14 Meningitis

Question 1

Normal CSF

Answer 1

Pressure: 60-150
Protein: 0.2-0.4
Glucose: More than ⅔ blood glucose
WBC: less than 5

Question 2

Lymphocytosis

Answer 2

Viral, TB, Lyme, Listeria, partially treated bacterial, Behcet, SLE, lymphoma, leukemia

Question 3

Pneumococ
Listeria
Lyme meningitis
Skull fracture

Answer 3

Pneumococ: followed by otitis media, Ceftriaxone
Listeria Meningitis: Positive bacil, Old, child, pregnant, immunocompromised( diabetes/alcohol) cheese, rash, Can be neutrophilic/lymphocytic, Brainstem involvement, Ampicillin + genta
Lyme meningitis: Erythema migrans (rash), Bilateral Bell’s palsy (facial weakness), lymphocytic meningitis, Tetracycline/ceftriaxone
Skull fracture: S. aureus, IV linezolid

Question 4

Most common viral meningitis

Answer 4

HSV1

Question 5

HSV 1 encephalitis, HSV 2 meningitis

Answer 5

SF PCR, Slightly low Glucose, Lymphocytosis, Temporal/frontal, erythema multiform, IV acyclovir 2 weeks

Question 6

Mumps

Answer 6

Proctitis

Question 7

Tuberculosis

Answer 7

very low bs, hyponatremia, india ink stain, CSF PCR, for culture to be + u need large volumes of CSF, 12 month, 4drugs 2month, 2drugs 10 month

Question 8

CMV

Answer 8

ependymal enhancement

Question 9

Subdural empyema

Answer 9

Frontal sinus infection, Streptococ, MRI

Question 9

ADEM/ Acute disseminated encephalomyelitis

Answer 9

Autoimmune demyelinating CNS, post infection measles,mumps, rubella, varicella, bacterial, after days to 2 month, multi focal neurologic symptoms such as sensory, motor, brainstem, oculomotor, non specific headache, fever, N/V
MRI: Supra-infra tentorial demyelination
Treatment: Corton -> IVIG

Question 10

Autoimmune encephalitis

Answer 10

Rasmussen, anti NMDAR/NR1, Glycine receptor mediated, bickerstaff brainstem, autoimmune limbic encephalitis
Treatment: Corton, IVIG, Plasmapheresis

Question 11

Limbic encephaliti

Answer 11

Potassium voltage gate