FN: Meningitis Flashcards Preview

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Flashcards in FN: Meningitis Deck (18):
1

Features

Meningitic
Neurological
Septic

2

Meningitic

HEadache
Neck stiffness
Photophobia
n/v

3

Neck stiffness signs

Kernigs
Brudzinskis

4

Kernigs

Straightening leg with hip @ 90degrees

5

Brudzinski's

Lifting head --> lifting of legs

6

Neurological

reduced GCS - coma
Seizures (20%)
Focal neuro (20%) e.g. CN palsies

7

Septic

Fever
low BP, high HR
Raised CRT
purpuric rash
DIC

8

Abx therapy

1. Community: benpen 1.2g IV/IM
2. 50 ceftriaxone + ampicillin 2g IVI/4h
4. If viral syspected: aciclovir

9

Organisms

1. viruses: enteroviruses (Coxsackie, echovirus), HSV2
2. Meningococcus
3. Pneumococcus
4. Listeria
5. Haemophilus
6. TB
7. Cryptococcus

10

Investigations

Bloods: FBC, U+E, clotting, glucose, ABG

Blood cultures

LP: MCS, glucose, virology/PCR, lactate

11

Acute Management
Step 1

ABC
1. Oxygen 15L - SpO2 94-98%
2. IVI fluid resus with crystalloid

distinguish between septicamic or Meningitis

12

Mainly septicaemic treat with

1. Dont attempt LP
2. Ceftriaxone 2g IVI
3. Consdier ITU if shocker

13

Mainly Meningitis

1. If no shock or CIs do LP
2. Dexamethasone 0.15mg/kg IV QDS
3. Ceftiaxone 2g IVI post-LP

14

Prophylaxis for nearby people

Rifampicin

15

Contraindications for an LP:
Try LP Unless ContraINdicated

Thrombocytopenia
LAteness (delay in antibiotic admin)
Pressure (Cardio + resp systems)
Unstable (Cardio + resp systems)
Coagulation disorder
Infection at LP site
Neurology (focal neurological signs)

16

Findings in CSF for Bacterial

Apperance: Turbid
Cells: PMN
Count: 100-1000
Glucose: low (1.5)

17

CSF findings in TB meningitis

Apperance: fibrin web
Cells: Lympho/mononuc
Count: 10-1000
Glucose: low (

18

CSF findings in Viral

AppearanceL Clear
Cells: Lympho/mononuc
Count: 50-1000
Glucose:>1/2 plasma
Protein mild

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