FN: Meningitis Flashcards
1
Q
Features
A
Meningitic
Neurological
Septic
2
Q
Meningitic
A
HEadache
Neck stiffness
Photophobia
n/v
3
Q
Neck stiffness signs
A
Kernigs
Brudzinskis
4
Q
Kernigs
A
Straightening leg with hip @ 90degrees
5
Q
Brudzinski’s
A
Lifting head –> lifting of legs
6
Q
Neurological
A
reduced GCS - coma
Seizures (20%)
Focal neuro (20%) e.g. CN palsies
7
Q
Septic
A
Fever low BP, high HR Raised CRT purpuric rash DIC
8
Q
Abx therapy
A
- Community: benpen 1.2g IV/IM
- 50 ceftriaxone + ampicillin 2g IVI/4h
- If viral syspected: aciclovir
9
Q
Organisms
A
- viruses: enteroviruses (Coxsackie, echovirus), HSV2
- Meningococcus
- Pneumococcus
- Listeria
- Haemophilus
- TB
- Cryptococcus
10
Q
Investigations
A
Bloods: FBC, U+E, clotting, glucose, ABG
Blood cultures
LP: MCS, glucose, virology/PCR, lactate
11
Q
Acute Management
Step 1
A
ABC
- Oxygen 15L - SpO2 94-98%
- IVI fluid resus with crystalloid
distinguish between septicamic or Meningitis
12
Q
Mainly septicaemic treat with
A
- Dont attempt LP
- Ceftriaxone 2g IVI
- Consdier ITU if shocker
13
Q
Mainly Meningitis
A
- If no shock or CIs do LP
- Dexamethasone 0.15mg/kg IV QDS
- Ceftiaxone 2g IVI post-LP
14
Q
Prophylaxis for nearby people
A
Rifampicin
15
Q
Contraindications for an LP:
Try LP Unless ContraINdicated
A
Thrombocytopenia LAteness (delay in antibiotic admin) Pressure (Cardio + resp systems) Unstable (Cardio + resp systems) Coagulation disorder Infection at LP site Neurology (focal neurological signs)
