Meningitis Flashcards

1
Q

Four clinical features of meningitis

A
headache
neck stiffness
photophobia
Reduced GCS
seizures
if septic- fever, hypotension
purpuric rash
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2
Q

Which bacteria causes meningococcal disease?

A

Neisseria meningiditis

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3
Q

What are the two main features of meningococcal disease?

A

meningitis and sepsis

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4
Q

Which two signs are positive in meningitis?

A

Kernig’s: Straightening leg c¯ hip @ 90 degrees

Brudzinski’s: lifting head → lifting of legs

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5
Q

What would confusion indicate in someone with meningitis?

A

encephalitis

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6
Q

Which bacteria would you worry about in someone with meningitis who has a rash (purpuric=/petechiae)

A

meningococcal disease, therefore N. mengiditis

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7
Q

Name the three main types of bacteria and their class that cause meningitis

A
  1. strep pneumoniae- gram positive diplococci 2. N. meningitidis- gram negative diplococci 3. Listeria monoctyogenes- gram positive rod
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8
Q

What bacteria causes pneumococcal disease?

A

strep pneumoniae

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9
Q

Three risk factors for developing bacterial meningitis

A
  1. Travel from countries with resistant strains 2. Implantable hearing disease- pneumoccocal 3. Alcohol excess- pneumococcal disease 4. IV drug use- staph and strep meningitis 5. Strep suis 6. Tuberculosis
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10
Q

Two signs of pneumococcal meningitis?

A

neurological focal signs e.g. weakness, seizures, VII palsy, hearing loss.

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11
Q

How does pneumococcal meninigitis presentation differ from other causes of meningitis?

A

neurological signs

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12
Q

Two indications for CT before performing lumbar puncture?

A

If GCS <12, CNS signs, seizure, immunocompromised. papilloedema

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13
Q

Three contraindications for LP?

A
Coagulation disorder
Focal neuro signs
Thrombocytopaenia
ICP signs
Haemodynamically unstable
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14
Q

In which meningococcal disease should you treat with steroids?

A

pneumococcal

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15
Q

Abx for bacterial meningitis?

A

ceftriaxone

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16
Q

Abx for listeria?

A

amoxicillin

17
Q

How to distinguish between viral and bacterial meningitis in CSF?

A

Bacterial- high WBC with neutrophil polymorph predominance, high protein, low glucose. Viral- high WBC with lymphocyte predominance, slightly raised protein and normal glucose

18
Q

Triad of meningitis?

A

fever, nuchal rigidity, altered mental state

19
Q

Name five cases in which you would do a CT for bacterial meningitis?

A

older age immunocompromised, LOC, low GCS, neurological signs, seizures, hx of CNS disease

20
Q

Two complications of meningitis?

A

hearing loss, seizures, memory loss, focal neurological deficits

21
Q

Two examples of antibiotics for bacterial meningitis, state route of admin

A

IV benzyl penicillin
IV chloramphenicol
IM cefotaxime

22
Q

Suggest four tests to confirm microbiology in meningitis

A

Blood cultures – blood for Gram stain/culture
Throat swab
Lumbar puncture/CSF – for Gram, culture, PCR
Skin scrape from purpuric lesion
Meningococcal PCR
Acute and convalescent meningococcal antibody titres