Neurology — Flashcards

Flashcard 471: _____ refers to meningitis and/or septicaemia caused by Neisseria meningitidis

Answer: Meningococcal disease

Flashcard 472: Headaches because of raised ICP are typically worse _____

Answer: in the morning

Flashcard 473: What is the first-line pharmacological agent for raised intracranial pressure? _____

Answer: IV mannitol

Extra: - **Mechanism**: Mannitol is an osmotic diuretic that reduces ICP by withdrawing water from the brain parenchyma into the intravascular compartment. - **Alternatives**: Hypertonic saline (3%) is also considered a first-line agent and is increasingly preferred in some protocols. - **Contraindications**: Anuria, severe pulmonary edema, or active intracranial bleeding (except during craniotomy).

Flashcard 474: What blood investigations are done for suspected meningitis? _____

Answer: Blood cultures

Flashcard 475: _____ is a life-threatening condition that involves inflammation of the leptomeninges caused by bacteria

Answer: Bacterial meningitis

Flashcard 476: Lumbar puncture for bacterial meningitis is contraindicated if _____, focal neurology, & signs of severe shock/sepsis

Answer: signs of ↑ ICP

Flashcard 477: What is the initial step in management for suspected bacterial meningitis in a primary care setting? \n_____ (and administration of pre-hospital antibiotics if delayed)

Answer: Emergency transfer to hospital

Extra: In suspected meningococcal disease in the community, the UK NICE guidelines and other international protocols recommend immediate IM/IV Benzylpenicillin if there's a non-blanching rash and a delay in hospital admission, but the absolute first step is calling for an emergency ambulance.

Flashcard 478: If ICP >_____mmHg then further management may be needed to ↓ ICP

Answer: 20

Flashcard 479: What is the most common cause of fungal meningitis? _____

Answer: Cryptococcus neoformans

Flashcard 480: A patient with raised ICP should be positioned _____

Answer: with head elevation of 30°