Meningitis Flashcards

1
Q

Age meningitis

A

children <5 (due to undeveloped immune system) but also hits over 65’s (poorly functioning immune system) and 19-25 yrs (due to different social behaviour)

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2
Q

How are bacteria transferred?

A

Through secretions of nose/throat

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3
Q

incubation period

A

1-3 days

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4
Q

skin rash is associated with….

A

septicemia by N. meningitidis

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5
Q

1st line blind treatment

A
benzyl penicillin (pen G) IV
OR
high dose 3rd gen ceph
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6
Q

What are your 3rd gen cephs used?

A

IV ceftriaxone

IV cefotaximine

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7
Q

1st line if pen allergic

A

Chloramphenicol qds

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8
Q

Why not intrathecal admin?

A

Has to be made up especially as cannot contain preservatives

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9
Q

Advantage of bezyl pen

A

broad spec
rapid absorb
non-toxic in high conc
penetration to CSF

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10
Q

Most common causative organism

A

Neisseria meningitidis

80%

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11
Q

Most common strains on Neisseria meningitidis

A
Type B (80-90%)
Type C (10%)

Type A, Y, W135 vaccines

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12
Q

Neisseria meningitidis pt group

A

<5

19-25

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13
Q

2 other common species

A
Streptococcus pneumoniae (65)
Haemophilus influenzae B  (now there are vaccines) (<5)
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14
Q

Add a steroid to…

e.g.

A

reduce inflammation (dexamethasone) - beta lactams cause cell lysis and LPS and cell products are released - inflam resposnse

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15
Q

MOA chloramphenicol

A

inhibit protein synthesis, bind to 50S subunit

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16
Q

MOR chloramphenicol

A
  1. plasmid encoded chloramphenicol acetyltransferase gene (acetylates cholam gene so can no longer bind to ribosome)
  2. Also reduced uptake
17
Q

MOA penicillins

A

inhibit cell wall synthesis (prevent x linking of PG chain)

18
Q

MOR

A
  1. beta lactamases
  2. altered PBP (lower af)
  3. Reduced perm due to porin mutations (gram -ve)
19
Q

If pen resistant S. pneumoniae suspected treat with

A

Rifampicin or vanc

20
Q

MOA Vanc

A

Inhibit cell wall synth (bind to terminal on 2 amino acids in peptide side chain, prevents incorporation of PG monomers into the PG chain)

21
Q

MOR Vanc

A

Dala Dala to Dala Dlac - reduces binding of vanc

22
Q

Prophylaxis for N meningitidis? - WHO

A

Close relatives - prolonged contact

23
Q

Prophylaxis for N meningitidis? TREATMENT

A

-Rifampicin 600mg bd 2 days
OR
-Ciprofloxacin 500mg stat

24
Q

Prophylaxis for S pneumoniae?

A

Nein, danke

25
Q

Prophylaxis for H. Influenzae B?

A

If pt is unvaccinated child < 4 whole household given Rifampicin

(most children are vaccinated at 4 months)

26
Q

What vaccines are available

A

H influ Type B
N menig Type C
P. pnmoae PVC

27
Q

Why does viral have a lower inflammatory response?

A

Virus is usually present in cells and not visible to phagocytic macrophages

28
Q

Common viruses

A

enterococcus
coxsackie
Herpes simplex

29
Q

Treatment for fungal

A

Amphotericin, flucytosine and fluconazole

30
Q

Causative fungi

A

C. albicans
cryptococcus neoforms
histoplasma