Meningitis

Question 1

define meningism

Answer 1

symptom complex of:
headache
photophobia
vomiting 
muscle spasm

Question 2

what can meningism be caused by?

Answer 2

> meningitis
subarachnoid haemorrhage
infection by bacteraemia
viral infection

Question 3

define meningitis

Answer 3

infection of the meninges

Question 4

what are the main causes of bacterial meningitis?

Answer 4

> Neisseria meningitidis

> streptococcus pneumonia

Question 5

what are the main causes of bacterial meningitis in neonates?

Answer 5

> e. coli

> group b streptococci

Question 6

what enteroviruses cause meningitis?

Answer 6

> echovirus
parechoviruses
coxsackie a and b viruses
polio

Question 7

what other viruses can causes meningitis?

Answer 7

> mumps

> herpes simplex

Question 8

what non-infection causes of meningitis are there?

Answer 8

> tumour
drug reactions
sacrcoidosis

Question 9

in shunt associated meningitis would you expect the course to be low or high grade?

Answer 9

low grade

Question 10

what signs and symptoms may meningitis present with?

Answer 10

> vomiting
> headache
> photophobia
> neck stiffness
> fever
> altered consciousness

Question 11

in what patients may meningitis presentation be subtle?

Answer 11

> elderly
neonates
infants
immunocompromised

Question 12

for how long are signs and symptoms present in acute meningitis?

Answer 12

less than 24 hours and rapidly progressive

Question 13

in subacute meningitis how long would you expect signs and symptoms to be present for?

Answer 13

1-7 days

Question 14

what are the risk factors for meningitis?

Answer 14

> skull trauma
alcoholism
diabetes mellitus
contact with an infected person

Question 15

what is kernigs sign?

Answer 15

this is when the patients hip is flexed and they cannot straighten their leg due to hamstring spasm

Question 16

if there is papilledema/focal signs what should you do before taking a lumbar puncture?

Answer 16

a head ct

Question 17

name that meningitis:
CSF findings:
> turbid appearance
> cell number greatly increased
> neutrophils are predominant cell
> glucose is reduced
> protein is greatly increased

Answer 17

bacterial meningitis

Question 18

Name that meningitis
CSF findings:
> clear/turbid appearance
> lymphocytes are the predominant cell
> normal glucose
> moderately increased protein

Answer 18

viral meningitis

Question 19

Name that meningitis
CSF findings
> clear-turbid appearance
> mixed cell type/lymphocyte
> reduced glucose
> greatly increased protein

Answer 19

tuberculosis meningitis

Question 20

what would a xanthochromic specimen suggest?

Answer 20

a subarachnoid haemorrhage

Question 21

what antibiotics would you give to treat acute bacterial meningitis?

Answer 21

> BENZYLPENICILLIN (4 hour regular doses)

> ceftriaxone

Question 22

what management reduces death rate in acute bacterial meningitis?

Answer 22

> AB prophylaxis of close contacts
> rapid detection of the pathogen
> early clinical recognition
> rapid initiation of antibiotic therapy
> early recognition and management of septicaemia and sequelae

Question 23

what predisposing factors exist for neonatal meningitis?

Answer 23

> low birth weight
prolonged rupture of the membranes
maternal diabetes mellitus