CNS Meninigitis

Question 1

Define Encephalitis:

Answer 1

Inflammation and infection of the brain PARENCHYMA.

Question 2

Define Vasculitis:

Answer 2

Inflammation of the vasculature, can be primary cerebral or secondary to systemic Vasculitis.

Question 3

Presentation of Meningitis:

Answer 3

Fever
Neck Stiffness
Altered mental status 
Rash
Seizure
Focal neuro findings
Sepsis

Question 4

Urgent orders with Meningitis:

Answer 4

Head CT without contrast
Lumbar puncture
Empiric antibiotics
Decadron and antibiotics

Question 5

If the client has symptoms of meningitis less then 48 hours it is usually due to?

Answer 5

Bacterial

Question 6

Subacute meningitis is likely due to

Answer 6

Viral infection

Question 7

Chronic symptoms of Meningitis is due to?

Answer 7

Fungal
Parasite
Non infectious source

Question 8

Risk factors for Meningitis

Answer 8

HIV
Immunocompromised
Travel
Vaccinations

Question 9

Thing to assess for when a client presents with meningitis

Answer 9

VS
HEENT: facial rash ( zoster) 
Thrush ( HIV) 
Parotiditis (MUMPS)
Mastoid tenderness
Dentition ( abscess)

Question 10

What is Budzinskis sign

Answer 10

Neck flexion

Leads to flexion of the hips/knees

Question 11

Kernels sign is :

Answer 11

Flex hip and knee with thigh against abdomen then extend the knee leads to pain and resistance is a positive sign.

Question 12

Imaging to be done with suspected meningitis

Answer 12

Head CT
MRI with contrast
EEG

Question 13

What should be done first before a lumbar puncture

Answer 13

R/O a head bleed

Question 14

What is a normal CSF reading

Answer 14

Cells : 0-5 lymphocyte
Glucose : 45-85
Protein: 15-45
Opening pressure : 70-80 
Color: clear 
RBC: 0
WBC: 0-5

Question 15

Bacterial meningitis you will see in the CSF fluid:

Answer 15

Cells : 200-20,000 neutrophils
Glucose : LOW 50
Opening Pressure : Markedly elevated

Question 16

Viral Meningitis CSF fluid will have

Answer 16

Cells: 25-2000 lymphocytes
Glucose: Normal or low
Protein: HIGH>50
Opening pressure : slightly elevated

Question 17

Fungal Meningitis CSF would look like :

Answer 17

Cells WBC: 100-1000 lymphocytes
Glucose: LOW 50
Opening pressure Moderately elevated

Question 18

Common micro organisms with meningitis

Answer 18

Streptococcus pneumoniae

Question 19

Treatment for meningitis is

Answer 19

Empiric ( from your clinical diagnosis)
Vancomycin, cefriaxone
If immunocompromised add
Ampicillin

Question 20

If the meningitis is viral you treat with

Answer 20

Acyclovir

Question 21

Every meningitis client receive what medication with the antibiotics.

Answer 21

Dexamethasone

Question 22

When C/S returns treat meningitis

Answer 22

Based on the culture

Question 23

Define Meningitis:

Answer 23

Inflammation and infection of the meninges surrounding the brain and spinal cord.

Question 24

Wernicke Ecephalopathy what are the triad of symptoms:

Answer 24

Confusion
Ataxia
Nystagmus

Question 25

Wernicke encephalopathy is due to

Answer 25

Thiamine deficiency

Question 26

How do you treat Wernikie Encephalopathy

Answer 26

Thiamine 50 mg IV then IM daily

Question 27

When is the diagnosis of Wernicke Encephalopathy confirmed?

Answer 27

Confirmed by response to treatment in 1-2 days.

Question 28

S/S of Myasthenia Gravies

Answer 28

Fluctuating weakness of voluntary muscles Activity increases weakness of affected muscles Dysphasia Diplopoda Ptosis Respiratory difficulty

Question 29

What type of antibodies are found with Myasthenia Gravis

Answer 29

Acetylcholine receptor antibodies 85%

Question 30

Treatment

Answer 30

Neostigmine Pyridostigmine Low dose steroid therapy