150 - Meningococcal Infections

Question 1

Neisseria meningitides is an __ G(_) colonizing the __ and can cause bacterial __/__.

Answer 1

aerobic 
-
nasopharynx
meningitis
sepsis

Question 2

In the __ countries meningococcus has decreased in recent years thanks to __

Answer 2

industrial

vaccination

Question 3

Which genetic deficiency is a risk factor for neisseria meningitides infection? Remember it increase __ but not __

Answer 3

C5-9 complement deficiency
morbidity
mortality

Question 4

Main risk factors for Neisseria meningitides include: 5

Answer 4

age (1st year, adolescences)
crowded habitat
contact with a carrier
hyposplenism 
hypogammaglobulinemia

Question 5

The severity of the disease depends on the levels of the __ (__), and the __ response

Answer 5

endotoxin
LPS
immune

Question 6

Although meningococcal __ is not common, symptoms are common

Answer 6

pharyngitis

URT

Question 7

The most common symptoms are:

Answer 7

meningitis/conductivities
sepsis
pneumonia
bacterial arthritis/OM
purulent pericarditis 
primary peritonitis

Question 8

Symptoms develop within - days, and sometimes even __

Answer 8

1-10

hours

Question 9

The rash is caused by __ necrosis. It does not disappear when pressing it (__/__) and found in __% of cases but in only __% of children

Answer 9

endothelial
purpura/petechia
80
10

Question 10

-% of patients present with __ alone, _% with __ and __.

Answer 10

30-50
meningitis 
40
meningitis
sepsis

Question 11

Bacterial meningitis should be suspected in patients with: 
\_\_
\+
\_\_/\_\_
\+
\_\_/\_\_/\_\_/\_\_

Answer 11

headache
current/history of recent fever
nuchal rigidity/photophobia/decreased conciseness/seizures

Question 12

__/__ help differentiate Neisseria meningitides from other meningitis.

Answer 12

Petechia/purpura

Question 13

Septicemia is present in __% of patients and can cause __ within __

Answer 13

20
death
hours

Question 14

Septicemia may cause: 5

Answer 14

hypoglycemia
acidosis
hypokalemia/hypocalcemia/hypomagnesemia/ hypophosphatemia
anemia

Question 15

What are the C/I for LP: 7

Answer 15

cranial HTN
shock
coagulation disorder
thrombocytopenia
respiratory insufficiency 
local infection
seizures

Question 16

What are the steps of treating meningitis? 5

Answer 16

shock? -> ABC
electrolyte/metabolic balance
empiric Abx (cephalosporines 3rd gen)
treat for 7 days (or 3-5)

Question 17

What are the complications of neisseria meningitides infection? 5

Answer 17

death 10%
skin scaring  (post necrosis) 10%
organ amputation 1-2%
hearing problems 5%
neurological complications 7%

Question 18

Which factors bare bad prognosis? 5

Answer 18

infancy/old age/adolescents
coma
purpura fulminans
DIC
thrombocytopenia

Question 19

Prevention is made by two types of vaccinations:

Answer 19

capsule vaccine

subcapsular

Question 20

If secondary exposure has occurred- __ prophylactic treatment for high risk patients and health care workers exposed to direct __ secretion.

Answer 20

preventive

respiratory

Question 21

What is the prophylactic treatment that should be given to the relevant patients?

Answer 21

cephalosporines 3rd gen
or
ciprofloxacin/ofloxacin (for non pregnant)