Meningitis (bacterial)

Question 1

An inflammation of the fluid and membrane (meninges) surrounding brain and spinal cord

Answer 1

Meningitis

Question 2

The inflammatory response to infection in meningitis causes _____ CSF glucose and CSF _____protein.

Answer 2

decreased glucose, increased protein

Question 3

Causative organisms of meningitis

Answer 3

1. Streptococcus pnuemoniae
2. Haemophilus influenzae
3. Neisseria meningitidis

Question 4

Modes of transmission of meningitis

Answer 4

Droplet, Direct Contact

Question 5

Incubation period of meningitis

Answer 5

2-10 days

Question 6

Average incubation period of meningitis

Answer 6

6-7 days

Question 7

Definitive diagnostic test for meningitis to collect cerebrospinal fluid (CSF).

Answer 7

Lumbar Tap, Spinal Tap, Spinal Puncture, Thecal Puncture, Rachiocentesis

Question 8

A test for subarachnoid obstruction, also known as lumbar manometric test performed by compressing the jugular veins for 10 seconds on each side of the neck during the lumbar puncture.

Answer 8

Queckenstedt’s test

Question 9

Pathognomonic signs of meningitis

Answer 9

1. Nuchal rigidity
2. Kernig’s Sign
3. Brudzinski’s Sign

Question 10

severe arching of the spine

Answer 10

Opisthotonos

Question 11

abnormal flexion of the arms with the extension of the legs

Answer 11

Decorticate

Question 12

an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward

Answer 12

Decerebrate

Question 13

hypertension, bradycardia, bradypnea

Answer 13

Cushing’s triad

Question 14

unequal pupils, due to the compression of CN III or the oculomotor.

Answer 14

Anisocoria

Question 15

double vision, due to the compression of the longest cranial nerve, CN VI or the abducens.

Answer 15

Diplopia

Question 16

eyes deviate in the opposite direction

Answer 16

Doll’s eyes sign

Question 17

sensitivity to light

Answer 17

Photophobia

Question 18

Position for increased ICP

Answer 18

semi-fowlers to drain excess CSF and to promote lung expansion

Question 19

HOB Elevation for increased ICP

Answer 19

30-45*

do not elevate the head of bed to about 90 because it may cause brain herniation, further brain swelling and possible hemorrhage.

Question 20

factors that increase ICP

Answer 20

bending, stopping, valsalva maneuver, enema, sneezing, blowing of the nose, coughing, and laxatives

Question 21

Osmotic diuretic to reduce cerebral edema

Answer 21

Mannitol

WOF: hypotension, dizziness

Question 22

only corticosteroids that could readily cross the blood brain barrier – this is for inflammation

Answer 22

Decadron (Dexamethasone)

Class: Corticosteroids

Question 23

Anticonvulsant for meningitis

Answer 23

Phenytoin/Dilantin

Question 24

SE of Phenytoin

Answer 24

1. GI upset
2. Nystagmus
3. Ataxia
4. Red urine
5. Gingival hyperplasia
6. Bone marrow depression

Question 25

DOC antibiotics IV for meningitis

Answer 25

Penicillin G

can give ceftriaxone and ampicillin

Question 26

DOC for severe headache in meningitis

Answer 26

Codeine

Classification: Opioid Analgesic
SE: respiratory depression, drowsiness, constipation

Question 27

DOC for fever above 38C for meningitis

Answer 27

Paracetamol

Question 28

Phenytoin PO is administered ____ meals

Answer 28

with

Question 29

Phenytoin IV requires ____ ml of NSS

because it crystalizes in the vein

Answer 29

10

Administer 5ml of NSS, followed by phenytoin, and another 5ml of NSS

Question 30

Inflammation of the optic chiasm due to increase in ICP (meningitis)

Answer 30

Papilledema