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Hugh's MD2 Intersession 2 > Meningitis > Flashcards

Flashcards in Meningitis Deck (26)
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1

What is the normal number of polymorphs in CSF?

0

2

Which bacteria causes meningitis in pregnant women?

L. monocytogenes

2

What is the protein and glucose in bacterial meningitis?

High >1g/dl

Low

3

What is the empircal abx therapy for bacterial meningitis?

Cetriaxone

Penicillin

4

In which seasons are viral meningitis most common?

Autumn and summer

5

Is it normal to have blood in the CSF?

Maybe in the first tube

If in all the tubes - think subarachnoid

5

When do you give antibiotics in relation to the CT?

Before

5

What is the most common cause so of encephalitis?

Herpes simplex virus

7

Which viruses cause viral meningitis?

Enteroviruses - Echo, polio, coxsackie

8

Which bacteria causes neonatal meningitis?

S. agalacticae

E. coli

8

What are some cause of aseptic meningitis?

Partially treated bacterial meningitis (when CSF is taken post abx)

Drugs (cotrimoxazole/NSAIDs)

Syphilis (particularly secondary)

Post ictal

10

How does meningitis present?

Headache, photophobia and neck stiffness

Fever, nausea and vomiting

Rash

(Clear conscious state)

11

What are the aetiology of bacterial meningitis?

Pneumococcus (most common)

Meningicoccus 

L. monocytogenes

S. agalacticae

E. coli

TB

[H influenzae type b]

 

12

What is the duration and administration of abx therapy?

3 days minimum

10 days for meningococcal

IV

13

What does Listeria monocytogenes meningits differ in presentation?

Tends to target brainstem - eye signs, brainstem signs

15

How does TB meningitis kill people?

Respiratory depression due to invasion of local vessels

Strokes 

15

What is Kernig's sign?

Raise the leg and there is limitation of hip flexion that is improved by flexing the knee

16

Why is ancyclovir specific to viral infected cells?

Because a HSV enzyme phosphorylates the first step of activation

17

What is added to abx in the treatment of bacterial meningitis?

Steroids - dexamethasone

19

What is the phenotype of meningococcus?

Gram -ve 

Intracellular

20

What is the protein and glucose in viral meningitis?

Both are normal

21

Where do the bacteria travel to the brain from?

Back of the throat

Secondary to a pneumonia, endocarditis

Cranial osteomyelitis

22

When is the empirical abx therapy for meningitis altered? How is it changed?

When Pneumococcus is suspected

- GPC seen, otitis media, CSF leak

 

Switch penicillin to vancomycin, (keep cefrtiaxone)

Add rifampicin if penicllin resistance is confirmed

24

What is the normal level of lymphocytes in the CSF?

2

25

How is TB meningitis treated?

Isoniazid

Rifampicin

Pyrazinamide

Ethambutol

26