Neurology

Question 1

What are the common non-specific signs and symptoms for meningitis

Answer 1

Fever, nausea/vomiting, headache, lethargy, muscle ache, joint pain, ill looking, non blanching rash (purpura), irritability, refusing food or drink

Question 2

Name specific signs and symptoms for meningitis

Answer 2

Photophobia, neck stiffness, seizures, non blanching rash, capillary refill >2 seconds, altered mental state, unusual skin colour, shock, leg pain, bulging fontanelle, back rigidity, hypotension, kernigs sign and Brudinskis sign

Question 3

What causes meningitis in a neonate?

Answer 3

E coli
Group B strep
Listeria monocytogenes

Question 4

What causes meningitis in 3 months - 6 years?

Answer 4

Nisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae

Question 5

What causes meningitis in over 6 years?

Answer 5

Nisseria meningitidis

Streptococcus pneumoniae

Question 6

What pathogen is more common in immunocompromised patients and those over 50?

Answer 6

Listeria

Question 7

How do you treat meningitis?

Answer 7

Ceftriaxone or cefotaxime IV
Add amoxicillin if over 50
If meningococcal use benzylpenicillin first
Consider adjunct dexamethasone if Haemophilus
Consider adding vancomycin if used antibiotics in past 3 months or if travelled to area of high resistance