NEURO 1

Question 1

causes of meningitis in 0-3m
children
10-21
12>
elderly

Answer 1

0-3m GBS commonest, listeria, E Coli
children HI, strep pneumonia, niess mening
10-21 meningoococcal
21> pneumonocccal 
elderly pneumo, listeria, mening

Question 2

kernigs

Answer 2

lie flat on the back, flex the thigh so that it is at a right angle to the trunk, and completely extend the leg at the knee joint. If the leg cannot be extended due to pain - POSITIVE

Question 3

brudzinski

Answer 3

Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed.

Question 4

partially treated meningitis

Answer 4

neg CSF culture

glucose, protein WCC remains unchanged

Question 5

GP

Answer 5

IV/IM benzylpenicllin 1.2g OR cefataxime 2g IV/IM

Question 6

empirical

Answer 6

IV ceftriaxone 2g BD and IV amox 2g QDS if > 55

dexa 10mg IV 15-20mins before first dose or with first dose of ABs and then 6 hourly for 4 hours

Question 7

who is dexa given in

Answer 7

pneumococcal - stopped in all others

Question 8

meningococca

Answer 8

IV ceftr 2g BD

PA chloramphenicol IV 25mg/kg QDS 5-7 days and stop dexa

Question 9

pneumococcal

Answer 9

10 d of ceftr or 14d if not responding and dexa for 4d

Question 10

penicillin/cephalosporin resistant

Answer 10

14d of ceftr and vancomycin and dexa 4d

Question 11

listeria

Answer 11

21d of amox IV 2g 4 hourly

PA co trimoxazole IV 120mg/kg QDS and stop dexa

Question 12

Post op

Answer 12

IV ceftiazimide 2g 8 hourly and IV fluclox and IV vanc

Question 13

prophylaxis for meningo rifampicin dose

Answer 13

600mg PO 12hourly 4 doses in >12

10mg/kg PO 12 hourly 4 doses in 3-11months

Question 14

proph for meningo cipro

Answer 14

500mg PO single dose

Question 15

proph ceftriaxone

Answer 15

250mg IM in adults single dose

125 mg IV single dose in <12s

Question 16

which proph is preferred

Answer 16

ciprofloxacin

Question 17

complications of meningitis

Answer 17

deafness is the commonest
epilepsy
infection - sepsis, abscess
pressure - brain herniation, hydrocephalus

Question 18

CSF of bacteria

Answer 18

high opening pressure
cloudy colour 
increased WCC >2000 - polymorphs neutrophils
glucose low <40%
increased protein

Question 19

CSF of viral

Answer 19

normal or increased pressure 
gin clear colour 
5-1000 WCC
lymphocytes 
normal glucose 
protein slightly raised

Question 20

CSF of TB

Answer 20

high pressure 
cloudy yellow colour 
<500 WCC
lymphocytes 
glucose low 
raised protein - can be higher than bacteria

Question 21

CSF of fungal

Answer 21

high/v high opening pressure 
clear/cloudy colour 
0-1000 WCC
lymphocytes 
normal/low glucose 
protein level variable

Question 22

viral meningitis cause
who
and treatment

Answer 22

ECHO
older, young, immunocomp
self limiting, analgesia

Question 23

aseptic meaning what is it
who
CSF

Answer 23

non pyogenic bacterial mening
HIV. viral mening
low WBC, minimally elevated protein, normal glucose

Question 24

treatment of viral encephalitis if immunocomp or 2m-12yo

if normal

Answer 24

21d aciclovir

14d

Question 25

aiclovir doses neonates-3m
3m-12yo
>12yo

Answer 25

20mg/kg
500mg/m swquared
10mg/kg
ADJUST FOR RENAL FAILURE

Question 26

cerebral abscess ix

Answer 26

CT/MRI contract enhanced
if d in doubt stereotaxic biopsy
increased WCC increased ESR/CRP coag if surgery

Question 27

rx of cerebral abscess

Answer 27

IV ceftriaxone 2g QDS and IV metro 500mg 8 hourly
Add Iv fluclox 2g QDS if staph infection suspected
IV vanc if PA/MRSA surgery - decompression