Meningitis

Question 1

presentation of meningitis

Answer 1

Headache, neck Stiffness (Kernig’s sign), Photophobia, Nausea and vomiting

Neuro - Seizures, CN Palsies, Reduced GCS
Septic - ISHOCKS: increased RR, Sinus Tachy, Hypotension, oliguria, Cyanosis, Klammy, Slow cap refill

Question 2

Causative Organisms 0-3months

Answer 2

GEL

Group B strep
E. Coli
Listeria monocytogenes

Question 3

Causative Organisms 3mo - 6 years

Answer 3

NHS

Nissearia Menigitidis
Haemophilus influenzae
Strep. Pneumonia

Question 4

Causative Organisms 6 - 60 years

Answer 4

Nissearia Menigitidis

Strep. Pneumoniae

Question 5

Causative Organisms >60 and immunocompromised

Answer 5

Listeria monocytogenes

Question 6

Acute management - Mainly Septic

Answer 6

NO LP
Ceftriaxone
ITU if In Shock

Question 7

Acute management - mainly meningitic

Answer 7

If no shock and no CI’s do an LP

Ceftriaxone + Dexamethasone

Question 8

Continued management

Answer 8

Maintenance Fluid for pt

Rifampicin Prophylaxis for Household contacts

Question 9

Contraindications for LP

Answer 9

Coag Disorder
Thrombcytopaenia
Focal neural Signs
Infected LP site
Unstable CVS/Resp
Delay in Abx
increased ICP

Question 10

LP finding in Bacterial mengitis

Answer 10

Appearance - Turbid
Cells - neutrophils
Glucose - Low
Proteins - Very High

Question 11

LP finding in TB

Answer 11

Appearance - Fibrin Web
Cells - Mono/lymphocytes
Glucose - Low
Protein - Very high

Question 12

LF finding in Viral Meningitis

Answer 12

Appearance - Clear
Cells - monocytosis/Lymphocytes
Glucose - Normal
Protein - Mildly high