MENINGITIS

Question 1

Meningitis: CAUSES in Different AGE GROUPS
🧠⚡0-6: BEL ⚡
🧠⚡6m-6yr: SNEH ⚡
🧠⚡6yr-60yr: SNHE⚡
🧠⚡> 60yrs: SPL ⚡

Answer 1

Question 2

⭐ NORMAL CSF VOLUME
⭐ NORMAL CSF PRESSURE
⭐ NORMAL CSF CELL COUNT
⭐ NORMAL CSF PROTEIN
⭐ NORMAL CSF GLUCOSE

Answer 2

⭐ NORMAL CSF VOLUME
🎯 150ml

⭐ NORMAL CSF PRESSURE
🎯 90-180 mm H2O

⭐ NORMAL CSF CELL COUNT
🎯 < 5 cell

⭐ NORMAL CSF PROTEIN
🎯 15-45

⭐ NORMAL CSF GLUCOSE
🎯 60-80% of Blood Glucose

Question 3

Differentiate BETWEEN Acute Pyogenic, Acute Viral & Tuberculous MENINGITIS

Answer 3

Question 4

Indications of LUMBAR PUNCTURE
🧠⚡M²ISS DM ⚡

Answer 4

🎯 DIAGNOSTIC

1. INFECTIONS
   ✨ Meningitis
   ✨ Encephalitis
2. SUBARACHNOID HEMORRHAGE
3. MALIGNANCY: Metastatic & 1°
4. DEMYELINATING conditions:
   ✨ MS
   ✨ SSPE
5. GBS
6. SPINAL CORD BLOCKAGE
7. MYELOGRAPHY

🎯 THERAPEUTIC
1. Spinal Anaesthesia & Epidural Anaesthesia

2. CSF Drainage in NORMAL PRESSURE HYDROCEPHALUS
3. INTRATHECAL INJECTION of CHEMOTHERAPEUTIC DRUG

Question 5

🚫 CONTRAINDICATION of LUMBAR PUNCTURE

Answer 5

1. Raised ICP
2. Coagulopathy
3. Infection at Injection site
4. Bone deformity at Injection site

Question 6

Substance more in CSF than Blood

Question 7

Causes of LOW GLUCOSE in CSF

Answer 7

1. Pyogenic MENINGITIS
2. TUBERCULOUS MENINGITIS
3. Fungal MENINGITIS
4. Carcinomatous MENINGITIS

Question 8

Causes of ELEVATED CSF PROTEIN

Answer 8

1. MENINGITIS
2. ABSCESS BRAIN
3. TUMOUR: Brain or SPINAL CORD Tumour
4. GBS
5. MS
6. SYPHILIS
7. HEMORRHAGE
8. FROIN’S SYNDROME

Question 9

Xanthochromasia

Answer 9

Yellowish appearance of CSF

Question 10

Causes of XANTHOCHROMASIA

Answer 10

1. Old SUBARACHNOID HEMORRHAGE
2. Jaundice
3. Froin SYNDROME

Question 11

Froin SYNDROME

Question 12

Albumino-cytological dissociation is seen in

🧠⚡FAG⚡

Answer 12

Increase in CSF PROTEIN without INCREASING CSF Cell count

F-FROIN’S LOCULATION SYNDROME A-ACOUSTIC NEUROFIBROMA G-GUILLIAN BARRE SYNDROME

✨ Non inflammatory degeneration of Brain Parenchyma
✨ Tumours
✨ Spinal Cord Compression

Question 13

⚡⚡ MOST COMMON CAUSE of MENINGITIS

Answer 13

Streptococcus pneumoniae

Question 14

Difference between:
✨ MENINGITIS
✨ Encephalitis
✨ Encephalopathy
✨ Acute Febrile Encephalopathy

Answer 14

✨ Meningitis
Meningeal signs present predominantly
Seizure Present/Absent

✨ Encephalitis
Sensorium affection (coma)
Seizures

⭐ Encephalitis: Inflammation of brain parenchyma

⭐ Encephalopathy: Noninflammatory diffuse cerebral dysfunction (altered sensorium due to any cause)

⭐ Acute febrile encephalopathy: A febrile illness with altered sensorium of ≤2 weeks duration in a previously well child. May have infectious or noninfectious causes

⭐ Meningitis: Inflammation of leptomeninges.

