Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
28 Cards in this Set
- Front
- Back
|
1. Typical triad of meningitis sx?
|
1. Fever
2. HA 3. Stiff neck |
|
|
2. Brudzinski sign?
|
a. A physical finding consistent w/meningitis.
b. While the pt is supine, the neck is passively flexed resulting in involuntary knee and hip flexion. |
|
|
3. Kernig sign?
|
a. A physical finding consistent w/meningitis.
b. While the pt is supine, the legs are flexed at the hip and knee at 90° resulting in pain w/leg extension |
|
|
4. Most common causes of Neonatal meningitis?
|
1. E. coli
2. Group B strep (strep agalactiae) b. Listeria and other organisms (Citrobacter, streph sp, group D strep, and candida) are less common. |
|
|
5. What infants are at increased risk for meningitis?
|
a. Low birth weight and preterm infants
b. Those born to mothers w/chorioamnionitis c. After a prolonged rupture of amniotic membrane d. Traumatic delivery. |
|
|
6. How does most neonatal bacterial meningitis occur?
|
a. Via Haematogenous spread.
|
|
|
7. Clinical symptoms of neonatal meningitis?
|
a. Nonspecific and not the typical triad.
b. Instead, may have: 1. Thermal instability (often hypothermia) 2. Poor feeding 3. Emesis 4. Seizures 5. Irritability 6. Apnea c. May have Bulging fontanelles!!!! d. May either be hypo or hypertonic. |
|
|
8. 2 main causes of bacterial meningitis in older children?
|
1. S. pneumoniae
2. N. Meningitidis b. Vaccination has essentially eliminated Haemophilus influenza type B. |
|
|
9. In what season does pneumococcal meningitis most commonly occur?
|
a. In winter.
|
|
|
10. What children are at highest risk for pneumoccal meningitis?
|
a. Poorly functioning or absent spleen (it is encapsulated).
b. Children w/sickle cell have an infection incidence 300x greater |
|
|
11. Other risk factors for pneumococcal meningitis?
|
a. Sinusitis
b. Otitis Media c. Pneumonia d. Head trauma w/CSF leak |
|
|
12. In what % of normal individuals does Neisseria meningitidis colonize the URT?
|
a. 15%.
b. Carriage rates up to 30% are seen during invasive disease outbreaks. c. Disease appears to be caused by “new” infection rather than by long-term carriage |
|
|
13. Most common disease causing serotypes of N. meningitidis?
|
a. B and C.
|
|
|
14. Classic symptoms of meningitis seen in older children and adults?
|
a. Mental status change
b. N/V c. Lethargy d. Restlessness e. Ataxia f. Back pain g. Kernig and Brudzinski signs h. Cranial nerve palsies. |
|
|
15. What do ¼ to 1/3 of pts w/meningitis experience during the course of their disease?
|
a. Seizure.
|
|
|
16. Rash in Meningitis caused by N. meningitidis?
|
a. Petechial or purpuric rash (purpura fulminans)
b. It is associated w/septicemia. |
|
|
17. Note: Pts w/septicemia due to N meningitidis often are gravely ill and may or may not have associated meningitis.
|
17. Note: Pts w/septicemia due to N meningitidis often are gravely ill and may or may not have associated meningitis.
|
|
|
18. Test of choice for suspected meningitis?
|
a. LP
|
|
|
19. Contraindications to LP?
|
a. Skin infection over the planned puncture site!!
b. Evidence of or clinical concern for increased ICP c. Critically ill pts who may not tolerate the procedure. |
|
|
20. What is measured in CSF analysis?
|
1. Gram stain and culture
2. White and red blood cell counts 3. Protein and glucose b. Bacterial antigen screens can be performed in pts already receiving abx before the LP; these antigens may persist for several days, even when the culture is negative. |
|
|
21. Typical bacterial meningitis findings with LP?
|
a. Elevated opening pressure
b. Several hundred to thousands of WBCs w/PMN predominance. c. ↑ protein d. ↓ glucose. |
|
|
22. What should guide the decision make process for tx of bacterial meningitis?
|
a. CSF gram stain.
|
|
|
23. Tx of meningitis in neonate?
|
a. Ampicillin + (3rd gen ceph or aminoglycoside)
b. To cover infections caused by GBS, L. monocytogenes, and E. coli. |
|
|
24. Tx of suspected pneumococcal meningitis?
|
a. 3rd gen ceph + Vanco.
|
|
|
25. What are most N. meningitidis strains susceptible to?
|
a. PCN or cephs
|
|
|
26. Acute meningitis complications?
|
a. Seizures
b. Cranial nerve palsies c. Cerebral infarction d. Cerebral or cerebellar herniation e. Venous sinus thrombosis f. Subdural effusions. g. SIADH w/hyponatremia and central diabetes insipidus |
|
|
27. Most common long-term sequela of acute meningitis infection?
|
a. Hearing loss (up to 30% of pts w/pneumococcus)
b. Pts w/bacterial meningitis usually have a hearing eval at the conclusion of abx tx. |
|
|
28. Note: retropharyngeal abscess can also cause a stiff neck. Look for sore throat, dysphagia and fullness in oropharynx. Prob have normal mental status. Can also have nuchal rigidity.
|
28. Note: retropharyngeal abscess can also cause a stiff neck. Look for sore throat, dysphagia and fullness in oropharynx. Prob have normal mental status. Can also have nuchal rigidity.
|
