Micro Neuro Hockey Q's

Question 1

What are the viral causes of meningitis?

Answer 1

EBV

Herpes simplex

Echo virus

Mumps

Question 2

What are the bacterial causes of meningitis?

Answer 2

Strep pneumoniae
Most common bacterial = infant, young adults,

Nesisseria meningitis
Diplococci, gram -ve= worse prognosis= young adults

Listeria monocytogene
Gram +vebacilli = neonates, elderly

Haemophilusinfluenzae
Gram –ve

GBS
Gram +ve, cocci= neonates

Question 3

What is the treatment of meningitis?

What do you give to the contacts?

Answer 3

GP/community
Immediate: IM benpen

Hospital
<55: IV cefotaxime,
>55, pregnant or immunocompromised: IV cefoxatime+ amoxicillin (worried that it is listeria monocytogenes)

If microbio results come back:
Strep pneumoniae (pneumococcal)
IV cefotaxime + IV dexamethasone
Listeria monocytogene
IV cefotaxime +amoxicillin

Contacts
Rifampicin, men C vaccine

Question 4

What is the worst cause of encephalitis?

What are the investigations?

What is the treatment?

Answer 4

Herpes simplex virus

Blood cultures, CT, LP, EEG

IV acyclovir

Question 5

What is the difference between shingles and chicken pox?

What happens with reactivation?

What is the treatment?

Answer 5

Herpes Zoster
Shingles
Varicella zoster
Chicken pox

Dormant in dorsal root ganglion
Reactivation = shingles (dermatome distribution, patients with HIV, elderly, imuunocomp…)

Acute
Oral acyclovir

Post-herpetic neuralgia
Amitriptyline etc