Meningitis

Question 1

Which organism causes meningococcal disease?

Answer 1

neisseria meningitidis

Question 2

Which organisms cause bacterial meningitis?

Answer 2

strep pneumoniae, N. meningitidis, haemophilus influenzae

Question 3

What are the features of CSF bacterial meningitis?

Answer 3

turgid colour, high protein, low glucose neutrophils

Question 4

CSF for viral meningitis?

Answer 4

normal to low protein, normal glucose, lymphocytes

Question 5

CSF features for SAH?

Answer 5

xanthochromic, high protein, normal glucose, RBCs

Question 6

Aside from meningitis/infection, list four other causes of seizures

Answer 6

Hypoglycaemia
Drug withdrawal
Head injury- SOL, non epileptic attack 
Stroke
Hyperglycaemia

Question 7

Patient with suspected bacterial meningitis. What action should be taken immediately?

Answer 7

IV antibiotics- ceftriaxone

IV steroids

Question 8

Patient is allergic to ceftriaxone but has bacterial meningitis. What do you treat them with?

Answer 8

chloramphenicol

Question 9

Aside from routine blood tests, list 3 other parts of your management plan for bacterial meningitis

Answer 9

CT brain
IV fluids
Blood cultures and PCR for neisseria
LP (only if save i.e. no evidence of raised ICP)

Question 10

Name evidence for raised ICP

Answer 10

seizure, findings on CT

Question 11

Name two complications of meningococcal meningitis

Answer 11

septic shock
hearing loss
seizures
intellectual impairment

Question 12

Who should be notified when bacterial meningitis is diagnosed?

Answer 12

public health as this is a notifiable disease

Question 13

Which two special tests can you evoke in meningitis?

Answer 13

kernig’s sign: Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.

Brudzinski’s: forced flexion of the neck elicits a reflex flexion of the hips.

Question 14

List four organisms that cause meningitis

Answer 14

meningococcus
pneumococcus
TB
haemophilus
listeria