Meningitis

Question 1

Give the 5 most common bacteria that cause meningitis:

Answer 1

1) Neisseria meningitidis
2) Streptococcus pneumonia
3) Haemophilus influenzae
4) Group B Strep (Strep. agalactiae)
5) Listeria monocytogenes

Question 2

What two bacteria are associated with bacterial meningitis in neonates?

Answer 2

1) Group B Strep
2) Listeria monocytogenes

Question 3

Is N. meningitidis gram positive or gram negative?

Answer 3

gram negative

Question 4

What is meningococcal meningitis?

Answer 4

N. meningitidis bacterial infection of the meninges and cerebrospinal fluid

Question 5

What is meningococcal septicaemia?

Answer 5

when the N. meningitidis bacteria infection is in the blood stream (here, you will see the non-blanching rash)

Question 6

Give the 3 most common viral causes of meningitis:

Answer 6

1) Enteroviruses e.g. Coxsackie virus
2) Herpes simplex virus
3) Varicella zoster virus

Question 7

What drug is used to treat viral meningitis?

Answer 7

aciclovir

Question 8

What test can be done on a CSF sample to check for viral meningitis?

Answer 8

viral PCR

Question 9

Give 7 symptoms associated with meningitis:

Answer 9

1) fever
2) photophobia
3) headache
4) seizures
5) vomiting
6) neck stiffness
7) altered consciousness

Question 10

In what disease would meningitis present with a non-blanching rash?

Answer 10

meningococcal septicaemia

Question 11

Give 4 meningitis signs and symptoms seen in neonates:

Answer 11

1) hypotonia (absence of muscle tone)
2) poor feeding
3) lethargy
4) bulging fontanelle

Question 12

Name two special tests for meningitis:

Answer 12

1) Kernig’s test
2) Brudzinski’s test

Question 13

Describe Kernig’s test for meningitis:

Answer 13

lay the patient on their back and flex one hip and knee to 90 degree - then slowly straighten the knee while the hip is flexed - this will stretch the meninges and create pain and resistance in meningitis

Question 14

Describe Brudzinskii’s sign for meningitis:

Answer 14

lay the patient flat on their back and gently lift their head - in meningitis, the patient will involuntarily flex their knees and hips

Question 15

At which vertebral level does the spinal cord end?

Answer 15

L1/L2

Question 16

At what vertebral level is a lumbar puncture need inserted?

Answer 16

L3/L4

Question 17

What blood sample is sent off along CSF analysis in meningitis to allow for comparison?

Answer 17

Blood glucose

Question 18

Describe the appearance of bacterial CSF:

Answer 18

Cloudy

Question 19

Describe the appearance of viral CSF:

Answer 19

Clear

Question 20

Is CSF protein level high, low or normal in bacterial meningitis?

Answer 20

high

Question 21

Is CSF protein level high, low or normal in viral meningitis?

Answer 21

normal (maybe slightly raised)

Question 22

Is CSF glucose high, low or normal in bacterial meningitis?

Answer 22

Low

Question 23

Is CSF glucose high, low or normal in viral meningitis?

Answer 23

normal

Question 24

What white cells are abundant in bacterial meningitis CSF?

Answer 24

neutrophils

Question 25

What white cells are abundant in viral meningitis CSF?

Answer 25

lymphocytes

Question 26

True or false: bacterial meningitis is a medical emergency

Answer 26

true

Question 27

What drug should children with suspected meningitis and a non-blanching rash be given in primary care while awaiting transfer to hospital?

Answer 27

IM/IV benzylpenicillin

Question 28

What blood test should be completed if meningococcal infection is suspected?

Answer 28

meningococcal PCR (tests for N. meningitidis DNA and is often faster than blood cultures)

Question 29

What antibiotics should be given to bacterial meningitis patients under 3 months?

Answer 29

1) cefotaxime 2) amoxicillin

Question 30

What antibiotic should be given to bacterial meningitis patients above 3 months?

Answer 30

Cefotaxime

Question 31

What additional antibiotic should be given if penicillin-resistant pneumococcal infection is suspected in bacterial meningitis?

Answer 31

vancomycin

Question 32

What drug class can be given to reduce the risk of complications such as hearing loss and neurological deficit in bacterial meningitis?

Answer 32

steroids (e.g. dexamethasone)

Question 33

True or false: bacterial meningitis and meningococcal infection are notifiable diseases to the UK Health Security Agency

Answer 33

True

Question 34

What drug should be given to people who have been in close contact with a meningococcal patient within 7 days before the onset of their illness as post-exposure prophylaxis?

Answer 34

single dose ciprofloxacin

Question 35

Give 5 potential complications of meningitis:

Answer 35

1) hearing loss (common) 2) seizures and epilepsy 3) cognitive impairment and learning disability 4) memory loss 5) focal neurological deficits such as limb weakness of spasticity