AHN 572 neuro 2 Exam Questions and Answers| New Update with 100% Correct Answers
CSF normal values clear appearance
protein 15-60 mg/100ml
glucose 50-80mg/100ml
cell count 0-5 WBC, no RBC
CSF Opening Pressure 70-180
Meningitis symptoms classic triad of headache, neck stiffness and fever
-photophobia, vomiting, altered mental status, cranial nerve palsies, seizure, exaggerated DTR
nuchal rigidity stiffness in cervical neck area
Brudzinski's sign pain with resistance and involuntary flex of hip/knee when neck is flexed to
chest when lying supine
Kernig's sign Sign of meningitis; positive when the leg is fully bent at the hip and knee, and
subsequent extension of the knee leads to pain and spasm of hamstrings
Meningitis Diagnosis 1st: CT Brain
2nd: Lumbar puncture
meningitis CSF findings cloudy
pressure > 180
elevated WBC 100-5000; polymorphonuclear
elevated total protein 100-500
,decreased glucose 5-40
Jolt accentuation turning head horizontally 2-3 times - worsening baseline HA
Babinski sign The toes flex upward when sole of foot is stimulated - dorsiflexion
positive/abnormal finding in meningitis
Pneumococcal meningitis - head trauma, sinusitis, pna
- cranial nerve palsies/ obtundation
- csf wbc > 1000, polymorphonuclear
- glu < 40
- gram + cocci
Meningococcal meningitis - high fever, chills, HA, myalgias, NV
- + kernigs / brudzinski
- petechial rash
- gram -
- DIC
- CSF with elevated pressures, inc protein and Dec glu
H. influenzae meningitis adults with sinusitis or otitis
Klebsiella (meningitis) infants/ elderly, immunocompromised
Fungal meningitis common in clients who have AIDS
, Chronic Meningitis CSF wbc 100-1000 mostly lymphocytes, glu < 45, protein > 50
Meningitis treatment 18-50 vancomycin + ceftraixone
Meningitis organisms 18-50 s. pneumoniae, N. meninitidis
meningitis over 50 tx vancomycin + ampicillin + ceftraixone
meningitis over 50 organisms s pneumoniae, N meningitidis, Listeria monocytogenes, gram -
bacilli, group b strep
Meningitis treatment immunocompromised vancomycin + ampicillin + cefepime
meningitis organisms immunocompromised L monocytogenes, gram - bacilli, s pneumoniae
meningitis post surgery / trauma tx vancomycin + cefepime
post surgery/ trauma meningitis organisms s aureus, s pneumoniae, aerobic gram - bacilli,
brain abscess tx -IV abx (ceftriaxone + metronidazole + vancomycin)
-Surgical drainage
brain abscess with dexamethasone start within 2-4 days, prior to or with first dose abx
0.15mg/kg IV q6h if s pneumoniae suspect
hydrocephalus abnormal accumulation of fluid (CSF) in the brain
CSF normal values clear appearance
protein 15-60 mg/100ml
glucose 50-80mg/100ml
cell count 0-5 WBC, no RBC
CSF Opening Pressure 70-180
Meningitis symptoms classic triad of headache, neck stiffness and fever
-photophobia, vomiting, altered mental status, cranial nerve palsies, seizure, exaggerated DTR
nuchal rigidity stiffness in cervical neck area
Brudzinski's sign pain with resistance and involuntary flex of hip/knee when neck is flexed to
chest when lying supine
Kernig's sign Sign of meningitis; positive when the leg is fully bent at the hip and knee, and
subsequent extension of the knee leads to pain and spasm of hamstrings
Meningitis Diagnosis 1st: CT Brain
2nd: Lumbar puncture
meningitis CSF findings cloudy
pressure > 180
elevated WBC 100-5000; polymorphonuclear
elevated total protein 100-500
,decreased glucose 5-40
Jolt accentuation turning head horizontally 2-3 times - worsening baseline HA
Babinski sign The toes flex upward when sole of foot is stimulated - dorsiflexion
positive/abnormal finding in meningitis
Pneumococcal meningitis - head trauma, sinusitis, pna
- cranial nerve palsies/ obtundation
- csf wbc > 1000, polymorphonuclear
- glu < 40
- gram + cocci
Meningococcal meningitis - high fever, chills, HA, myalgias, NV
- + kernigs / brudzinski
- petechial rash
- gram -
- DIC
- CSF with elevated pressures, inc protein and Dec glu
H. influenzae meningitis adults with sinusitis or otitis
Klebsiella (meningitis) infants/ elderly, immunocompromised
Fungal meningitis common in clients who have AIDS
, Chronic Meningitis CSF wbc 100-1000 mostly lymphocytes, glu < 45, protein > 50
Meningitis treatment 18-50 vancomycin + ceftraixone
Meningitis organisms 18-50 s. pneumoniae, N. meninitidis
meningitis over 50 tx vancomycin + ampicillin + ceftraixone
meningitis over 50 organisms s pneumoniae, N meningitidis, Listeria monocytogenes, gram -
bacilli, group b strep
Meningitis treatment immunocompromised vancomycin + ampicillin + cefepime
meningitis organisms immunocompromised L monocytogenes, gram - bacilli, s pneumoniae
meningitis post surgery / trauma tx vancomycin + cefepime
post surgery/ trauma meningitis organisms s aureus, s pneumoniae, aerobic gram - bacilli,
brain abscess tx -IV abx (ceftriaxone + metronidazole + vancomycin)
-Surgical drainage
brain abscess with dexamethasone start within 2-4 days, prior to or with first dose abx
0.15mg/kg IV q6h if s pneumoniae suspect
hydrocephalus abnormal accumulation of fluid (CSF) in the brain
