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PharmQ1Questions > MeningitisC > Flashcards

MeningitisC Flashcards

1
Q

What are viral pathogens in meningitis?

A

Enterovirus, arbovirus, herpes

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2
Q

What are parasitic pathogens in meningitis?

A

Naeglaria sp, Acanthameoba sp

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3
Q

What are bacterial pathogens in meningitis

A

Step pneumo, neisseria meningitidis, h influenzae, listeria monocytogens

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4
Q

What are fungal pathogens in meningitis

A

Cryptococcus neoformans

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5
Q

What is meningitis most commonly caused by and how it it treated?

A

Virus, Empirically w/acyclovir until results are back , Tx symptoms

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6
Q

What is the most common bacterial meningitis?

A

Strep pneumo

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7
Q

Why is HIB making a comeback?

A

People arenít vaccinating! ESTUPIDOS!

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8
Q

Clinical presentation of meningitis in adults is typically what?

A

HA, fever, stiff neck, photophobia, change in mental status, obtundation, seizures, and vomiting

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9
Q

Clinical presentation of meningitis in infants is typically what?

A

Irritability, altered sleep, vomit, high pitch cry, decreased oral intake

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10
Q

Clinical presentation of meningitis in children is typically what?

A

Lethargy, confusion, somnolence

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11
Q

What are the 2 ìsignsî you can test for in meningitis?

A

Brudzinski neck sign and kernigs sign

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12
Q

What are the characteristics of normal CSF?

A

Clear, 50-60% serum glucose, pH 7.4,

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13
Q

What type of infection has the highest WBC count, neutrophilic differential, 80-500 mg/dL protein, and

A

Bacterial

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14
Q

Viral and fungal causes of meningitis both have what differential?

A

Lymphocytic

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15
Q

How do you diagnose meningitis?

A

CSF evaluaton w/ gram stain and culture, enzyme ammunoassay for bacteria, and PCR for virus, mycobacteria and fungal

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16
Q

When is empiric therapy started and how long is it continued for?

A

w/in 30 minutes of presentation regardless, 48-72 hrs or until diagnosis of meningitis is ruled out, if ID causative agent, stop empirical and start specific

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17
Q

If the CSF gram stain has nothing growing, is meningitis ruled out?

A

NO , Start empirical tx until ruled out by other more definitive testing

18
Q

If clinical presentations are in an infant

A

Listeria monocytogens

19
Q

What other pt population is more likely to be infected by listeria?

A

> 50 or alcoholic

20
Q

What drug do you add to tx if you suspect listeria?

A

Ampicillin

21
Q

What anti-inflammatory is used in meningitis?

A

Dexamethasone

22
Q

Should dexamethasone be given before or after antibiotics?

A

BEFORE

23
Q

What are concerns associated with use of dexamethasone?

A

Increased GI bleeds, decreased antibiotic penetration

24
Q

What drug penetration is NOT affected by dexamethasone?

A

vancomycin

25
Q

What type of adult pt should NOT be given dexa?

A

Meningitis with septic shock

26
Q

What pt population most often gets N meningitidis and when?

A

Kids and young adults in the winter and spring

27
Q

What is the drug of choice for n. meningitidis and alternatives?

A

High dose IV PCN G , Cefotaxime, ceftriaxone, and chloramphenicol are, alternatives for allergy

28
Q

Do pt with n. meningitidis need to have prophylaxis tx of all close contacts? If so what is given and when?

A

YES!, Rifampin w/in 24 hours is ideal, after 14 days no effect

29
Q

Strep pneumo is the most common cause of meningitis is what pt population?

A

Adults but also in kids

30
Q

What is a condition commonly seen in survivors?

A

Neurologic sequelae

31
Q

How is meningitis from strep pneumo treated?

A

IV 3rd generation ceph for 10-14 days. Cefotaxime or ceftriaxone

32
Q

What if the meningitis from strep pneumo is resistant to beta lactam drugs? What do you treat with?

A

Vancomycin

33
Q

How can you prevent meningitis from strep pneumo?

A

Vaccine- >65, immunocompromised, asplenic or have a cochlear implant. Also prevnar vaccine as a infant

34
Q

What is the tx of choice for H influenzae meningitis?

A

Ceftriaxone or cefotaxime bc lots of ampicillin resistance, Vaccinate your children then they wont be at risk for this- duhhhh

35
Q

Do pt with H influenzae induced meningitis need prohylaxis tx for close contacts?

A

Yes unless fully vaccinated before 2y/o

36
Q

When do cases of meningitis from listeria peak?

A

Summer/ early fall

37
Q

What is the D.O.C for listeria meningitis?

A

IV ampicillin x14 -21 days +/-aminoglycosides x10 days

38
Q

What type of meningitis are neonates most at risk for?

A

E.coli and klebsiella

39
Q

What are the risk factors for gram neg bacilli meningitis?

A

Cranial trauma, neurosurgery, immunosuppressant, hospitalization, and elderly

40
Q

How do you treat gram ñ bacilli meningitis?

A

IV ceftazidime WITH gentamicin x3weeks for pseudo aeruginosa Other bacteria 3rd gen ceph for 3 weeks

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