Neuro CIS Flashcards
When evaluating a child, what is important to establish?
Some type of baseline to monitor their progress/recovery
What is a concerning symptom for a ped patient?
Wants to be left alone, doesn’t move, doesn’t eat.
What can a high fever with tachycardia cause in a ped patient?
Flow murmur secondary to increased CO
How do we obtain urine for culture from a ped patient?
Via catheterization
Explain an elevated white count with left shift?
A left shift occurs when immature neutrophils are sent out of the marrow to fight an infection.
What ratio can be helpful in determining the presence of an infection and what is the value for an infection?
Immature neutrophil to total neutrophil ratio. Greater than .2 means there is likely an infection.
Top 3 pathogens causing meningitis in 0-2 year age group?
Strep b, E. coli, and list mono
Top 3 pathogens causing meningitis in 2-12 year age group?
Strep pneumonia, n meningitis, and h influenza
Top 2 pathogens causing meningitis in age 60 years and older?
Strep pneumonia and list mono
Top pathogen causing meningitis in teens and young adults?
N meningitis
What is the opening pressure in CSF for bacteria, Viral, Neoplastic and Fungal?
Greater than 300, less than 300, 200 and 300
WBC count for bacteria, viral, neoplastic and fungal in CSF?
Greater than 1000, less than 1000, less than 500, less than 500
PMN % of bacteria in CSF?
80%
Glucose level in bacteria, viral, neoplastic, and fungal in CSF?
Less than 40, greater than 40, less than 40, less than 40
Protein levels for bacteria, viral, neoplastic, fungal in CSF?
Greater than 200, less than 200, both greater than 200.
What do we need to be very careful about when we are considering a Lumbar Puncture?
Bleeding or high cranial pressures
5 common symptoms of meningitis?
Fever, N/V, headache, nuchal rigidity, and photophobia
What are the three special tests for suspected meningitis?
Nuchal rigidity, brudzinski, and kernig
How do you perform the kernig test and what is a positive test?
Flex hip and knee. Slowly extend the knee. Positive test is pain behind the knee.
How do you perform brudzinski test and what is a positive sign?
Flex head. Positive sign is a flexion of hips and knees in response of the flexion of the neck.
How do you perform nuchal rigidity and what is a positive test?
Flex neck. Resistance to the flexion/stiffness.
What special test can you perform for kids 2 and younger?
Fontanelle test.
What is your empiric treatment for meningitis?
Vancomycin and ceftriaxone
What do you add if the patient is over 50?
Ampicillin
