Mehl. UW meningococcal + other meningitis in kids 04-01 (2)

Question 1

Uw. meningococcal table. epidemiology? in what population?

Answer 1

Neisseria meningitidis
Most common in young children and young adults

Question 2

Uw. meningococcal table. CP Initial?

Answer 2

nonspecific = fever, headache, vomiting, myalgia, sore throat

Question 3

Uw. meningococcal table. CP within 12-24h?

Answer 3

Petechia/purpura, meningeal signs, AMS (altered mental status)

Question 4

Uw. meningococcal table. Tx?

Answer 4

ceftriaxone

Question 5

Uw. meningococcal table. complications? 3

Answer 5

shock
DIC
adrenal hemorrhage

Question 6

UW meningococcal table. prevention?

Answer 6

droplet precautions
chemoprophylaxis for close contacts

Question 7

UW meningococcal table. prevention. chemoprophylaxis for close contacts? what abs 3

Answer 7

rifampin, ciprofloxacin, ceftriaxone

Question 8

UW. meningococcus. Brudzinski sign. Onset?

Answer 8

neck flexion elicits pain and knee/hip flexion
onset: usually absent in <1 y/o.

Question 9

UW. meningococcus. in older children what cp can be?

Answer 9

headache and severe myalgias (eg leg pain).

Question 10

UW. meningococcus. symptoms progress rapidly, over 12-24h.!!!

Answer 10

.

Question 11

UW. meningococcus. what is diagnostic?

Answer 11

CSF culture

Question 12

UW. meningococcus. testing of CSF should not delay administration of ceftriaxone

Answer 12

.

Question 13

UW. meningococcus. in addition to ceftriaxone what abs should be added and why?????

Answer 13

empiric abs should include VANCOMYCIN for coverage of penicillin-resistant Streptococcus pneumoniae, which is the most common pathogen in children > 1 month.

Question 14

Mehl. presents as?

Answer 14

high fever + stiff neck and photophobia.

Question 15

Mehl. what gram?

Answer 15

gram-negative diplococcus.

Question 16

Mehl. Causes meningitis + ….?

Answer 16

characteristic non-blanching rash.

Question 17

Mehl. Low BP can be endotoxic shock, but student should bear in mind Waterhouse- Friderichsen syndrome is often asked; Tx? 2

Answer 17

give hydrocortisone to increase BP after normal saline is administered.

Question 18

UW. CP of meningococcal meningitis. What lab need to take?

Answer 18

serum fibrinogen
because one of complications = DIC

Question 19

UW. manifestation of DIC?

Answer 19

oozing from iv line sites, GI hemorrhage, purpura.

Question 20

UW. LAB of DIC?

Answer 20

decr. PLT, elevated PT, aPTT; LOW FIBRINOGEN

Question 21

UW. Mx of DIC?

Answer 21

supportive

Question 22

UW. what is purpura fulminants?

Answer 22

less common complication of meningococcal meningitis, which presents with gangrenous necrosis of purpuric lesions.

Question 23

UW. in general meningitis in children. <1 month? 4

Answer 23

GBS
E.coli and other gram negative bacteria
Listeria monocytogenes
HSV

Question 24

UW. in general meningitis in children. >1 month? 2

Answer 24

Strep pneumonia
Neisseria meningitidis