Infectious diseases in the ER Flashcards
1
Q
what is classic triad of bact. meningitis
A
- fever
- neck stiffness
- altered mental status
(4) headache
absence of all 3 eliminates diagnosis
2
Q
what is usual presentation of Bmen
A
2/4 symptoms in 95% of cases
3
Q
what are signs to looks for (3)
A
- papilledema
- brudzinski’s sign
- kernig’s sign
4
Q
4 short term complications of Bmen
A
- altered mental status
- elevated ICP
- seizures
- focal neuro deficits
5
Q
4 long term comp. of Bmen
A
- cerebrovasc. abnormalities
- intellectual impariment
- sensorineural hearing loss
- death
6
Q
6 investigations to order for BMen
A
- labs - CBC, BUN
- ECG
- cultures
- urinalysis/culture
- CT head
- lumbar puncture
7
Q
what to look for on CT head
A
space occupying lesion or elevated ICP
8
Q
where to do lumbar puncture
A
b/w L3 and L4
9
Q
what is taken in 4 vials of LP
A
- cell count and differential
- glucose, protein
- Gram stain, culture, special studies
- cell count and differential, xanthrochromia
10
Q
what is abnormal cell count
A
elevated WBCs
11
Q
what is abnormal glucose
A
12
Q
what is abnormal protein
A
> 1 g/L
13
Q
what is seen on gram stain
A
nothing in 60% - esp. if on antibiotics before LP
14
Q
what is treatment key in BM
A
start if suspected
15
Q
treatment of BM
A
- IV dexamthasone - stop host mediated inflammation
2. ampicillin, vancomycin, ceftriaxone
