13/11

Question 1

What is the treatment for bacterial meningitis?

How could this potentially differ in extremes of age?

Answer 1

IV ceftrioxone and dexamathesone

IM BenzylPenicillin immediately

Listeria can be a cause in extremes of age and needs IV amoxicillin

Question 2

What are the potential complications of lumbar puncture?

What must be checked before?

Answer 2

BIP
Bleeding
Infection
Pain - back pain and headache

Brain herniation

Clotting screeen

Question 3

What are the investigations that need to be done to check if an adrenal mass is functional?

Answer 3

Aldosterone - aldosterone:renin
Cortisol - overnight dexametheone suppression
Noradrenaline/adrenaline - urinary 24hr metanephrines

Question 4

What are the causes of SIADH?

What are the biochem findings?

Treatment

Answer 4

Surgery (24-48hrs post op)
Idiopathic/intracranial/infection
Acute and chronic lung disease
Deficiency of cortisol/drugs e.g. SSRIs
Hypothyroidism/ hyponatremia

Low Na in blood/low osmolality
High Na in urine and high osmolality

Restrict fluid intake

In sever situations .. seizures
Give 1.8% saline - osmosis water out of cells by reducing water conc in blood

Question 5

Main side effect of gentamicin toxicity

Answer 5

Ototoxicity - lose hearing