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Oh no- Infections > Meningitis & encephalitis > Flashcards

Meningitis & encephalitis Flashcards

1
Q

whats the most common causes of viral encephalitis

A

HSV

Enteroviruses

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2
Q

how can meninigits present

A

Fever

Headache

Neck stiffness

Altered mental state

Seizures

Mengiococcal rash

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3
Q

what are signs of encephalitis on CSF

A

High protein & normal glucose

Mononuclear cells

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4
Q

what type of rash occurs in meningocococal meningits

how woudl you describe it

A

Petechial

Burst blood vessels under the skin

Looks “vasculitic”

non-blanching on tumbler test

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5
Q

what are the most common bactrerial causes of meningitis in adults & kids

A

adults -> strep. pneumoniae

kids -> niseeria meningitidis

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6
Q

what is the main type of abx that’s used to treat meninigtis

what type is it

A

CefoTAXime

cephalosporin

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7
Q

what treatment can be given for viral encephalitis

A

aciclovir

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8
Q

what are your meninges

A

a membrane that surrounds the brain & spinal cord

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9
Q

whats the main difference between meningitsi and encephalitis regarding symtpoms

A

meningitis

sever headache

neck stiffness

photophobia

drowsiness

N&V

encephalitis

behavioural changes

seizures

confusion

obvs both cause a fever

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10
Q

whats like the main symptom of encephalitis that doesn’t tend to occur in meningitis

A

behavioural changes

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11
Q

what virus is the main cause of encephalitis

A

HSV

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12
Q

what are some causes of encephalitis

A

HSV

Rabies

HIV

Autoimmune

Insects

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13
Q

what type of encephalitis do you get from insects

A
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14
Q

what is aseptic meningits

A

all causes of mengiits with a -ve CSF bacterial culture

often caused by viruses

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15
Q

what viruses can cause mengintiis

A

HSV

Enterovirus (most common)

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16
Q

enteroviruses are the most common cause of viral meningits

what are they and give an exampel

A

RNA (single stranded) viruses

e.g, coxsakie virus

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17
Q

what test do you do for petechiae which can be a sign of meningiococcal septicemia

A

Meningitis glass test

AKA Tumbler test

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18
Q

how is meningitis treated for…

  1. 3m -> 50yo
  2. <3m & >50yo
  3. prophylaxis for family members
  4. neonatal
A
  1. IV cefotaxime
  2. IV cefotaxime + amoxicillin
  3. ciprofloxacin
  4. Gent + amox
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19
Q

what bacteria can casue meningitis

A

Group B strep

Strep pneumonia

Nisseria

Listeria monocytogenes

H. influenzae

E.coli

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20
Q

what bacteria can cause meningitis that is often found in the bum or vagina

hence why it’s a common cause in neonates

what is it’s fancy name

A

Group.B strep (agalactiae)

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21
Q

ages & bacteria causes of meningitis

  1. <3m old
  2. 3m -> 6yo
  3. 3m -> 50yo
  4. >50y old
A

1.

Listeria monocytogenes

E. coli 0157

Group B strep

2.

H. influenzae

Strep pneumoniae

Nisseria

3.

Strep pneumoniae

Niseeria

4.

Listeria monocytogenes

Strep pneumonia

Nisseria

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22
Q

what causes meningitis in both neonates and those who are proper old

(extremmes of age)

A

Listeria monocyotgenes

23
Q

what the main type of cause of meningitis

A

bacterial

24
Q

what are hte 5 steps of the pathogenesis of meningitis

A
  1. attaches to mucosa
  2. transgression (penetration) of mucosal barrier
  3. survucal in blood stream
  4. entry into CSF
  5. meningitis
25
Q

LP results for meningitis

  1. what does it looks like
  2. what happens to glucose
  3. what happens to protein
  4. what are the main types of immune cells present
A

1.

usually cloudy regardless of cause

Viral may look clear

Fibirn web if TB

2.

Viral only one causing it to go up

all other casues it’s down

3.

Pretty much always increased

May be normal in viral

4.

bacteria is only one with neutorphils as most common

other types it’s lymphocytes

26
Q

if you can see a fibrin web from an LP sample, what might be the cause of the meningits

A

TB

27
Q

what are the differences between bacterial and viral meningitis on an LP

A

Bacterial

Glucose is low

Protein is high

Neurophils most common

Viral

Glucose is high

Protein is high or normal

Lymphocytes most common

28
Q

what is the main fungal cause of meningitis

where can you get it from

A

Cryptococcus neoformans

bird poo

29
Q

what is the main risk factor for crytpococcal (fungal) meningitis

A

HIV

30
Q

what demographic is most commonly affected by viral meningitis

A

children & young adults

31
Q

how is viral meningits treated

A

usually just supportive cause it’s self-limiting

Enterovirus -> supposrtive, will be fine after 72hrs

HSV -> may need aciclovir

32
Q

are seizures more common in meningitis or encephalitis

A

encephalitis

33
Q

what investigations are doen for meningitis

A

LP -> microcopy & culture + PCR

Bloods

Sputum samples

Stool samples

34
Q

what are the main causes of neonatal meningits & how can you get them

A

Listeria monocytogenes -> refrigerated food

Group B strep -> from vagina commensals

e.coli -> from poo

35
Q

how can you prevent neonatal meningitis

A

test mum for any of the causes

if cultures +ve -> giev mum abx (e.g. amox)

36
Q

what examination test can you do for meningits and how do you do it

A

Kernig sign

Lie pt flat, flex their knee and hip

check for pain when extending knee

37
Q

what are the 4 classifications of meningits

A

Bacteiral

Viral

Fungal

Other

38
Q

What falls under the ‘other’ class of meningits

A

Aseptic

Shunt-associated

39
Q

what are the main clincial features of meningitis and what do you call it

A

Menigisim

Neck stiffness

Photophobia

Headache

N&V

Altered mental state

40
Q

what are some differentials for meningitis

A

SAH

Sepsis

Brain/spinal canal tumorur

41
Q

what CN palsies are associated with meningits & why

A

CN 5, 7 & 8

as they branch off the cerebo-pontine angle

42
Q

if you get a pt with suspected meningitsi in GP land, what abx can you give ASAP

A

Benzyl penicllin

Probs won’t have cefotaxime eh

43
Q

what do you have to consider prior to doing an LP

A

if there’s any raised ICP

44
Q

along with abx, what other med do you always give for bacteral meningitis

A

Dexamethasone

45
Q

what causes the following types of bacterial meningits:

  1. meningiococcal
  2. pneumococcal
A
  1. nisseria meningiotidis
  2. strep pneumoniae
46
Q

what are the 2 types of menignits vaccine

A

MenACWY -> against A, C, W and Y

Meningits B vaccine -> obvs against B

47
Q

If you suddenly get severe meningococcal mengintisi along with sepsis, what is this called

A

Fluminant meningioccoal septicemia

48
Q

what adrenal problem can be caused by meningioccoal septicemia

what is it

A

Waterhouse Friedrichsn syndrome

Adrenal glands can’t work as they are bleeding (BVs rupture)

49
Q

is meningiococcal meningitis a notifiable disease

A

yes it is

50
Q

whats the most common cause of bacterial meningitis in adults

A

Strep pneumoniae -> pneumococal meningitis

51
Q

what are some causes of aseptic meningits

A

HIV

Lymes

Leptospirosis

52
Q

what type of enterovirus is the most common cause of viral meningits

A

Coxsackie B

53
Q

is meiningits a complication of mumps

A

yes

Oh no- Infections (13 decks)

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