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w222 Meningitis > Meningitis > Flashcards

Meningitis Flashcards

1
Q

What symptoms would prompt urgent action in a case of suspected meningitis?

A

If the patient has 2 of the following symptoms and is not yet in hospital administer benzylpenicillin 1.2g IM/IV

  • Headache
  • Pyrexia
  • Neck stiffness
  • Altered mental state
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2
Q

What is the glass test in suspected meningitis testing for?

A

Septicamic petechiae

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3
Q

What are the early symptoms of Meningitis?

A
  • Headache
  • Leg pains
  • Cold hands and feet
  • Abnormal skin colour
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4
Q

If in a case of meningitis there are signs of raised intracranial pressure, what do you do?

A

Summon help immediately and inform the neurosurgeons

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5
Q

What is the treatment for meningitis for children less than 3 months and adults older than 55 yrs?

A

Cefotaxime + Ampicillin/Amoxicillin

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6
Q

What is the treatment for meningitis in children and adults <55 yrs?

A

Cefotaxime

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7
Q

What does the amipicillin/amoxicillin in the treatment of children <3 months and adults over 55yrs cover?

A

Listeria monocytogenes

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8
Q

What are the 2 signs that can be looked for in a suspected case of meningitis?

A

Kernigs sign and brudzinskis sign

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9
Q

What is brudzinskis sign?

A

Sever neck stiffness causes the patients hips and knees to flex when their neck is flexed

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10
Q

What is kernigs sign?

A

Severe stiffness of the hamstring causes an inability to straighten the leg when the hip is flexed to 90°

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11
Q

What are 4 later stages of meningitis?

A
  • Meningism → Neck stiffness, Photophobia, kernigs sign
  • ↓ Conscious lvl
  • Seizures → ± focal CNS signs ± opisthotonus
  • Petechial rash → May be only 1 or 2 spots
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12
Q

What do you give a patient in suspected viral meningitis?

A

Aciclovir

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13
Q

What is the main contraindication for a lumbar puncture in suspected meningitis?

A

Raised intracranial pressure

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14
Q

What are the NICE recommended first line investigations for suspected Meningitis?

A
  • full blood count
  • CRP
  • coagulation screen
  • blood culture
  • whole-blood PCR
  • blood glucose
  • blood gas
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15
Q

When would you do a lumbar puncture?

A
  • Usually after a CT head

* BUT if GCS 15, no symptoms of raised intracranial pressure and no focal neurological deficit then can be done without.

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16
Q

What is viral meningitis often called?

A

Aseptic meningitis

17
Q

What are the 3 most common causative agents of meningitis in children <3 months old?

A
  • Group B Streptococcus (most common cause in neonates)
  • E. coli
  • Listeria monocytogenes
18
Q

What are the most common causative agents of Meningitis in children aged 3 months - 6 yrs?

A
  • Neisseria meningitidis
  • Streptococcus pneumoniae
  • Haemophilus influenzae
19
Q

What are the most common causative agents of Meningitis in patients aged 6 yrs - 60 yrs?

A
  • Neisseria meningitidis

* Streptococcus pneumoniae

20
Q

What are the most common causative agents of meningitis in patients aged over 60yrs?

A
  • Streptococcus pneumoniae
  • Neisseria meningitidis
  • Listeria monocytogenes
21
Q

What is the main causative agent in meningitis in patient who is immunosuppresed?

A

Listeria monocytogenes

22
Q

What would you find in bacterially infected CSF?

A
  • Cloudy appearance
  • ↓ glucose → < 1/2 blood glucose score
  • ↑ protein → High (> 1 g/l)
  • ↑↑ White cell count → 10 - 5,000 polymorphs/mm³
23
Q

What would you find in a virally infected CSF?

A
  • Clear cloudy appearance
  • reduced glucose → 60-80% predicted
  • Normal/raised protein
  • ↑ Whitebloodcells → 15 - 1,000 lymphocytes/mm³
24
Q

What would you find in tuberculous Meningitis CSF?

A
  • Slight cloudy, fibrin web appearance
  • ↓ glucose → < 1/2 blood glucose score
  • ↑ Protein → High (> 1 g/l)
  • ↑ Whitebloodcells → 10 - 1,000 lymphocytes/mm³
25
Q

What are 3 signs of raised intracranial pressure?

A
  • focal neurological signs
  • papilloedema
  • significant bulging of the fontanelle
  • disseminated intravascular coagulation
  • signs of cerebral herniation
26
Q

What is used as prophylaxis in people with exposure to meningococcal meningitis?

A

Ciprofloxacin or rifampicin

w222 Meningitis (2 decks)

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