immunology and meningococcal

Question 1

what is asthma

Answer 1

chronic inflammatory disease of the airways
cough SOB and wheeze

bronchial and hyperrepsonsiveness leading to broncho-constriction - reducing the airway calibre

Question 2

autoimmunity is increased what t cell

Answer 2

TH1

allergy is TH2

Question 3

gram-negative intracellular diplococcus what

Answer 3

Neisseria meningitidis

intravascular coagulation

Question 4

sx of meningococcal disease

Answer 4

Meningococcaemia (septicaemia)
Meningitis (non-specific signs such as lethargy, headache, fever, rigors and vomiting).
A mixture of both, associated with a rapidly developing purpuric skin rash.
Hypovolaemic shock may present with cold peripheries, poor capillary refill time and tachycardia, with decreased urine output.
When this is associated with massive adrenal haemorrhage and septic shock, the presentation is known as Waterhouse-Friderichsen syndrome. This is rare.

Diagnosis of meningococcal infection is confirmed by blood or CSF cultures (as appropriate).
Polymerase chain reaction (PCR) testing for Neisseria meningitidis is highly sensitive.

Question 5

prevention of meningococcal disease

Answer 5

ciprofloxacin or rifampicin as post-exposure prophylaxis.

Question 6

what is CI in meningococcal septicaemia

Answer 6

lumbar puncture

Question 7

intial tx of meningococcal disease in community

Answer 7

IM or IV benzylpenicillin

Question 8

what is a positive brudzinskis sign

Answer 8

neck flexion triggers involuntary knee or hip flexion - bacterial meningitis

Question 9

for a 15yr old male what dose of abx is needed

Answer 9

1.2g benzylpenicillin IM/IV

Question 10

menignitis associated with massive adrenal haemorrhage and septic shock is known as

Answer 10

waterhouse-friderichsen syndrome

Question 11

DD of meningococcal disease

Answer 11

blood culture