Inflammation

Question 1

What are the symptoms of meningitis?

Answer 1

Headache, fever, leg pain, cold extremities, abnormal skin colour, neck stiffness, photophobia, LOC, seizures, non-blanching rash

Kernig’s sign (knee flexion on forced neck flexion)

Question 2

How is meningtis treated?

Answer 2

1. Take blood cultures
2. Measure urine output and lactate
3. Give oxygen, abx and fluids

LP - providing no signs of high ICP

Question 3

How does CSF appear in bacterial meningitis?

Answer 3

Turbid
Polymorphs
Glucose <0.5 plasma glucose
Protein >1.5

Question 4

How does CSF appear in TB meningitis?

Answer 4

Fibrin web
Monomorphs
Glucose <0.5 plasma glucose
Protein 1-5

Question 5

How does CSF appear in viral miningitis?

Answer 5

Clear
Monomorphs
Glucose >0.5 plasma
Protein <1

Question 6

What are the symptoms of encephalitis?

Answer 6

Bizarre behaviour, LOC, fever, headache, focal signs, seizures
History of travel

Question 7

What do investigations for encephalitis show?

Answer 7

CT: bilateral temporal lobe involvement (HSV)
LP: high protein, low glucose , lymphocytes
EEG: diffuse abnormalities

Question 8

How is encephalitis treated?

Answer 8

Aciclovir