PPT Meningitis

Question 1

What should be done in menigitis without signs of shock?

Answer 1

Blood cultures
Lumbar puncture
10mg IV dexamethasone
2g ceftriazone or cefotaxime

Question 2

What should be done in menigitis with signs of shock or raised ICP?

Answer 2

Secure airway with high flow oxygen
Take bloods
IV 10mg dexamethasone
Delay lumbar puncture

Question 3

When to delay lumbar puncture?

Answer 3

Severe sepsis
Raised ICP like papilloedema, focal neurological signs and raised GCS

Question 4

What is the immediate management of menigitis?

Answer 4

A to E assessment
Senior review for warning signs of raised ICP or shock

Question 5

What is given for primary care management of menigitis?

Answer 5

Benzylpenicillin

Question 6

What are the side effects of benzylepnicllin?

Answer 6

Encephalopathy or seizures
Toxic epidermal necrolysis
Cholestasis

Question 7

What are the indications for benzylpenicillin?

Answer 7

Tonsillitis
Bacterial menigitis
Endocarditis
Tonsillitis

Question 8

What is the empirical antibiotic choice for bacterial menigitis?

Answer 8

Cephalosporins like ceftriaxone or cefotaxime which are beta-lactase and are bactericidal and can cross blood-brain barrier

Question 9

What are the indications for cefotaxime?

Answer 9

Bacterial menigitis
STI
Haemophilus epiglottis

Question 10

What is the adverse side effect of cefotaxime?

Answer 10

Antibiotic associated colitis
Hypersensitivity
GI disturbance

Question 11

what is the dose of cefotaximetaxime for menigitis?

Answer 11

2g IV or IM

Question 12

What is the stat dose of benzylpenicillin for meningitis?

Answer 12

1.2g IM or IV

Question 13

What is thee dose of steroid given for raised ICP?

Answer 13

IV dexamethasonethasone 10mg

Question 14

Which drugs can dexamethasoneethasone cause Hypokalemia with?

Answer 14

Citationopram and venlafaxine

Amiodarone

Antipsychotic

Question 15

What is the treatment for suspected encephalitis?

Answer 15

Aciclovir which inhibits viral DNA polymerase

Question 16

What is the treatment course for encephalitis?

Answer 16

Minimum 14 days
-> increase to 21 days of immunocompromised

Question 17

What is a key issue with use of Aciclovir?

Answer 17

Dehydration nad AKI
-> use of trimethoprim, methotrexate, cephalosporins and NSAIDs, and ACE-i increase this risk

Question 18

What are the alternative side effects of Aciclovir?

Answer 18

AKI
CNS effect
GI disturbance
Skin reaction

Question 19

What should be done before stopping Aciclovir?

Answer 19

Repeat lumbar puncture to confirm negative CSF

Question 20

What increases levels of Aciclovir?

Answer 20

Aminophyline and theophylline