Question 15

⚡⚡ MOST COMMON CAUSE of POST SHUNTING MENINGITIS

Answer 15

Staphylococcus epidermidis > > Staphylococcus aureus

Question 16

⚡⚡ MOST COMMON CAUSE of MENINGITIS Post CRANIOTOMY, Head Trauma & CSF Rhinorrhea

Answer 16

Pseudomonas (Gram negative)

Question 17

Classical Triad of MENINGITIS

Answer 17

SHORT HISTORY (1 DAY) with Lethargy & Drowsiness

1. Fever HIGH GRADE
2. Neck Stiffness
3. Altered Sensorium
   ➕
   Headache

Question 18

Classical Tetrad of ENCEPHALITIS

Answer 18

Fever
➕
Altered Sensorium
➕
Focal Neurological Deficit
➕
Seizure

Question 19

⚡⚡ MOST COMMON SYMPTOM OF MENINGITIS

Answer 19

Severe HEADACHE

Question 20

Characteristics of Headache in ACUTE BACTERIAL MENINGITIS

Answer 20

Frontal TIGHTNESS, feels like Compression

Question 21

🧑🏻‍⚕️ORDER of Clinical Features in Acute MENINGITIS

Answer 21

Tiredness
⬇️
Irritable
⬇️
LETHARGIC
⬇️
High Grade Fever with intermittent episodes of Vomiting

Question 22

Which type of MENINGITIS present SUBACUTELY?

Answer 22

✨ TB MENINGITIS
✨ FUNGAL MENINGITIS

Question 23

Classical Signs of MENINGITIS

Answer 23

1. Neck Stiffness / Cervical RIGIDITY
2. KERNIG’S sign
3. BRUDZINSKI’s sign

Question 24

Answer 24

KERNIG’S sign
BRUDZINSKI’s sign

Question 25

Other Features of MENINGITIS

Answer 25

1. Raised ICP
   ✨ Papilledema
   ✨ Projectile Vomiting
   ✨ 6th CN palsy
   ✨ Reduced level of Consciousness
   ✨ Cerebral Herniation
2. Decerebrate Posturing
3. Cushing Reflex: ⬇️ HR, ⬆️ BP, RR ⬆️

Question 26

Special features of MENINGOCOCCAL MENINGITIS

Answer 26

Rash: diffuse erythematous maculopapular

Question 27

Focal Seizures of ➕ in MENINGITIS indicates

Answer 27

Encephalopathy

Question 28

Meningism
Meaning

Answer 28

Classical constellation of symptoms and signs associated with irritation of the meninges.

Question 29

INTERMITTENT NECK STIFFNESS IS CHARACTERISTIC FEATURE OF

Answer 29

Arnold Chiari Malformation

Question 30

Causes of NECK STIFFNESS

Answer 30

1. Meningism
   ✨ MENINGITIS
   ✨ SUB ARACHNOID HEMORRHAGE (SAH)
2. MENINGISM Mimics
   ✨ Cervical Spondylosis
   ✨ After Cervical Fusion
   ✨ Impending TONSILLAR HERNIATION (⬆️ ICP)
   ✨ Acute DYSTONIC Reaction
   ✨ Tetanus
   ✨ Strychnine Poisoning
3. INTERMITTENT: Arnold Chiari Malformation

Question 31

Imaging before LUMBAR PUNCTURE is done i

Question 32

NON-INFECTIVE CAUSES OF MENINGITIS
🧠⚡C²DS⚡

Answer 32

1. Carcinomatous
2. CTD
3. Drugs
4. Substances injected into SAH

Question 33

Causes of CARCINOMATOUS MENINGITIS

Answer 33

1. Leukemia
2. Lymphoma
3. Myeloma
4. Melanoma
5. Breast Cancer
6. Lung cancer

Question 34

CTDs causing MENINGITIS

Answer 34

1. Behcet’s
2. SLE
3. Sarcoidosis
4. Rheumatoid arthritis
5. Sjogren’s

Question 35

DRUGS causing MENINGITIS

Answer 35

Sulphasalazine
Cyclosporine
Azathioprine

Question 36

Types of MENINGITIS based on HERNIATION

Answer 36

🎯 UNCOMPLICATED MENINGITIS
✨ Raised ICT ➕ NO IMPENDING HERNIATION
✨ Lumbar PUNCTURE DONE

🎯 COMPLICATED MENINGITIS
✨ RAISED ICT ➕ IMPENDING HERNIATION
✨ Lumbar PUNCTURE 🚫 CONTRAINDICATION