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Flashcards in meningitis Deck (35)
1

what does neutrophils in the SAS suggest?

pyogenic meningitis

2

what is acute pyogenic meningitis ?

bacterial

3

what is aseptic meningitis ?

viral meningitis

4

what is acute encephalitis?

infection of the brain parenchyma

5

treatment of bacterial community acquired meningitis?

DECE - IV dexamethasone and ceftriaxone

6

if penicillin allergic, what is the treatment?

DECH - dexamethasone and chloramphenicol

7

what do you add as listeria cover?

IV ampicilin or amoxicillin (a is start of list)

8

who gets infected by listeria?

the very young and very old (start and end of list)

9

when is viral meningitis more common ?

late summer to autumn

10

which type of viruses would cause meningitis

enteroviruses (eg echovirus)

11

diagnosis od viral meningitis?

stool culture, throat swab, CSF PCR

12

treatment of viral meningitis?

supportive as self limiting

13

causitive orgs bacterial by age

explaining hot neck stiffness
infant - e coli
child - HI
young adult - Nesseria
old - strep pneumoniae

14

what prevents meningitis becoming an access?

pia

15

what can cause infection in immunocompromised patient s?

listeria monocytogenes
iMono

16

what causes meningococcal ?

n meningiditis

17

what are the symptoms in meningococcal meningitis due to?

endotoxin

18

most common cause of meningitis in children under 4 years old?

H Influenza

19

what antibiotic is used for listeria and which has no value ?

amoxicilin used, ceftriaxone has no value

20

previous TB on x ray, poor yield from CSF?

tuberculous meningitis

21

how do you treat tuberculous meningitis ?

rifampicin and Isoniazid (then add pyrazinimide and ethambutol)

22

3 clinical signs of bacterial meningitis ?

fever, stiff neck, alteration in consciousness

23

small, pleomorphic, gram negative rods?

HI

24

what cells are usually seen in bacterial meningitis?

predominantly polymorphs

25

CSF glucose in bacterial?

less than 70% of blood glucose

26

CSF glucose in viral ?

normal

27

cells in CSF in viral meningitis?

lymphocytes

28

protein in viral/bacterial/tuberculous?

normal or slightly high in viral
high in bacterial
high or very high in tuberculous

29

why do you get high protein in bacterial ?

bacterial meningitis leads to a more permeable blood brain barrier, due to increased inflammation. Protein leaks into the SAS from the blood, so you get markedly increased CSF protein levels

30

what do you give if over 55 to cover listeria?

amox

31

lumbar puncture, should it always be done?

yes, unless clear contraindication exists

32

if penicillin allergy, which antibiotic would you give in place of ceftriaxone?

DECH - chloramphenicol

33

Rapidly developing rash suggests

meningococcal disease

34

when would you do a CT scan of the head ?

immunocompromised, history of CNS disease, new onset seizure, papilloedema, focal neurological deficit

35

prophylaxis for contacts?

600mg rifampicin orally 12 hourly for four doses
or ciprofloxacin
or ceftriaxone (not recommended in children)