Viral meningitis/Encephilitis

Question 1

Define meningitis

Answer 1

inflammation of the meninges

Question 2

Define encephalitis

Answer 2

inflammation of the brain

Question 3

Define meningo-encephalitis

Answer 3

inflammation of the brain and meninges

Question 4

What is the commonest cause of aseptic meningitis?

Answer 4

viruses

Question 5

What is the basic infectious particle of a virus?

Answer 5

virion

Question 6

What is the commonest viral cause of viral meningitis?

Answer 6

enteroviruses

Question 7

Describe the pathogenesis of viral meningitis

Answer 7

• colonisation of mucosal surfaces
• invasion of epithelial surface
• replication in cells
• dissemination and CNS invasion
• symptoms due to inflammatory response in CNS

Question 8

What are the general features of clinical presentation of viral meningitis?

Answer 8

• fever
• meningism (headache, stiff neck, photophobia)
• sometimes viral prodrome

Question 9

What is Kernig’s sign?

Answer 9

flex hip and knee to 90 degrees, knee cannot extend due to pain and stiffness

Question 10

What is Brudzinski’s sign?

Answer 10

felxing the neck causes the hips and knees to flex

Question 11

Define nuchal rigidity

Answer 11

resistance to flexion of the neck

Question 12

What do you test in a lumbar puncture sample for suspected meningitis?

Answer 12

MC&S, protein, glucose (must check blood glucose at same time), viral PCR

Question 13

Define pleocytosis

Answer 13

white cells in CSF

Question 14

What would you expect to see in the WBC count of someone with viral meningitis?

Answer 14

lyphocytic (

Question 15

What is the first treatment for suspected meningitis?

Answer 15

start IV antibiotics if any risk of bacterial meningitis

Question 16

What is Mollaret’s meningitis?

Answer 16

• recurrent aseptic meningitis

- wide differentil but major cause is HSV2

Question 17

What symptoms would you get in enteroviral meningitis?

Answer 17

fever, vomiting, anorexia, rash, URTI,

Question 18

What abnormal features are seen in people with mumps meningitis?

Answer 18

abdominal pain and orchitis

Question 19

What are the associated features of mengitis as part of primary infection in HIV?

Answer 19

fever, lymphadenopathy, pharyngitis, rash

Question 20

What is the cause of the majority of viral encephalitis?

Answer 20

HERPES SIMPLEX VIRUS (90% HSV1)

Question 21

What is the clinical presentation of viral encephalitis?

Answer 21

-ALTERED MENTAL STATE
-fever
-headache
-meningism
(also may have seizures, weakness, dysphagis, cranial nerve palsy and ataxia)

Question 22

How would you treat viral encephalitis?

Answer 22

• high dose IV acyclovir

- oral switch not recommended

Question 23

What are the CSF findings in viral encephalitis compared with that of viral meningitis?

Answer 23

the same

Question 24

What is acute disseminated encephalomyelopathy?

Answer 24

immune mediated CNS demyelination

Question 25

What are the long term complications of viral encephalitis?

Answer 25

paralysis, speech loss, personality change

Question 26

What treatment is given fro ADEM?

Answer 26

steroids/immunosuppressants

Question 27

What will the CSF findings show in ADEM>

Answer 27

same as viral meningitis