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COMMUNITY DSE. 1 > MENINGITIS > Flashcards

MENINGITIS Flashcards

1
Q

Is an inflammation of the fluid and membranes (meninges) surrounding brain and spinal cord.

A

Meningitis

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2
Q

The inflammatory response to infection in meningitis causes

A

Increased ICP

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3
Q

3 Meninges of the brain and spinal cord

A

Dura, arachnoid, pia

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4
Q

Normal CSF pressure

A

0-15 mmHg

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5
Q

Normal CSF glucose

A

50-80 mg/dl (Decreased during increased ICP)

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6
Q

Normal CSF protein

A

20-50 mg/dl (Increased during increased ICP)

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7
Q

Normal specific gravity

A

1.007

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8
Q

Causative organisms of Meningitis

A

Streptococcus pneumoniae
Haemophilus influenzae
Neisseria meningitidis

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9
Q

Classification of meningitis

A

Bacterial

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10
Q

Mode of transmission of meningitis

A
  • Droplet
  • Direct contact
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11
Q

Incubation period of meningitis

A

2-10 days

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12
Q

Average incubation period of meningitis

A

6-7 days

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13
Q

Diagnostic test

A

Lumbar tap

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14
Q

definitive diagnosis of meningitis: to collect cerebrospinal fluid (CSF)

A
  • Lumbar tap
  • spinal tap
  • lumbar puncture
  • Thecal puncture
  • Rachiocentesis
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15
Q

Position during lumbar tap

A
  • Knee-chest
  • fetal pos.
  • side-lying pos
  • sitting or leaning forward
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16
Q

Number of test tubes and ml for lumbar tap

A

3 test tubes; 2-3 ml

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17
Q

Position after lumbar tap

A

Flat on bed for 6-8 hours

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18
Q

Test for spinal blockage or subarachnoid obstruction of the subarachnoid space, done before lumbar tap

A

Queckenstedt’s test

also known as lumbar manometric test performed
by compressing the jugular veins for 10 seconds on each side of the neck during the lumbar puncture

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19
Q

Pathognomonic sigs of meningitis

A
  1. Nuchal rigidity
  2. Kernig’s sign
  3. Brudzinski’s sign
20
Q

Other s/sx for meningitis

A
  1. Opisthotonus
  2. Decortication
  3. Decerebration
21
Q

Signs of increased ICP
CADDHNPS

A
  • Cushing’s triad
  • Anisocoria
  • Diplopia
  • Doll’s eyes sign
  • High temperature and chills
  • Nausea and vomiting
  • photophobia
  • seizures
22
Q

CUSHING’S TRIAD

A

Hypertension, bradycardia, bradypnea

23
Q

Anisocoria

A

Unequal pupils
CN III- Oculomotor

24
Q

Diplopia

A

Double vision
CN VI- Abducens
Longest cranial nerve (prone to compression)

25
Q

Doll’s eye sign

A

Disconjugate eye (cover eye with cloth)

26
Q

Management of increased ICP:
Position

A

Semi- fowler (drain CSF fluid)

27
Q

Management of increased ICP:
HOB Elevation

A

30-45 degree
(>90 degree= brain herniation lead to swelling and bleeding)

28
Q

Management of increased ICP:
Safety

29
Q

Management of increased ICP:
Limit fluid intake

A

Decrease CSF

30
Q

Management of increased ICP:
REST

A

Any strenuous act can stimulate seizure and convulsion

31
Q

Management of increased ICP:
Avoid factors that increase ICP

A

AVOID: bending, stooping, valsalva maneuver, blowing of nose, sneezing, laxative, enema

32
Q

Pharmacologic mgt for meningitis

A
  1. OSMOTIC DIURETIC
  2. CORTICOSTEROIDS
  3. ANTICONVULSANTS
  4. ANTACIDS
33
Q

Osmotic diuretic mgt for meningitis

A

Mannitol (decrease cerebral edema)

WOF: hypotension and dizziness

34
Q

Corticosteroids/Glucocorticoids mgt for meningitis

A

Dexamethasone/ Decadron

Crosses blood brain barrier

35
Q

Anticonvulsants mgt for meningitis

A

Phenobarbital: Phenytoin/Dilantin

Causes: GI upset, nystagmus, ataxia, red urine

36
Q

Antacids mgt for meningitis

A

H2 receptor blockers

37
Q

Collaborative Management
Bed rest for meningitis

A

dark room (prevent seizure) and cool cloth over eyes (photosensitivity)

38
Q

Collaborative Management
Antibiotics IV for meningitis

A

Pen. G./ Ceftriaxone/ Ampicillin

39
Q

Collaborative Management
For severe headache for meningitis

A

Codeine (Opioid Analgesic)

SE: drowsiness and constipation

40
Q

Collaborative Management
Temp above 38 degree C

A

Antipyretics

41
Q

Collaborative Management for meningitis to prevent seizures

A

Phenytoin/Dilantin

42
Q

Common SE of Phenytoin/Dilantin

A

Gingival hyperplasia

43
Q

PHENYTOIN THERAPY
IF GIVEN P.O. , ADMINISTER _______ MEALS

A

With

to prevent GI upset

44
Q

IF PHENYTOIN IS GIVEN PER IV, PREPARE ______NSS.WHY?

A

10 ml NSS; crystalizes in the vein (5ml NSS —> MEDS —> 5 ml NSS

45
Q

SE OF PHENYTOIN/DILANTIN
(GNARGB)

A

G - GI upset
A- ataxia
N- nystagmus
RU- red urine
Gingival hyperplasia
BMD- bone marrow depression (plastic anemia)

46
Q

PATHOGENESIS

A
  1. Nasopharyngeal colonization of the bacteria (causative agents: S,H,N)
  2. Invasion in the bloodstream (bacteremia)
  3. Bacteria will invade the meninges
  4. Bacterial multiplication in the subarachnoid and ventricular space
  5. Cytokines & chemokines
  6. Neutrophil invasion
  7. Blood brain barrier breakdown & increase of CSF outflow resistance
  8. Edema
  9. Increase ICP- signs of increased ICP

COMMUNITY DSE. 1 (19 decks)

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