial meningitis

A

headache, fever, stiff neck

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2
Q

What additional features are sometimes present in meningitis

include what effect does meningitis have on blood pressure and HR

A
non-blanching rash
papilloedema
photophobia
confusion
hypertension
bradycardia
lethargy
loss of consciousness
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3
Q

Which bacteria is associated with meningitis in those over 65yo

A

s. pneumoniae

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4
Q

Which bacteria is associated with meningitis in those aged 10-21

A

neisseria meningitides

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5
Q

What age ranges are associated with listeria monocytogenes meningits

A

neonates and over 55yo

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6
Q

Which organisms in meningitis are particularly associated with immunosuppressed patients

A

listeria and crytococcus

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7
Q

Which bacteria is associated with meningitis in military people / university freshers

A

neisseria meningitides

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8
Q

Which bacteria is associated with meningitis in cribriform plate fractures

A

s. pneumoniae

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9
Q

Which bacteria is associated with meningitis in alcoholic, diabetics and those with cochlear implants

A

s. pneumoniae

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10
Q

Neisseria is a gram +ve intercellular bacteria. True of false

A

false, gram -ve intracellular

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11
Q

Listeria is a gram +ve cocci. T or F

A

false, gram +ve bacilli

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12
Q

What is aseptic meningitis

A

no bacteria found

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13
Q

Which organisms known to cause meningitis have vaccines available

A

neisseria, Hib, others?

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14
Q

Which viruses can cause aseptic meningitis

A

syphilis, HSV

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15
Q

TB is known to cause bacterial meningitis. T or F

A

F, causes aseptic meningitis

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16
Q

What blood tests should be done when investigating meningitis

A
FBC
CRP
clotting screen
U+Es
LFTs
BG
urea
creatinine
serology
17
Q

What microbiology specific tests should be done for meningitis

A

blood culture
throat swab + culture (for meningococcus/ enterovirus)
PCR (for meningococcus/ pneumococcus)

18
Q

What is seen in CSF after LP in bacterial meningitis

A

> WCC, >protein, lactate, >pressure, decreased glucose

19
Q

What imaging should be done for suspected bacterial meningitis

20
Q

Empirical management of bacterial meningitis (incl allergy)

A

IV dexamethasone+ IV ceftriaxone

allergy: chloramphenicol

21
Q

What drug should be added to empirical management of bacterial meningitis in patients over 60 yrs

A

amox or co-trimoxazole

22
Q

What drug should be added to empirical management of bacterial meningitis in patients who have traveled to an amox resistant country in the last 6 months

23
Q

When are CCS contraindicated in the management of bacterial meningitis

A

immunocompromised, post-surgery, shock

24
Q

What are the contact prophylaxis options for bacterial meningitis in people over 12 years old

A
rifampicin 
OR 
1X IV ciprofloxacin 
OR 
IM ceftriaxone
25
What complication of bacterial meningitis occurs when the pia is invaded
brain abscess
26
What virus is the commonest cause of viral meningitis
enterovirus eg. ECHO
27
Investigations for viral meningitis
viral stool culture, throat swab, LP
28
What abnormalities are seen in CSF in viral meningitis
none: protein/glucose normal my other notes say raised proteins and lymphocytes?
29
Management of viral meningitis
supportive
30
What is stupor
decreased consciousness of cognitive function
31
Commonest organism in encephalitis
HSV
32
What structure is inflamed in encephalitis
brain parenchyma
33
How does encephalitis present
decreased consciousness focal sign hemiplegia, speech psychosis seizure recent fever!
34
Is encephalitis acute or insidious
sudden acute
35
1st line investigation for encephalitis
LP (EEG also indicated)
36
Investigation for encephalitis if LP contraindicated
CT (EEG also indicated)
37
CSF abnormalities in encephalitis
mild >protein >WCC lymphocytosis OTHER ?
38
Aetiology of brain abscesses
skull fracture sinusitis mastoiditis bloodborne
39
Presentation of brain abscess
>ICP + fever + underlying cause