Meningitis

Question 1

What is the definition of meningitis?

Answer 1

This is inflammation of the meninges

Question 2

What cells are seen in the CSF of meningitis?

Answer 2

White cells

Question 3

What is the pathology of meningitis?

Answer 3

Attachment to the mucosal epithelium, transgression of barrier, survival in the bloodstream, entry into CSF production of overt infection +/- encephalitis

Question 4

What is the most common cause of meningitis in children and young people?

Answer 4

Neisseria Meningitides

Question 5

What is the most comm causative organism in adults?

Answer 5

Streptococcus Pneumonaie

Question 6

What other bacteria can cause meningitis?

Answer 6

H.Influenzae
Listeria monocytogenes
E.coli
Strep pyogenes

Question 7

What viruses can cause meningitis?

Answer 7

Enterovirus
Mumps
HSV

Question 8

What fungus can cause meningitis?

Answer 8

Cryptococcus

Question 9

What are the key symptoms of meningitis?

Answer 9

Headache
Neck stiffness
Photophobia 
Nun-blanching purpuric rash 
Nausea and Vomiting 
Fever
LOC
Cranial Nerve palsies 6,7,8
Tachy/bradycardia
Hypotension

Question 10

What is the examination test to do in meningitis?

Answer 10

Kerning’s Sign = hip flexed and the patient can’t straighten their leg du to hamstring spasm

Question 11

What are the 2 key investigations in meningitis?

Answer 11

Lumbar puncture

Blood cultures

Question 12

If the CSF shows the following, what type of meningitis is present?
Clody, low glucose
High protein
Polymorphs

Answer 12

Bacterial

Question 13

If the meningitis is viral in origin then what is the CSF results?

Answer 13

Usually clear
High glucose
Protein can be normal or raised
Mononuclear

Question 14

If the CSF results show this then what type of meningitis is present?
Slightly cloudy or fibrin web 
Mononuclear
Low glucose 
High protein

Answer 14

Tuberculosis

Question 15

What is the initial management of meningitis?

Answer 15

Benzylpenicillin 4hrly

Question 16

If the meningitis is confirmed bacterial, then what antibiotic will you use?

Answer 16

Ceftriaxone

Question 17

What additional medication will you use?

Answer 17

Dexamethasone - reduces long term complications

Question 18

What are the associated conditions with meningitis?

Answer 18

Recent Skull Trauma
Alcoholism
DM

Question 19

If a family member has also recently had meningitis then what is the MORE likely cause?

Answer 19

Meningococcal

Question 20

What antibiotic covers Listeria monocytogenes?

Answer 20

Ampicillin

Question 21

What medication will cover the viral causes of meningitis?

Answer 21

Aciclovir

Question 22

What medication will cover the fungal causes of meningitis?

Answer 22

Amphotericin with Fluconazole

Question 23

What are 4 common causes of NEONATAL MENINGITIS?

Answer 23

Group B streptococcus
E.coli
Listeria Monocytogenes
Enterovirus

Question 24

What are the symptoms of neonatal meningitis?

Answer 24

Onset within 3 days of birth 
Prematurity 
Failure to thrive
Problems ending 
Bacteraemia 
Respiratory distress 
Acquired at birth form mothers genital tract

Question 25

Whta is the treatment of bacterial neonatal meningitis?

Answer 25

Parental AMPICILLIN and GENTAMICIN or CEFOTAXIME

Question 26

What is the prevention options for meningitis?

Answer 26

AMOXICCILLIN or CO-AMOXICLAV for high risk mothers

Question 27

What is the mortality for neonatal meningitis?

Answer 27

50%

Question 28

What is PURPURA in the febrile child diagnosed as until proven otherwise?

Answer 28

Bacterial meningits

Question 29

What is a cynical feature of meningitis in the child regarding the head?

Answer 29

Bulging fontanelle