Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Infectious disease, Oncology, & Urology > Meningitis, Malaria, Pneumonia > Flashcards

Meningitis, Malaria, Pneumonia Flashcards

1
Q

You’re working in a GP practice. A patient comes in with signs suggestive of meningitis. What should you do?

A

Call an ambulance

Give Benzyl Penicillin IM or IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

You’re working in a GP practice. A patient comes in with signs suggestive of meningitis. They have a penicillin allergy. What should you do?

A

Call an ambulance

If they’ve anaphylaxis to penicillin you can give cefuroxime if there is any.

If the allergy is minor give BenPen anyway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A patient is referred from their GP with suspected meningococcal septicaemia.

What should your immediate investigations and treatment be?

A

BUFALO

Blood cultures
Urine output
Fluids
Antibiotics (a 3rd gen. cephalosporin)
Lactate
Oxygen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What antibiotics should you give to a patient with suspected meningitis?

A

3rd gen cephalosporin: cefotaxime

If over 50 or under 3 months also give amoxicillin for listeria cover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What sort of rash would you see in meningococcal septicaemia?

A

Petechiae
Purpura
Ecchymosis

Non-blanching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Investigations for meningitis?

A

BUFALO

Bedside

  • Obs
  • BM
  • ABG/VBG

Routine

  • Bloods: FBC, U+E, CRP, Clotting, LFTs
  • Cultures
  • LP

Specialist
- CT head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you know if it is safe to do an LP?

A

If they have signs of raised ICP then you should do a CT head before doing an LP

Papilloedema
Reduced GCS
Seizures
Focal neurology
Previous malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are signs of raised ICP?

A 
Papilloedema
Reduced GCS
Seizures
Focal neurology
Previous malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In CSF…

What are glucose and protein levels like in bacterial, viral and TB meningitis?

What leukocytes are present?

What colour is the CSF?

A

Glucose

  • viral = normal
  • bacterial = low
  • TB = low

Protein

  • viral = normal
  • bacteria = high
  • TB = high

Leukocytes

  • viral = lymphocytes
  • bacterial = neutrophils
  • TB = lymphocytes

Colour

  • viral = clear
  • bacterial = turbid
  • TB = opalescent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which organisms cause meningitis in:

  1. neonates
  2. children
  3. adults
  4. elderly
A
  1. Group B strep, E. coli, S. pneumoniae, Listeria
  2. N. meningitidis, S. pneumoniae, H. influenzae
  3. N. meningitidis, S. pneumoniae
  4. N. meningitidis, S. pneumoniae, Listeria, H. influenza
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which viruses cause meningitis?

Management?

A

Enteroviruses
Herpes virus
Mumps

Supportive, usually self resolving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which bugs cause encephalitis?

Management?

A

Herpes simplex
EBV
CMV
Varicella zoster

Aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are contacts of meningitis patients given as prophylaxis?

A

Ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the neuro signs of meningitis?

A

Kernig’s: unable to extend knee with hip flexed

Brudzinski’s: unable to lift head and legs off bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the clinical features of meningitis and meningococcal septicaemia?

A 
Stiff neck
Photophobia
Malaise
Fever
N + V
Headache
Reduced consciousness

Septicaemia:

  • low BP
  • tachycardia
  • purpuric rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clinical features of malaria?

A 
Fever, rigors
Myalgia
Malaise
Headache
Vomiting + diarrhoea
17
Q

Investigations for malaria?

A

BUFALO if they look septic

Bedside:

  • obs
  • BM
  • ABG, VBG

Routine:

  • Bloods: FBC, U+E, CRP, Clotting, LFTs, lactate
  • Blood film
  • CXR

Specialist:
- MRI if concerned about cerebral malaria

18
Q

What special blood test identifies malaria?

A

Blood film
Thick and thin

Thick is best to see parasites

Also, antigen assay

19
Q

What’s the incubation period for malaria?

A

Depends on type:
- falciparum 9-14 days

Others can be up to a year

20
Q

List the types of malaria?

What’s the basic difference between them?

A

Falciparum (main, most severe)

Ovale
Vivax
Malariae
Knowlesi
(These all are less severe and don't cause cerebral malaria, they also have a liver stage)
21
Q

What would make a case of malaria ‘complicated malaria’?

A 
Impaired consciousness, seizures
Renal impairment
Acidosis
Hypoglycaemia
Hb < 80
DIC or bleeding
Shock
Haemoglobinuria
Parasite count >2%
22
Q

Management of falciparum malaria?

A

UNCOMPLICATED:

1st line: Riamet (PO equivalent of artesunate)

2nd line: malarone, quinine + doxy

COMPLICATED:

1st line: IV artesunate

2nd line: IV quinine + PO doxy

23
Q

Management of non-falciparum malaria?

A

Chloroquinine
Riamet

The malaria can go dormant in the liver, so treatment must include ‘eradication of liver stage’ with primaquine

24
Q

What are the possible complications of malaria?

A

Splenomegaly
Cerebral malaria
Renal and liver impairment

25
Q

What are the clinical features of cerebral malaria?

A 
Stroke
Oedema
Seizures
Reducing GCS
Coma
Death
26
Q

Which drugs are used as malaria prophylaxis?

A

Chloroquine
Doxycycline
Proguanil

27
Q

Investigations of pneumonia?

A

BUFALO if he looks septic

Bedside:

  • obs
  • BM
  • ABG, VBG

Routine:

  • bloods: FBC, UE, CRP, lactate, LFT, clotting
  • CXR
  • sputum sample
  • blood cultures

Specialist

  • CT
  • MRI
  • bronchoscopy + lavage
28
Q

What are the markers of clinical severity and increased risk of death in pneumonia?

How would you manage based on these?

A

CURB65

Confusion
Urea > 7 mmol/L
Resp rate > 30
BP < 90/60

0-1 = low risk, manage in community, amoxicillin
2 = moderate risk, admit, amox + clarithromycin
3+ = high risk, consider ITU, co-amox + clari
29
Q

Management of pneumonia?

A

Supportive

Oxygen

Antibiotics:
low risk: amoxicillin
moderate risk: amox + clari
high risk: co-amox + clari

If Pen allergic: use macrolide (clari) or tetracycline

30
Q

What is the most common bug that causes pneumonia?

What others cause it?

A

Strep pneumoniae

Legionella pnuemophila
H. influenzae
Mycoplasma pneumonia
Klebsiella
Pseudomonas
31
Q

What’s the full name of:

  • legionella
  • listeria
A

Legionella pneumophila

Listeria monocytogenes

32
Q

What would make you consider legionella pneumonia?
How can you test for it?
What antibiotic treats it?

A

Exposure to poorly maintained air conditioning

No improvement with amoxicillin

Deranged renal and liver function tests

Makes young and fit people very unwell

Urinary antigen
Macrolide (clari)

33
Q

Complications of pneumonia?

A 
Sepsis
Lung abscess
AKI
Extra-thoracic infection
Effusions
Multi-organ failure
Death
34
Q

Clinical features of pneumonia?

A

SOB
Cough + sputum
Fever
Malaise

Low oxygen sats
Crepitations
Dull to percussion

35
Q

What test do you do to test vocal resonance?

What does it help you with?

A

Patient says 99 while you auscultate

It should sound muffled

Increased vocal resonance - it sounds clearer: consolidation

Decreased or absent vocal resonance - pleural effusion or collapse

Infectious disease, Oncology, & Urology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions