Meningitis Flashcards

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1
Q

What does the CNS comprise of?

A

Brain and spinal column

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2
Q

What is cerebro spinal fluid (CSF)?

A

Clear fluid that occupies the subarachnoid space and ventricular system cushioning the brain

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3
Q

How do infections of the CNS originate?

A

Generally originate from bloodstream

or severe trauma to head or spine

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4
Q

What is the blood brain barrier (BBB)

A

Separation of circulating blood and the CSF in the CNS

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5
Q

What is the meninges?

A

System of protective membranes enveloping the CNS

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6
Q

What do the meninges comprise of?

A

Dura mater
Arachnoid mater
Pia mater

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7
Q

What is meningitis?

A

Inflammation of meninges (due to infection)

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8
Q

What pathogen can meningitis be caused by?

A

Bacteria (most severs)
Virus
Fungi

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9
Q

What are the symptoms of meningitis?

A

Fever
Photophobia
Neck stiffness
Altered mental status (drowsiness)

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10
Q

What common organism infects neonates?

A

Group B Streptocooci

E. coli

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11
Q

What common organism infects infants/children/adults?

A

N. menigitidis

Streptococci pneumoniae

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12
Q

What common organism infects immunosuppressed patients?

A

Cryptococcus neoformans

L. monocytogenes

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13
Q

What is the glass test?

A

Purpuric rash does not fade under pressure from glass

Sign of meningococcal septicaemia

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14
Q

What pathogenicity factors does Neisseria meningitidis have?

A
Type IV pilus (mucosal colonisation)
Polysaccharide capsule (avoid phagocytosis)
Major toxin lipo-oligosaccharide (LOS) endotoxin
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15
Q

How does Neisseria meningitidis infect?

A

Crosses the nasopharyngeal mucosa to the bloodstream which then crosses the BBB

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16
Q

What is the fatality rate in neonatal meningitis E. coli?

A

40%

17
Q

How common is neonatal bacterial meninigitis?

A

250-300 cases per year in the UK

18
Q

What pathogenicity factors does E. coli have in neonatals?

A

K1 capsule
OmpA (outer membrane protein A) and type 1 pili (adhesion and invasion)
CNF-1 (cytotoxic necrotising factor 1) and IbeA (invasion)
Enterobactin (iron acquisition)

19
Q

What is the treatment?

A

If strong suspicion of meningitis treat before CSF sample taken
High dose of 3rd generation cephalosporins

20
Q

Which cephalosporins is used to treat meningitis?

A

Cefotaxime or Ceftriaxone