Meningitis and Encephalitis Flashcards

1
Q

Even with ABx therapy & imaging, condition still carries a ~
___% mortality rate.

A

14

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2
Q

Meningitis typically occurs through what two routes of inoculation?

A

(a) Hematogenous seeding
(b) Direct contiguous spread

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3
Q

What route of meningitis inoculation?
Organisms enter CSF via neighboring anatomic structures (otitis media, sinusitis) or foreign objects (medical devices, penetrating trauma).

A

Direct contiguous spread

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4
Q

What route of meningitis inoculation?
Bacteria colonize in nasopharynx & enter bloodstream. Upon making their way to the subarachnoid space, the bacteria cross the blood-brain barrier, causing a direct inflammatory and immune-mediated reaction.

A

Hematogenous seeding

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5
Q

What is the Classic Meningeal Tetrad

A

Fever, nuchal rigidity, altered mental status, & severe headache

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6
Q

True/False
However, the presence of all four signs of meningitis is necessary for clinical diagnosis;

A

False
patients may only have 2-3 out of the 4 signs.

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7
Q

Meningitis
What should be done prior to lumbar puncture and CSF collection?

A

CT

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8
Q

What comprises the foundation of meningitis management/treatment

A

Managing airway
maintaining oxygenation
sufficient IV fluids
controlling fever

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9
Q

Meningitis Antibiotic Treatment:

A

(a) Ceftriaxone 2g IV Q12H x 7 days
(b) Pen-G 4 million units IV Q4H x 7 days

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10
Q

Steroids
Administration of ________________ IV is associated with reduction in rate of hearing loss, neurologic complications, and decreased mortality rates.

A

dexamethasone 4mg

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11
Q

Meningitis
Signs of ICP (altered mental status, neurologic deficits, non-reactive pupils, bradycardia), may require what

A

-Elevating the head of the bed to 30 degrees
-inducing mild hyperventilation in the intubated patient
-osmotic diuretics such as 25% mannitol or 3% saline (CALL MO)

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12
Q

Chemoprophylaxis regimen for meningitis

A

a) Ceftriaxone 250mg IM one time
b) Ciprofloxacin 500mg PO one time

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13
Q

Meningitis – Disposition

A

Medical Evacuation is indicated for any patient with suspected meningitis, regardless of etiology or status.

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14
Q

Meningitis Differential Diagnosis

A

Stroke,
subdural hematoma,
subarachnoid hemorrhage,
metastatic brain disease,
brain abscess (may coexist with meningitis)

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