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Flashcards in Revision 2 Deck (198)
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181

what causes meningitis in the elderly

pneumococcal > listeria

182

what causes meningitis in immunocompromised

S. pneumoniae, N. meningitidis, Listeria, aerobic GNR (including Ps.aeruginosa)

183

what causes meningitis in patients who have had neurosurgery/ open head trauma

staphylococcus, gram -ve rods
S. aureus, S. epidermidis, aerobic GNR

184

what causes meningitis in patients with a # of the cribiform plate

pneumococcal
(S. pneumoniae, H. influenzae, beta-hemolytic strep group A)

185

what causes meningitis in patients who have a CSF shunt

S. epidermidis, S. aureus, aerobic GNR, Propionibacterium acnes

186

what is the management for meningitis

Ceftriaxone I.V 1.2mg bd +/- amoxicillin if over 60 (listeria cover)

Penicillin allergy:
Chloramphenicol + Vancomycin +/- co-trimoxazole (listeria cover)

If it is meningococcal - additional steroids are not required but everyone gets it until its established

187

what is the treatment for status epilectus

1st stage (0−10 minutes):
-Secure airway and resuscitate
-Administer oxygen
-Assess cardiorespiratory function
-Establish intravenous access – get help to hold site still
-Glucose (50 ml of 50% solution) and/or intravenous thiamine if appropriate

Pre-hospital - Diazepam 10−20 mg per rectum
1mg Midazolam buccally

In hospital - Lorazepam IV 0.1mg/kg with 4mg bolus (don’t worry about dose)
if unable to get IV access, go to rectal diazepam
This stage call MUST call senior/ICU

Established (20mins or more despite therapy) – IV phenytoin or fosphenytoin
MUST CALL ICU!!!

188

what is the mnemonic for things that can cause cerebellar symptoms

DAISIES
Demyelination
Alcohol
Infarction
SOL- schwannoma
Inherited (wilsons, fredricks ataxia)
Epilepsy medication
(multiple) System atrophy

189

what is rhombergs testing

proprioception and sensory ataxia
wont be able to stay balanced with eyes shut

190

what type of nystagmus in cerebellar disease

horizontal

191

what is speech like in cerebellar disease

slurred staccato

192

what is the fast phase of nystagmus going towards

the side of the lesion

193

what happens to the tremor in parkinsons when counting back from 100

gets worse- gets worse on concentration

194

what type of tremor might a dopamine agonist cause

bilateral

195

can patients with parkinsons draw a neat circle

yes- have RESTING tremor

196

what does a babinski +ve test mean

claw out
UMN lesion

197

what is a bovine cough seen in

vagus nerve lesions

198

what disease are tongue fasciculations seen in

MND