Meningitis and Encephalitis

Question 1

2 most common bugs in acute bacterial meningitis in adults

Answer 1

Streptococcus pneumoniae and Neisseria meningitidis

Question 2

risk factors for listeria monocytogenes meningitis

Answer 2

pregnant, >50 years old, impaired cell mediated immunity (chronic illness, organ transplant, AIDS, malignancy, on immunosuppressives)

Question 3

4 common presenting signs of meningits

Answer 3

2/4 of headache, fever, nuchal rigidity, AMS

Question 4

CSF in bacterial meningitis

Answer 4

high WBC>50K, neutrophil predominant, , high protein, low glucose, increased OP

Question 5

CSF in viral/fungal meningitis

Answer 5

semi high WBC, lymphocyte predominant, normal protein, normal glucose, normal OP

Question 6

CSF in tuberculous meningitis

Answer 6

WBC>25, lymphocyte predominant, elevated protein, markedly reduced glucose

Question 7

When should cranial imaging precede LP?

Answer 7

new onset seizures, immunocompromised, high ICP signs, impaired consciousness

Question 8

When to use steroids in meningitis

Answer 8

If septic shock- use low dose steroids (hydrocortisone 50 mg)
If no shock, use dexamethasone 10 mg QID x 4 days

Question 9

empiric antibiotics in community acquired bacterial meningitis

Answer 9

age 16-50: vancomycin + 3rd gen cephalosporin

>50 or a risk factor: vanc, 3rd gen cephalosporin, ampicillin

Question 10

definition of encephalitis

Answer 10

presence of inflammatory process in the brain with clinical evidence of neurologic dysfunction

Question 11

agammaglobulinemia puts you at risk for what cause of encephalitis

Answer 11

enterovirus, mycoplasma pneumoniae

Question 12

bats puts you at risk for what cause of encephalitis

Answer 12

rabies, nipah virus

Question 13

cats puts you at risk for what cause of encephalitis

Answer 13

rabies, coxiella burnetti, bartonella henselae, T gondii

Question 14

dogs puts you at risk for what cause of encephalitis

Answer 14

rabies

Question 15

sheeps and goats puts you at risk for what cause of encephalitis

Answer 15

coxiella burnetti

Question 16

swine puts you at risk for what cause of encephalitis

Answer 16

japanese encephalitis, Nipah virus

Question 17

white tailed deer puts you at risk for what cause of encephalitis

Answer 17

borrelia burgorferi

Question 18

raw or partially cooked meat puts you at risk for what cause of encephalitis

Answer 18

toxoplasma gondii

Question 19

sandflies puts you at risk for what cause of encephalitis

Answer 19

bartonella bacilliformis

Question 20

sexual contact puts you at risk for what cause of encephalitis

Answer 20

HIV, t. pallidum

Question 21

spelunking puts you at risk for what cause of encephalitis

Answer 21

rabies, H, capsulatum

Question 22

swimming puts you at risk for what cause of encephalitis

Answer 22

enterovirus, naegleria fowleri