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Hint
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Answer
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Give four symptoms of bacterial meningitis (not age-specific)
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Neck stiffness
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Bulging fontanelle
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Decreased level of consciousness
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Convulsive status epilepticus
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"A non-blanching rash is always present in an infant or child with bacterial meningitis." True or false?
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False
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What is the key investigation for a diagnosis of BM?
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Isolation of pathogen from CSF sample / Lumbar puncture
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Name the special tests which look for meningeal irritation.
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Kernig's test
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Brudzinski's test
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CSF that is contaminated with BM pathogens will have what appearance?
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Cloudy
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CSF samples are sent for what tests?
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Cell count and differential
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Protein
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Glucose (and serum glucose)
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Microscopy, cultures and sensitivity / MC&S
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Viral PCR
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In BM-infected CSF samples, will there be high or low: protein?
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High
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Glucose?
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Low
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White cells?
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High
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What other bedside tests might be performed on a patient with suspected BM?
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Throat swab
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Respiratory viral screen / nasopharyngeal swab
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Apart from a FBC, U&E and LFTs, what other blood and biochemical tests may be ordered for a patient with suspected BM?
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Bone profile
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Coagulation / Coag
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CRP / c-reactive protein
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Blood culture
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VBG / venous blood gas
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What type of imaging may be used to look for contraindications to the LP?
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CT
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What are the most common organisms which cause meningitis?
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Neisseria meningitidis
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Streptococcus pneumoniae / pneumococcus
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Haemophilus influenzae
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Group B streptococcus / GBS
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Listeria monocytogenes
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Escherichia coli / E. coli
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What type of white cell is the most common in an infected CSF sample from a patient with BM?
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Neutrophils
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Antibiotics should not be administered intra-muscularly to patients with what type of disorders?
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Bleeding
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Topical antibiotics are prescribed to patients with infections where?
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Skin
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Ear
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Eye
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"A doctor may wait to prescribe antibiotics until after a blood culture and LP have been taken." Is this true?
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Yes
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What antibiotic is usually given to babies <3 months old for a bacterial meningitis infection?
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Cefotaxime
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Which other antibiotics may be given alongside this (i.e. as a dual therapy) to protect against listeria?
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Amoxicillin
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Ampicillin
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What antibiotic is usually given to children >3 months old for a bacterial meningitis infection?
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Ceftriaxone
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What is the Route of Administration for this drug?
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IV / intravenous
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What other type of medication is given alongside antibiotics to help prevent complications from meningitis?
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Steroids
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What is the main potential complication of bacterial meningitis?
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Hearing loss / deafness
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What other complications can be caused by this disease?
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Seizures / epilepsy
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Cognitive impairment / learning disability
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Memory loss
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Cerebral palsy
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