peds83

Question 1

why would you give steroids with antibiotics to treat meningitis?

Answer 1

before or with first dose of abx; effectively reduce hearing loss in HIB meningitis

Question 2

complications of meningitis

Answer 2

hearing loss is most common (up to 25% of patients); global brain injury occurs in 5-10%; SIADH, seizures, hydrocephalus; brain abscess, CN palsy; learning disability; and focal neuro defects

Question 3

CSF in acute bacterial infection

Answer 3

high protein, low glucose

Question 4

CSF in viral meningitis

Answer 4

normal to high protein, normal glucose

Question 5

tuberculosis meningitis- CSF

Answer 5

lymphocytes predom (as opposed to PMNs in bacterial); very high protein; very low glucose

Question 6

CSF in fungal meningitis

Answer 6

lymphocytes predom; normal to high protein; low glucose

Question 7

CSF in parameningeal focus (brain abscess)

Answer 7

polys or monos predom; high protein; low glucose; CSF culture neg

Question 8

aseptic meningitis

Answer 8

inflamm of the meninges with CSF lymphocyte pleocytosis; can be caused by virus (most common) or TB

Question 9

classic finding on brain imaging for TB meningitis

Answer 9

basilar enhancement

Question 10

acid fast stains in TB meningitis?

Answer 10

rarely positive

Question 11

most common cause of aseptic meningitis

Answer 11

viral

Question 12

most common cause of viral meningitis

Answer 12

enteroviruses, mumps, lymphocytic choriomeningitis, herpes viruses (EBV, CMV, VZV)

Question 13

viruses that commonly cause encephalitis and meningitis together

Answer 13

arboviruses (St louis, Western equine, Eastern equine, west nile virus), influenza, herpes virus

Question 14

bacterial causes of ASEPTIC meningitis

Answer 14

mycobacterim tuberculosis; borrelia burgdorferi (lyme dz); treponema pallidum(syphilis)

Question 15

fungal causes of aseptic meningitis

Answer 15

coccidioides immitis, crypto, histoplasmosis

Question 16

parasitic causes of aseptic meningitis

Answer 16

taenia solium, toxoplasma gondii

Question 17

management of viral meningitis

Answer 17

none

Question 18

management of TB meningitis

Answer 18

four meds: rifampin, pyrazinamide, isoniazid, and streptomycin; corticosteroids are also commonly used

Question 19

which cause of aseptic meningitis has the worst prognosis?

Answer 19

TB; it has a 20% mortality in kids

Question 20

common viruses that cause the common cold

Answer 20

rhinovirus, parainfluenza, coronavirus, and RSV

Question 21

URI sx for how long should prompt the physician to evaluate for bacterial superinfection?

Answer 21

greater than 10 days

Question 22

when do sinuses develop?

Answer 22

ethmoid and maxillary present at birth; sphenoid develop between ages 3 and 5 yo; frontal between 7 and 10 yo

Question 23

how is sinusitis classified?

Answer 23

acute, subacute, and chronic based on the duration of symptoms

Question 24

imaging for uncomplicated sinusitis?

Answer 24

no, it’s a waste and not helpful