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Neurology > Meningitis > Flashcards

Meningitis Flashcards

1
Q

What is meningitis?

A

Inflammation of the meninges

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2
Q

What are the different classifications of meningitis?

A

bacterial/pyogenic

viral/aseptic

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3
Q

What are some early symptoms of meningitis?

A

headache
leg pains
cold hands and feet
abnormal skin colour

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4
Q

What are the later symptoms of meningitis?

A

meningism: stiff neck, photophobia, Kerning’s sign
reduced conscious level, coma
seizure and focal CNS signs
petechial rash - non blanching

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5
Q

Do you get altered consciousness in viral meningitis?

A

No - this is what differentiates it from bacterial

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6
Q

What is a late sign of bacterial meningitis?

A

papilloedema

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7
Q

What are the most common organisms causing bacterial meningitis?

A 
strep. pneumoniae (older ages)
Neisseria meningitidis (younger)
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8
Q

What are the most common organisms causing meningitis in neonates?

A

listeria
group B strep
E coli

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9
Q

What is the most common organism causing meningitis in children?

A

H influenzae

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10
Q

What is the most common organism causing meningitis in 10-21 year olds?

A

meningococcal (Neisseria meningitidis)

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11
Q

Who is at risk of listeria?

A

neonates
old people
immunocompromised

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12
Q

What is the headache like in viral meningitis?

A

severe - onset 1-6hours

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13
Q

What viruses cause viral meningitis?

A

enteroviruses e.g. echo, coxsackie

self limiting

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14
Q

What is worse - bacterial or viral meningitis?

A

bacterial

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15
Q

How is viral meningitis diagnosed?

A

viral PCR - stool culture, throat swab

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16
Q

What is the CSF like in bacterial meningitis?

A 
turbid
v high WBC 
high neutrophils 
high protein 
low glucose
17
Q

What is the CSF like in viral meningitis?

A

clear
high WCC
protein normal/slightly raised
glucose normal

18
Q

What is the management of bacterial meningitis?

A

immediate Abx
ABCDE
blood culture
CT

19
Q

What are red flags in meningitis?

A

seizure
GCS >2 or <12
focal neurology

20
Q

What antibiotics do you give immediately in bacterial meningitis?

A

ceftriaxone IV
also dexamethasone IV

penicillin allergic:
chloramphenicol and vancomycin

21
Q

What antibiotics do you add if you suspect listeria?

A

add amoxicillin or ampicillin

penicillin allergic: co-trimoxazole only

22
Q

What is prophylaxis for contacts in bacterial meningitis?

A

children: rifampicin
adults: ciprofloxacin

Neurology (24 decks)

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