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STG 2017 > MENINGITIS > Flashcards

MENINGITIS Flashcards

1
Q

Type of meningitis common in Nothern and Upper regions of Ghana

A

Cerebrospinal meningitis (CSM)

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2
Q

Which season is CSM most common

A

Harmattan season

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3
Q

Causative agent for cerebrospinal meningitis

A

Neisseria meningitides

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4
Q

Bacterial causes of meningitis

A

Neisseria meningitides
Streptococcus pneumoniae
Haemophilus influenza
Mycobacterium tuberculosis
Staphylococcus aureus
Escherichia coli (neonates)

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5
Q

Viral causes of meningitis

A

Herpes virus

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6
Q

Protozoal causes of meningitis

A

Toxoplasma gondii in HIV

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7
Q

Fungal causes of meningitis

A

Cryptococcus neoformans

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8
Q

Symptoms of meningitis in children less than 1year

A

Fever
Vomiting
Irritability
Refusal to eat
Poor suckling
Focal or generalized convulsions after which the child is sleepy
Lethargy
Bulging fontanelle

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8
Q

Signs of meningitis in adults and children over 5 years

A

Fever
Neck stiffness
Kernig’s sign
Altered consciousness
Coma

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9
Q

Symptoms of meningitis in adults and children over 5 years

A

Fever
Neck pains
Severe headache
Photophobia
Convulsions
Vomiting

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9
Q

Symptoms that occur in both children and adults

A

Fever
Vomiting

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10
Q

Signs of meningitis in children less than 1 year

A

Neck retraction
Hypotonia or hypertonia
Bulging fontanelle

Presence or absence of neck stiffness
Presence or absence of fever

Coma
Convulsion

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10
Q

Investigations in meningitis

A

FBC
RDT for malaria
Blood film for malaria
Lumbar puncture
Blood culture and sensitivity

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10
Q

Signs of meningitis that is present only in children under 1 year

A

Bulging fontanelle
Hypotonia or hypertonia
Neck retraction

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11
Q

Signs of meningitis that can be present or absent in children less than 1 year

A

Fever
Neck stiffness

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12
Q

Non-pharmacological interventions

A

Tepid sponging
Keep the airway clear
Nasogastric tube feeding if applicable

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12
Q

Lumbar puncture is done only after excluding……………..

A

Increased intracranial pressure

13
Q

Second line treatment for bacterial meningitis

A

IV Cefotaxime and IV Vancomycin

13
Q

First line treatment for bacterial meningitis

A

IV Ceftriaxone and IV Vancomycin

or

IV Benzylpenicillin and IV Chloramphenicol

or in penicillin allergy

IV Clindamycin and IV Chloramphenicol

14
Q

Prophylaxis for cerebrospinal meningitis

A

Tab Ciprofloxacin
or
IM Ceftriaxone

15
Q

Dose of ciprofloxacin for prophylaxis of CSM

A

Adults
500 mg as a single dose

Children
5-12 years; 250 mg as a single dose

15
Q

Role of steroids in meningitis

A

Dexamethasone started together with the first dose of the appropriate antibiotic has been found to lead to major reduction in hearing loss and death in both children and adults.

16
Q

Dose of dexamethasone in bacterial meningitis

A

IV Dexamethasone 4-10 mg 6hourly for 5-7 days

17
Q

Dose of ceftriaxone for prophylaxis of CSM

A

Adults
250 mg as a single dose

Children
< 12 years; 125 mg as a single dose

18
Q

Dose for IV vancomycin in Bacterial meningitis

A

Adults and children over 2 years:
15 mg/kg 12 hourly for 7-10 days

1 month-2 years; 15 mg/kg 8 hourly for 10-14days

< 1 month; not recommended

19
Q

IV Cefotaxime dose used in Bacterial meningitis

A

Adults
2g 6 hourly for 7 days

Children
> 12 years or body weight > 50kg; 2 g 6 hourly

< 12 years or body weight < 50kg; 50 mg/kg 6 hourly

20
Q

Dose for IV Clindamycin in bacterial meningitis

A

Adults
600-900 mg 8 hourly for 14 days

Children
13 mg/kg 8 hourly for 14 days

20
Q

IV Chloramphenicol dose in bacterial meningitis

A

Adults
1g 6 hourly for 14 days

Children
25 mg/kg 6 hourly for 14 days

21
Q

Dose for IV/IM Ceftriaxone in bacterial meningitis

A

Adults
2-4 g daily for 7-10 days

Children
> 12 years; 2-4 g daily for 7-10 days

< 12 years; 50-80 mg/kg for 10-14 days

Neonates; 20-50 mg/kg once daily for 21 days

22
Q

Dose for benzylpenicillin in bacterial meningitis

A

Adults
4 MU 4 hourly for 14 days

Children
0.2 MU/kg 6 hourly for 14 days

23
Q

Dose for IV chloramphenicol in bacterial meningitis

A

Adults
1 g 6 hourly for 14 days

Children
25 mg/kg 6 hourly for 14 days

24
Q

Dose for IM Chloramphenicol in bacterial meningits

A

Adults
100 mg/kg as a single dose

Children
100 mg/kg as a single dose

25
Q

Chloramphenicol is not used in these populations….

A

Children below 2 months
Pregnancy
Lactation

26
Q

Most likely pathogens for bacterial meningitis in adults under 50 years

A

Meningococcus
Pneumococcus
Haemophilus Influenza

27
Q

Most likely pathogens for bacterial meningitis in adults over 50 years

A

Pneumococcus
Listeria
Gram-negative bacilli

28
Q

Most likely pathogens for hospital acquired meningitis

A

Staphylococci,
Gram-negative bacilli
Pneumococcus
Pseudomonas

29
Q

First line antibiotics for managing meningitis in patients under 50 years

A

Ceftriaxone
And
Vancomycin

30
Q

Alternative antibiotics for managing meningitis in people under 50 years

A

Cefotaxime
Meropenem
Fluoroquinolones

31
Q

First line antibiotics for managing meningitis in patients over 50 years

A

Ceftriaxone
Or
Ampicillin
And
Vancomycin

32
Q

Alternative antibiotics for managing meningitis in patients over 50 years

A

Fluoroquinolones

32
Q

First line antibiotics for managing hospital acquired meningitis

A

Ceftazidime with/without Gentamycin

33
Q

Alternative antibiotics for managing hospital acquired meningitis

A

Meropenem
Vancomycin

STG 2017 (88 decks)

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