Clinical Neuroscience > Meningitis + encephalitis > Flashcards

Meningitis + encephalitis Flashcards

(43 cards)

Study These Flashcards
1
Q

Categories of CNS infections

A
  • encephalitis: infections of parenchyma
  • meningitis: infections of meninges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the triad of meningism?

A

Headache
Neck stiffness
Photophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation of meningitis

A
  • triad of meningism with fever
  • joint pain
  • meningococcal non blanching rash
  • reduced GCS
  • flu like symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presentation for babies in meningitis

A
  • listen to parents
  • inconsolable crying/high pitched
  • reduced feeds
  • floppy
  • bulging fontanelle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What commonly causes meningitis rash?

A

Meningococcal meningitis/septicaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe meningeal rash

A

Non balancing
Purpuric rash
Often on trunk, legs, mucous membranes, conjunctivae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is meningitis commonly due to in neonates?

A

E. coli
Group B streptococcus
Listeria monocytogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is meningitis commonly due to in children?

A

Haemophilias influenzae type B
Neisseria meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is meningitis commonly due to in eldery?

A

Streptococcus pneumoniae
Listeria monocytogenes
Neisseria meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Risk factors of meningitis

A
  • CSF defects e.g. spina bifida
  • spinal procedures e.g. surgery, lumbar puncture
  • diabetes
  • alcoholism
  • endocarditis
  • splenectomy
  • crowded housing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pathophysiology of meningitis

A
  • nasal commensals enter circulation > bacteraemia
  • damages vessel walls in brain + meninges
  • allowing pathogens to enter subarachnoid space
  • pathogen multiply rapidly > purulent CSF + meningeal inflammation
  • cerebral oedema + raised ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Complications of meningitis

A
  • sensorineural hearing loss (most common)
  • septic shock
  • disseminated intravascular coagulation
  • coma
  • seizures
  • hydrocephalus
  • focal paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Kernig sign?

A
  • supine patient with thigh flexed at 90°
  • extension of knee met with resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Brudzinki’s neck sign?

A

When neck is flexed there is involuntary flexion of knees and hips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are two tests signs of meningitis?

A

Kernig sign
Brudzinski

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Investigations of meningitis

A
  • lumbar puncture
  • blood cultures
  • meningococcal PCR if indicated
  • viral PCR if indicated
  • head CT if raised ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What signs would delay a lumbar puncture?

A
  • Decreasing consciousness GCS below 9
  • Brainstem signs
  • Recent seizure
  • Papilloedema
  • signs of severe sepsis
  • rapidly evolving rash
  • severe resp or cardiac compromise
  • significant bleeding risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Lumbar puncture findings of bacterial meningitis

Study These Flashcards
A
  • cloudy CSF
  • high protein
  • high white cells (especially neutrophils)
  • low glucose (bacteria metabolise it)
19
Q

Lumbar puncture findings of viral meningitis

Study These Flashcards
A
  • clear or cloudy
  • protein level normal or raised
  • high white cells (especially lymphocytes)
  • normal glucose
20
Q

Antibiotic treatment of meningitis

Study These Flashcards
A
  • 3 months -60 years: IV Ceftriaxone
  • <3 months or >60 years: add amoxicillin
  • meningococcal meningitis: IV benzylpenicillin or IV ceftriaxone
  • due to listeria: IV amoxicillin + gentamicin
21
Q

Why is dexamethasone given in treatment of meningitis?

Study These Flashcards
A

To prevent hearing loss in pneumococcal meningitis

22
Q

Viral causes of meningitis

Study These Flashcards
A

herpes simplex virus
varicella zoster virus

23
Q

What is used in post exposure prophylaxis of meningitis?

Study These Flashcards
A

single dose of ciprofloxacin given ASAP after contract tracing

24
Q

What must happen after a diagnosis of meningitis?

Study These Flashcards
A

Notify public health england
bacterial meningitis + menigococcal infection are notifiable diseases

25
Presentation of encephalitis
- headache - confusion/drowsiness - seizures - N+V - behavioral changes - fever - loss of consciousness
26
Causes of encephalitis
- autoimmune - herpes simplex virus - varicella zoster virus - rarely bacterial or fungal infection - could be spread by mosquitos, ticks or from mammals with rabies
27
Prevention of encephalitis
- MMR vaccine - encephalitis vaccines for travelers - rabies vaccine
28
Diagnosis of encephalitis
- CT or MRI head - lumbar puncture - EEG - FBCs, LFTs, urinalysis
29
Treatment of encephalitis
- antiviral/antibiotics/antifungal medications depending on cause - ***IV aciclovir** - steroid injections if due to the immune system - painkillers - plasmapheresis - anticonvulsants
30
Complications of encephalitis
- amnesia - personality or behavioral changes - dysphagia - epilepsy - balance + coordination problems
31
Antibiotics for meningococcal meningitis
IV benzylpenicillin or IV ceftriaxone
32
Antibiotics for meningitis caused by listeria
IV amoxicillin + gentamicin
33
Management of meningitis
- blood cultures - lumbar puncture - IV abx - **IV ceftriaxone** - IV dexamethasone if pneumococcal meningitis - AVOID in meningococcal septicaemia or immunocompromised
34
Management of meningitis patients with signs of raised ICP
- critical care input - secure airway + high flow O2 - bloods + blood cultures - IV dexamethasone - IV abx - neuroimaging
35
What should be given in meningitis due to pneumococcal meningitis in addition to abx and why?
IV dexamethasone To reduce risk of hearing loss
36
Management of contacts in cases of meningitis -
- prophylactic abx if close contact within 7 days before onset - oral Ciprofloxacin or rifampicin - not needed for pneumococcal meningitis
37
Gram stain of neisseria meningitidis
Gram negative diplococci
38
Gram stain of listeria
Gram positive bacilli
39
Gram stain of Haemophilus influenza
Gram negative cocco-bacillus
40
Gram stain of streptococcus pneumoniae
Gram positive diplococci
41
Compare the white cells seen in a LP of viral vs bacterial meningitis
Viral - lymphocytes Bacterial - neutrophils (polymorphs)
42
Lumbar puncture of TB meningitis
- clear or cloudy - high white cells - mainly lymphocytes - very high protein - very low glucose
43
Management of viral meningitis
self limiting 7-14 days
Clinical Neuroscience
flashcards
Decks in class (22)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions