Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SALMAN HARRISON'S > 133 - Acute Meningitis > Flashcards

133 - Acute Meningitis Flashcards

1
Q

General damage, usually due to a __ infection, will be treated as __, and local will be called __ or __, depending on the involvement of the capsule

A

viral
encephalitis
cerebritis
abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Neck stiffness is pathognomonic for __

A

meningeal irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute meningitis, empiric __ should be administered soon after __ was taken

A

Abx

cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the indications for performing imaging (CT/MRI) prior to LP?

A 
recent trauma
immunodepression
CNS malignancy 
focal signs/papilledema 
decreased consciousness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Immunocompetent with normal consciousness, no previous Abx, typical viral meningitis CSF- should be treated as __. If no improvement after _ h, reevaluate including __

A

outpatients
48
LP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
What is typical viral meningitis CSF sample?
lymphocytosis _-_
protein _-_ mg/dL
glucose \_\_
opening pressure _-_
\_\_ may be high in the first 48h
A 
25-500
20-80 (normal)
normal
100-350 (normal- slightly high)
PMN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute bacterial meningitis=__

A

acute infection of the subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the common pathogens causing bacterial meningitis? 5

A 
pneumococcus
neisseria meningitis
GBS
Listeria
Haemophilus (decreased thanks to vaccination)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common pathogen causing meningitis? what is the main risk factor? what is the prognosis under treatment?

A

S. pneumoniae
pneumococcus pneumonia
20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mention risk factors for S. pneumoniae meningitis beside pneumococcus pneumonia: 5

A 
sinusitis/OM
alcoholism
diabetes
splenectomy 
hypogammaglobulinemia/complement deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the leading cause for acute bacterial meningitis in ages of 2-20? more in patients with __

A

neisseria meningitis

complement deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the classical triad of bacterial meningitis?

A

fever
headache
neck stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acute bacterial meningitis if untreated will __ quickly within days, decreased __,nausea-vomiting, __, __ (focal/general), increased __.

A 
deteriorate
consciousness
photophobia
seizures
ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Maculopapular rash might suggest __ infection

A

meningococcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When suspecting acute bacterial meningitis: __->__->__->__

A

blood cultures
LP
empiric treatment
dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q 
Diagnosing acute bacterial meningitis is based on:
opening pressure >\_\_mmH20
WBC> \_\_ cells/uL (mostly\_\_)
no \_\_
glucose  \_\_ mg/dL
G stain will be positive in \_\_% of cases
culture will be positive in \_\_% of cases
consider Latex agglutination test/PCR
A 
180
100, neutrophils
RBV
40
0.4
45
60
80
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the best imaging test for meningitis?

A

MRI, better than CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 4 DDx you should consider when suspecting acute bacterial meningitis?

A

HSV encephalitis
rickettsia
focal inflammation (abscess)
non infectious process (subarachnoid hemorrhage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In acute bacterial meningitis Abx should be given in the first __ minutes of arrival

A

60

20
Q

What are the empiric Abx for acute bacterial meningitis?

Dexamethasone should always be added to reduce the edema

A

cephalosporins (3rd/4th gen)
vancomycin
acyclovir
doxycycline

21
Q

Red man syndrome is a diffused__ when giving __ of __. To avoid it, choose __ drip.

A

erythema
IV
vancomycin
slow

22
Q

Immunocompetent children >_ and adults

A

cefotaxime
ceftriaxone
cefepime + vancomycin

23
Q

Adults > 55, any alcoholics, debilitating illness should receive the following Abx:

A

Ampicillin + cefotaxime/ceftriaxone
or
cefepime + vancomycin

24
Q

Nosocomial meningitis, posttraumatic/post-neurosurgery op, neutropenic, impaired cell mediated immunity- should receive the following Abx:

A

Ampicillin + ceftazidime
or
meropenem + vancomycin

25
Q

What are the best Abx for meningitis due to strep pneumonia/GBS/H. influenza?

A

cefotaxime

ceftriaxone

26
Q

Why do we add ampicillin to weaker patients?

A

to cover against listeria

27
Q

In which cases will you opt for metronidazole?

A

otitis/sinusitis/mastoiditis

28
Q

Ceftazidime is recommended for bacterial meningitis __ like __ which are the only nosocomial pathogens causing meningitis

A

G (-)

pseudomonas

29
Q

Meropenem is effective against __, __, __

A

listeria
pseudomonas
pneumococci

30
Q

What is the Abx of choice for meningococcal meningitis? If its resistance- __/__. All of whom that have been in contact with the patient should receive

A

penicillin G
cefotaxime/ceftriaxone
rifampin

31
Q

Listeria is a _ bacteria. If meningitis is caused- treat with __+__ for __ weeks

A

ampicillin
gentamicin
3

32
Q

What are the deadliest pathogens causing meningitis? __(20%), __(15%), __(3-7%)

A

strep pneumonia
listeria
neisseria/GBS

33
Q

Thanks to __,__,and __ a viral pathogen causing meningitis can be found in -% of cases

A

PCR
culture
serology
60-90

34
Q

What are the top viruses causing acute meningitis and encephalitis? 6

A 
enteroviruses (coxsackie/echoviruses)
VZV
HSV
EBV
arboviruses (west Nile)
HIV
35
Q

Secondary meningitis can be caused by inflammatory disease such as: 2

A

Bechet’s disease

sarcoidosis

36
Q

What is usually the treatment for acute viral meningitis?

A

symptomatic (analgesia, antipyretic, antiemetic) as outpatient

37
Q

Viral encephalitis=__

A

involvement of the brain’s parenchyma +/- meningitis

38
Q

What are the most common neurological symptoms of viral encephalitis? 5

A 
aphasia 
ataxia
hemiparesis
cranial nerve damage
hypothalamus-hypophysial axis damage
39
Q

Hypothalamus-hypophysial axis damage can lead to: 3

A

temperature dysregulation
diabetes insipidus
SIADH

40
Q

__ should be given whenever we suspect viral encephalitis. It is best against __. Choose __ drip to minimize renal damage

A

acyclovir
HSV, VZV, EBV
slow

41
Q

What is the drug of choice for CMV viral encephalitis?

A

ganciclovir

42
Q

What are the main causes for subacute meningitis?

A

TB
Cryptococcus neoformans
T. Pallidum (syphilis)
H capsulatum

43
Q

What is the empiric treatment for TB meningitis? 5

A

a combination of:

  • pyridoxine
  • pyrazinamide
  • isoniazid
  • rifampin
  • ethambutol
44
Q

When treating TB meningitis, which drugs should be discontinued after 8 weeks if the response is good? if the patient has developed hydrocephalus what should you add?

A

pyrazinamide

ethambutol

45
Q

When treating TB meningitis, if the patient has developed hydrocephalus what should you add?

A

steroids

SALMAN HARRISON'S (163 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions