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16 Cards in this Set
- Front
- Back
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List six (6) other causes of fever in a child.
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1. Malignancy
2. Heat stroke 3. Exercise 4. Toxins, Immunisations 5. Damage to hypothalamus 6. Teething |
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Outline the four (4) routes of entry of bacteria into the CNS.
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1. Direct penetration
2. Haematogenous 3. Local extension (e.g. from sinus) 4. Peripheral nervous system |
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What are the most common infective agents in meningitis?
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Infection by normal flora:
- Neisseria meningitidis - Haemophilus influenzae - Streptococcus pneumoniae - Viruses (mumps, HSV) |
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Outline the process by which meningitis infection may lead to coma.
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> Invasion of CSF by pathogens
> Inflammatory cytokine release > Increased permeability of BBB > Oedema + increased blood flow > Raised ICP > Coma |
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List four (4) major features in the clinical presentation of meningitis (adults & children).
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1. Headache
2. Fever 3. Neck stiffness (nuchal rigidity) 4. Skin rashes |
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How might you ascertain meningitis in a very young infant who is unable to inform you of headache, etc?
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- Irritability
- High pitched meningeal cry - Anorexia - Vomiting/diarrhoea |
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What three (3) tests could you perform to elicit pain related to meningitis?
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1. Kernig's test
2. Brudzinski's test 3. Nuchal rigidity test |
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List three (3) signs of raised intracranial pressure.
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Raised ICP:
1. Papilloedema 2. Impaired consciousness 3. Dilated pupils (poor response to light) |
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What might skin rashes and petichiae on a child with meningitis suggest?
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- Septicaemia
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List six (6) major complications of severe meningitis.
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Complications
1. Septic shock 2. Gangrene > Amputation 3. Adrenal haemorrhage (Waterhouse-Friedrichsen) 4. Brain damage 5. Renal damage 6. Hearing loss (most common) |
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What investigations would you do for a suspected case of meningitis?
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1. Blood culture
2. Lumbar puncture 3. Head CT / MRI |
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Descibe the CSF findings for both viral and bacterial meningitis for the following variables:
- Gross appearance - Glucose - Opening pressure - Cell count |
VIRAL
- Opalescent appearance - Glucose normal - Slightly elevated opening pressure - Cell count moderately elevated BACTERIAL - Turbid appearance - Glucose very low - Opening pressure high - Cell count very high |
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What is the therapy of choice for bacterial meningitis?
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EMPIRICAL THERAPY
Penicillin G + Ceftriaxone + Vancomycin |
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What prevention measures are there for meningitis in the community?
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- Pneumococcal vaccines
- Meningococcal vaccines |
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Other than meningitis, list four (4) other CNS infections.
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1. Cerebral abscess
2. Empyema 3. Encephalitis 4. Creutzfeldt-Jakob (Prion) Disease |
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List four (4) major types of CNS tumours.
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1. Gliomas (e.g. astrocytoma)
2. Meningiomas (e.g. gangliocytoma) 3. Neuronal tumors 4. Poorly-differentiated tumour |
