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Exam - M - Paediatrics (Megan) > Meningitis > Flashcards

Meningitis Flashcards

1
Q

What is meningitis?

A

Inflammation of the meninges and the CSF.

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2
Q

What are the bacterial causes of meningitis?

A 
Most common: 
Neiserria meningitides (meningococcal) 
Other: 
streptococcus pneumonia (pneumococcus)

Group B strep

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3
Q

What is the most common bacteria causing meningitis?

A

Neiserria meningitides

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4
Q

What is the most common bacteria causing meningitis in neonates?

A

Group B strep

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5
Q

What type of bacteria is neisseria meningitides?

A

Gram negative diplococcus

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6
Q

What is meningococcal septicaemia?

A

Infection of the blood causing subcutaneous haemorrhage and disseminated intravascular coagulation.

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7
Q

What is disseminated intravascular coagulopathy?

A

Tiny blood clots form in the blood blocking small blood vessels.
This uses up platelets and clotting factors resulting in excess bleeding as the blood can’t clot properly when needed.

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8
Q

What are the main signs of meningitis?

A 
Neck stiffness
Fever
Vomiting
Photophobia
Non blanching rash 
Headache
Altered consciousness
Seizures
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9
Q

Which cause is the non blanching rash specific to?

A

Meningococcal septicaemia

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10
Q

What are non specific signs seen in neonates?

A 
Poor feeding
Hypotonia
Lethargy
Hypothermia
Bulging fontanelles
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11
Q

When should children get a lumbar puncture?

A

<1 month - all with fever
1-3 months - fever and unwell
<1 year - unexplained fever and unexplained symptoms

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12
Q

What are 2 practical tests done?

A

Kernigs

Brudzinski

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13
Q

What is kernigs sign?

A

Patient lies on back and flexes hips and knees, the knee is straightened out and it causes pain (due to spinal cord being stretched)

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14
Q

What is brudzinski sign?

A

Patient lies on back and the neck is lifted - positive sign is when the patient unvoluntarily flexes the hip and neck too

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15
Q

What is done in primary care if. bacterial meningitis is suspected?

A

Injection of benzylpenicillin

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16
Q

What tests are done in the hospital?

A

Blood culture

Lumbar puncture

17
Q

What antibiotics are given to treat bacterial meningitis?

A

> 3 months Ceftriaxone/cefotaxime
+Vancomycin added if suspected penicillin resistance

Add amoxicillin if < 1 month

18
Q

What steroids are given for bacterial meningitis?

A

4x daily dexamethasone for 4 days

19
Q

What is the prophylaxis given for bacterial meningitis?

A

For anyone with contact 7 days before symptoms appeared.

Single dose ciprofloxacin.

20
Q

What are the causes of viral meningitis?

A

Herpes simplex virus
Enterovirus
Varicella zoster virus

21
Q

How is viral meningitis treated?

A

Milder illness than bacterial meningitis.

Usually supportive treatment.

Acivlovir - for herpes simplex virus or varicella zoster virus.

22
Q

What are the lumbar puncture results in bacterial meningitis?

A

Colour - cloudy
White cell count - high (neutrophils)
Protein - >1.5g/L

23
Q

What is the lumbar puncture results in viral meningitis?

A

Colour - clear
Protein - mildly raised or normal
White cell count - >1000 (lymphocytes)

24
Q

What level does the spinal cord end?

A

L1-L2

25
Q

What level is a lumbar puncture performed at?

A

L3-L4

26
Q

Which white cells does the body produce more of in bacterial and viral infections?

A

Bacteria - neutrophils

Virus - lymphocytes

27
Q

What are the complications of meningitis?

A 
Hearing loss
Cerebral palsy
Learning difficulties
Seizures
Epilepsy 
Memory loss
28
Q

What is the main cause of meningitis in neonates (<1 month)?

A

Group B streptococcus

EColi

Listeria

29
Q

what are the main causes of meningitis in older infants and children?

A

Streptococcus pneumonia
neiserria meningitidis
Haemophilus influezae type B

30
Q

When should a lumbar puncture NOT be performed?

A

within 30 minutes of a seizure

Exam - M - Paediatrics (Megan) (57 decks)

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