2023-12-03T05:12:03+03:00[Europe/Moscow] en true <p>b</p>, <p>mucosal colonization/infection, immunoglobulins inhibit colonization, bacteria invade bloodstream, bacteria invade CNS via BBB, bacteria replicate freely in SA space</p>, <p>a</p>, <p>b</p>, <p>b</p>, <p>a</p>, <p>b</p>, <p>strep. pneumo, neisseria meningitis, listeria</p>, <p>babies, older adults, pregnant</p>, <p>nuchal rigidity, altered mental status, photophobia, severe headache, fever</p>, <p>altered mental status, seizures, severe headache</p>, <p>b</p>, <p>a</p>, <p>brain herniation</p>, <p>opening pressure, WBC, differential, protein, glucose, CSF/blood glucose ratio</p>, <p>5-20 cm H2O</p>, <p>&lt; 5 cells</p>, <p>lymphocytes</p>, <p>neutrophils</p>, <p>&lt;50 mg/dL</p>, <p>45-80 mg/dL</p>, <p>50-60%</p>, <p>false</p>, <p>10-20 min before or with 1st dose of ABs; all patients with suspected/proven pneumococcal meningitis </p>, <p>dexamethasone can lower inflammatory response and decrease vancomycin CNS penetration </p>, <p>ampicillin + cefotaxime or aminoglycoside </p>, <p>vancomycin + 3rd gen ceph</p>, <p>vancomycin + 3rd gen ceph + ampicillin </p>, <p>amphotericin + flucytosine OR fluconazole </p>, <p>acyclovir </p>, <p>supportive care </p>, <p>acyclovir, fluconazole, flucytosine, metronidazole</p>, <p>augmentin, cefepime, cefotaxime, ceftazidime, ceftriaxone, vancomycin</p>, <p>cryptococcus </p>, <p>vancomycin + antipseudomonal agent; 10-14 days </p>, <p>n. meningitis </p>, <p>rifampin, ceftriaxone, ciprofloxacin</p>, <p>NSAIDs, IVIG, bactrim, mAB, lamotrigine, carbamazepine</p>, <p>MMR, hepatitis, diptheria </p> flashcards
Meningitis

Meningitis

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  • b

    Which is more common?

    a) meningitis

    b) encephalitis

  • mucosal colonization/infection, immunoglobulins inhibit colonization, bacteria invade bloodstream, bacteria invade CNS via BBB, bacteria replicate freely in SA space

    What is the pathophysiological cascade of meningitis? (5)

  • a

    Invade the CNS via motor neurons that are outside of the BBB.

    a) neuronal encephalitis

    b) hematogenous encephalitis

  • b

    Invade the CNS via the BBB.

    a) neuronal encephalitis

    b) hematogenous encephalitis

  • b

    Capillary endothelial cells are infected.

    a) neuronal encephalitis

    b) hematogenous encephalitis

  • a

    CNS damage is caused by inflammation.

    a) meningitis

    b) encephalitis

  • b

    CNS damage is caused by direct cell damage.

    a) meningitis

    b) encephalitis

  • strep. pneumo, neisseria meningitis, listeria

    What are the common pathogens involved in meningitis? (3)

  • babies, older adults, pregnant

    Which groups of people are more susceptible to Listeria-induced

    Meningitis?

  • nuchal rigidity, altered mental status, photophobia, severe headache, fever

    What are the symptoms of Meningitis? (5)

  • altered mental status, seizures, severe headache

    What are the symptoms of Encephalitis? (3)

  • b

    Involuntary flexion of the patient's hips and knees occurs in response to neck flexion.

    a) Kernig's sign

    b) Brudzinski's sign

  • a

    Patient experiences pain and exhibits resistance to the extension of the knee

    a) Kernig's sign

    b) Brudzinski's sign

  • brain herniation

    ________ may occur following lumbar puncture if intracranial pressure is elevated.

  • opening pressure, WBC, differential, protein, glucose, CSF/blood glucose ratio

    Which labs are examined in Meningitis/Encephalitis? (6)

  • 5-20 cm H2O

    The normal value for Opening pressure =

  • < 5 cells

    The normal value for WBC =

  • lymphocytes

    Normal/viral/fungal differential =

  • neutrophils

    Bacterial differential=

  • <50 mg/dL

    Normal protein =

  • 45-80 mg/dL

    Glucose=

  • 50-60%

    CSF/blood glucose ratio =

  • false

    In the treatment of Meningitis/Encephalitis, we should wait for fluid cultures before starting therapy. T/F

  • 10-20 min before or with 1st dose of ABs; all patients with suspected/proven pneumococcal meningitis

    When do we administer Dexamethasone? Who do we administer it to?

  • dexamethasone can lower inflammatory response and decrease vancomycin CNS penetration

    What do we have to consider when giving a patient Dexamethasone?

  • ampicillin + cefotaxime or aminoglycoside

    What is the empiric treatment for a patient less than 1 month old?

  • vancomycin + 3rd gen ceph

    What is the empiric treatment for a patient who is 1 month -50 years old?

  • vancomycin + 3rd gen ceph + ampicillin

    What is the empiric treatment for a patient who is > 50 years old? (3)

  • amphotericin + flucytosine OR fluconazole

    What is the treatment for cryptococcus species? (2)

  • acyclovir

    What is the treatment for HSV & Varicella?

  • supportive care

    What is the treatment for Enterovirus & Arbovirus?

  • acyclovir, fluconazole, flucytosine, metronidazole

    Which Antimicrobials penetrate the CNS without inflammation? (4)

  • augmentin, cefepime, cefotaxime, ceftazidime, ceftriaxone, vancomycin

    Which Antimicrobials penetrate the CNS ONLY with inflammation? (6)

  • cryptococcus

    Which CNS infection has a treatment course for up to a year?

  • vancomycin + antipseudomonal agent; 10-14 days

    What is the empiric therapy for Healthcare-associated

    Ventriculitis/Meningitis?

    How long is the treatment?

  • n. meningitis

    Which organism requires post-exposure prophylaxis?

  • rifampin, ceftriaxone, ciprofloxacin

    What is the treatment for post-exposure prophylaxis? (3)

  • NSAIDs, IVIG, bactrim, mAB, lamotrigine, carbamazepine

    Which medications can cause meningitis? (6)

  • MMR, hepatitis, diptheria

    Which vaccines can cause meningitis? (3)