Neuro

Question 1

Common causes of bacterial meningitis in neonates? 3

Answer 1

Listeria
Group B strep
E. Coli

Question 2

Common cause of bacterial meningitis in children?

Answer 2

H Influenza

Question 3

Common cause of bacterial meningitis in ages 10 -21?

Answer 3

Meningococcal

Question 4

Common cause of bacterial meningitis in >21?

Answer 4

Pneumococcal

Question 5

Risk factors for listeria meningitis?

Answer 5

Decreased cell mediated immunity

Question 6

Risk factors for staph meningitis?

Answer 6

Recent neurosurgery or open head trauma

Question 7

Risk factors for pneumococcal meningitis?

Answer 7

Fracture of cribiform plate

Question 8

Describe potential pathogenesis of bacteria meningitis

Answer 8

1. Nasopharyngeal colonisation
2. Direct extension from parameningeal foci (sinusitis, mastoiditis)
3. From remote location (UTI. endocarditis)

Question 9

Causes of meningitis in immunocompromised patients?

Answer 9

Listeria monocytogenes most common
Strep pneumonia
Staph aureus
Mycobacterium TB

Question 10

Most common cause of meningitis in children

Answer 10

H influenzae type B

Question 11

What does H influenzae vaccine work agains?

Answer 11

Capsular polysaccharide antigen

Question 12

What type of bacterium is listeria monocytogenes?

Answer 12

Gram + bacilli

Question 13

Who is susceptible to Listeria meningitis?

Answer 13

Neonates
>55years
Immunosuppressed

Question 14

What is the antibiotic used in listeria meningitis?

Answer 14

IV ampicillin/ amoxicillin

Question 15

Treatment tuberculous meningitis

Answer 15

Rifampicin
Isoniazid
plus then add
Pyrazinamide
Ethambutol

Question 16

Clinical signs and symptoms of bacterial meningitis?

Answer 16

Altered consciousness/ confusion
Fever
Stiff neck 
Headache
Vomiting
Photophobia
Lethargy
Rash

Question 17

What viruses cause meningitis?

Answer 17

Enteroviruses e.g ECHO virus

Question 18

Investigations for viral meningitis?

Answer 18

Stool culture
CSF PCR
Throat swab

Question 19

Causes of viral encephalitis?

Answer 19

Herpes simplex
Varicellar zoster
CMV
HIV
Measles
Travel - West Nile, Japanese B, Tick Bourne
Rabies

Question 20

Investigations of viral encephalitis?

Answer 20

Lumbar puncture
Electroencephalogram (EEG)
MRI

Question 21

What is the fungal cause of meningitis?

Answer 21

Cryptococcal meningitis

Question 22

CD4 levels in crytococcal meningitis?

Answer 22

<100

Question 23

Treatment of cryptococcal meningitis?

Answer 23

IV amphotericin and fluconazole

Question 24

Treatment of bacterial meningitis?

Answer 24

IV ceftriazone
Add IV ampicillin/ amoxicillin if listeria suspected
Steroid

Question 25

What is given in bacterial meningitis if pen allergic?

Answer 25

Chloramphenicol with vancomycin

Question 26

Predominant cell type in CSF of viral meningitis?

Answer 26

Lymphocytes

Question 27

Predominant cell type in CSF of bacterial meningitis?

Answer 27

Polymorphs

Question 28

Predominant cell type in CSF of TB meningitis?

Answer 28

Lymphocytes

Question 29

Protein levels in CSF of viral meningitis?

Answer 29

Normal or slightly high

Question 30

Protein levels in CSF of bacterial meningitis?

Answer 30

High

Question 31

Protein levels in CSF of TB meningitis?

Answer 31

High or very high

Question 32

Glucose levels in CSF of viral meningitis?

Answer 32

Normal

Question 33

Glucose levels in CSF of bacterial meningitis?

Answer 33

<70% of blood glucose

Question 34

Glucose levels in CSF of TB meningitis?

Answer 34

<60% of blood glucose