Meningitis & encephalitis

Question 1

whats the most common causes of viral encephalitis

Answer 1

HSV

Enteroviruses

Question 2

how can meninigits present

Answer 2

Fever

Headache

Neck stiffness

Altered mental state

Seizures

Mengiococcal rash

Question 3

what are signs of encephalitis on CSF

Answer 3

High protein & normal glucose

Mononuclear cells

Question 4

what type of rash occurs in meningocococal meningits

how woudl you describe it

Answer 4

Petechial

Burst blood vessels under the skin

Looks “vasculitic”

non-blanching on tumbler test

Question 5

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

Answer 5

adults -> strep. pneumoniae

kids -> niseeria meningitidis

Question 6

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

what type is it

Answer 6

CefoTAXime

cephalosporin

Question 7

what treatment can be given for viral encephalitis

Answer 7

aciclovir

Question 8

what are your meninges

Answer 8

a membrane that surrounds the brain & spinal cord

Question 9

whats the main difference between meningitsi and encephalitis regarding symtpoms

Answer 9

meningitis

sever headache

neck stiffness

photophobia

drowsiness

N&V

encephalitis

behavioural changes

seizures

confusion

obvs both cause a fever

Question 10

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

Answer 10

behavioural changes

Question 11

what virus is the main cause of encephalitis

Answer 11

HSV

Question 12

what are some causes of encephalitis

Answer 12

HSV

Rabies

HIV

Autoimmune

Insects

Question 13

what type of encephalitis do you get from insects

Question 14

what is aseptic meningits

Answer 14

all causes of mengiits with a -ve CSF bacterial culture

often caused by viruses

Question 15

what viruses can cause mengintiis

Answer 15

HSV

Enterovirus (most common)

Question 16

enteroviruses are the most common cause of viral meningits

what are they and give an exampel

Answer 16

RNA (single stranded) viruses

e.g, coxsakie virus

Question 17

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

Answer 17

Meningitis glass test

AKA Tumbler test

Question 18

how is meningitis treated for…

1. 3m -> 50yo
2. <3m & >50yo
3. prophylaxis for family members
4. neonatal

Answer 18

1. IV cefotaxime
2. IV cefotaxime + amoxicillin
3. ciprofloxacin
4. Gent + amox

Question 19

what bacteria can casue meningitis

Answer 19

Group B strep

Strep pneumonia

Nisseria

Listeria monocytogenes

H. influenzae

E.coli

Question 20

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

Answer 20

Group.B strep (agalactiae)

Question 21

ages & bacteria causes of meningitis

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

Answer 21

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

Question 22

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

(extremmes of age)

Answer 22

Listeria monocyotgenes

Question 23

what the main type of cause of meningitis

Answer 23

bacterial

Question 24

what are hte 5 steps of the pathogenesis of meningitis

Answer 24

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

Question 25

**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

Answer 25

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

Question 26

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

Answer 26

TB

Question 27

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

Answer 27

**Bacterial** Glucose is low Protein is high Neurophils most common **Viral** Glucose is high Protein is high or normal Lymphocytes most common

Question 28

what is the main fungal cause of meningitis where can you get it from

Answer 28

Cryptococcus neoformans bird poo

Question 29

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

Answer 29

HIV

Question 30

what demographic is most commonly affected by viral meningitis

Answer 30

children & young adults

Question 31

how is viral meningits treated

Answer 31

**usually just supportive cause it's self-limiting** Enterovirus -\> supposrtive, will be fine after 72hrs HSV -\> may need aciclovir

Question 32

are seizures more common in meningitis or encephalitis

Answer 32

encephalitis

Question 33

what investigations are doen for meningitis

Answer 33

LP -\> microcopy & culture + PCR Bloods Sputum samples Stool samples

Question 34

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

Answer 34

Listeria monocytogenes -\> refrigerated food Group B strep -\> from vagina commensals e.coli -\> from poo

Question 35

how can you prevent neonatal meningitis

Answer 35

test mum for any of the causes if cultures +ve -\> giev mum abx (e.g. amox)

Question 36

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

Answer 36

**Kernig sign** Lie pt flat, flex their knee and hip check for pain when extending knee

Question 37

what are the 4 classifications of meningits

Answer 37

Bacteiral Viral Fungal Other

Question 38

What falls under the 'other' class of meningits

Answer 38

Aseptic Shunt-associated

Question 39

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

Answer 39

**Menigisim** Neck stiffness Photophobia Headache N&V Altered mental state

Question 40

what are some differentials for meningitis

Answer 40

SAH Sepsis Brain/spinal canal tumorur

Question 41

what CN palsies are associated with meningits & why

Answer 41

CN 5, 7 & 8 as they branch off the cerebo-pontine angle

Question 42

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

Answer 42

Benzyl penicllin Probs won't have cefotaxime eh

Question 43

what do you have to consider prior to doing an LP

Answer 43

if there's any raised ICP

Question 44

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

Answer 44

Dexamethasone

Question 45

what causes the following types of bacterial meningits: 1. meningiococcal 2. pneumococcal

Answer 45

1. nisseria meningiotidis 2. strep pneumoniae

Question 46

what are the 2 types of menignits vaccine

Answer 46

MenACWY -\> against A, C, W and Y Meningits B vaccine -\> obvs against B

Question 47

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

Answer 47

Fluminant meningioccoal septicemia

Question 48

what adrenal problem can be caused by meningioccoal septicemia what is it

Answer 48

Waterhouse Friedrichsn syndrome Adrenal glands can't work as they are bleeding (BVs rupture)

Question 49

is meningiococcal meningitis a notifiable disease

Answer 49

yes it is

Question 50

whats the most common cause of bacterial meningitis in adults

Answer 50

Strep pneumoniae -\> pneumococal meningitis

Question 51

what are some causes of aseptic meningits

Answer 51

HIV Lymes Leptospirosis

Question 52

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

Answer 52

Coxsackie B

Question 53

is meiningits a complication of mumps

Answer 53

yes