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Neurology > Meningitis > Flashcards

Meningitis Flashcards

1
Q

a collection of cells surrounding a group of capillaries in each ventricle that produces the CSF

A

choroid plexus

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2
Q

which 2 structures are infected and inflamed in meningitis?

A

meninges
subarachnoid space

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3
Q

what organism in most common in a patient between 18-50 years old?

A

strep pneumo.

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4
Q

what organism would we suspect in a patient between 18-50 yo who lives in a crowded area?

A

neisseria meningitis

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5
Q

what organism could be the cause of meningitis in a patient over 50 who was infected by a co-morbid infection?

A

strep pneumo.

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6
Q

what organism could be the cause of meningitis in a patient over 50 who lives in a crowded area?

A

Neisseria

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7
Q

what organism is a concern in a patient who is over 50 yo and has had suspicious food?

A

listeria mono.

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8
Q

what 3 organisms would we expect in a patient who is post-surgical or post-trauma?

A

gram negative
strep pneumo
staph aureus

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9
Q

what 3 organisms would we expect in a patient who is immunocompromised, HIV, has alcoholism, or uses steroids?

A

gram negative
strep pneumo
listeria mono.

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10
Q

what are the 3 etiologies of chronic meningitis?

A

mycobacterium TB
atypical bacteria
fungi

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11
Q

in a viral meningitis, what do we worry about?

A

HSV

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12
Q

what is the classic triad of symptoms in meningitis?

A

fever
headache
neck stiffness

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13
Q

what are 3 parts of the physical exam that would point to meningitis?

A

Kernig sign
Brudzinski sign
AMS

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14
Q

a patient presents within 2 days of symptom onset and has the classic presentation of fever, headache, and neck stiffness. what is the type of meningitis?

A

bacterial (acute)

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15
Q

a patient presents months after onset with focal neurological signs, strokes, seizures, and cranial nerve deficits. what is the type of meningitis?

A

chronic

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16
Q

a patient presents days-1week after onset with headache and fever. what is the type of meningitis?

A

viral

17
Q

what 4 diagnostics should we order for meningitis?

A

Head CT
LP + CSF culture
blood culture
CBC

18
Q

what should we order if we are concerned about contaminated injection as a source of infection?

A

MRI with contrast of injection site

19
Q

CSF findings show increased neutrophils, low glucose, high protein, and markedly elevated opening pressure. what is the type of meningitis?

A

bacterial meningitis

20
Q

CSF findings show increased lymphocytes, low glucose, high protein, and moderately elevated opening pressure. what is the type of meningitis? (2)

A

mycobacterial or fungal

21
Q

CSF findings show increased lymphocytes, normal glucose, high protein, and normal-elevated opening pressure. what is the type of meningitis?

A

spirochetal meningitis

22
Q

CSF findings show increased lymphocytes, normal-low glucose, high protein, and slightly elevated opening pressure. what is the type of meningitis?

A

viral meningitis

23
Q

what should be done before obtaining blood or CSF?

A

IV empiric therapy

24
Q

what is the treatment for a 2-50 yo patient with bacterial meningitis? (2)

A

vancomycin
+
cefotaxime OR ceftriaxone

25
Q

what is the treatment for a patient over 50 yo with bacterial meningitis? (3)

A

vancomycin
+
ampicillin
+
cefotaxime OR ceftriaxone

26
Q

what is the treatment for a immunocompromised patient with bacterial meningitis? (3)

A

vancomycin
+
ampicillin
+
cefepime

27
Q

what is the treatment for a post-surgical/post-trauma patient with bacterial meningitis? (2)

A

vancomycin
+
cefepime

28
Q

what treatment should be given at the same time as the first dose of antibiotics, for bacterial meningitis if bacteria is unknown or strep pneumo is confirmed?

A

IV dexamethasone

29
Q

what are 3 considerations for transitioning to outpatient therapy?

A

inpatient therapy > 6 days
no fever for at least 24-48 hours
no significant neuro dysfunction

30
Q

what is the treatment for viral meningitis?

A

supportive care

31
Q

what is the treatment for fungal meningitis?

A

IV amphotericin B x 11-21 days

32
Q

what is the treatment for syphilis meningitis? (2)

A

IV aqueous penicillin x 10-14 days

THEN

IM benzathine pen G 1/week x 3 weeks

33
Q

what is the treatment for lyme disease meningitis? (2)

A

IV ceftriaxone x 2-4 weeks
+/- dexamethasone

34
Q

what is the treatment for TB meningitis?

A

IM/PO Isoniazid x 6-18 months

35
Q

what is the complication of DIC associated with?

A

meningococcal meningitis

36
Q

what can cause hearing loss in a patient with meningitis?

A

inflammation of cochlear aqueduct (CN VIII)

Neurology (22 decks)

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