Infections

Question 1

CNS infections are medical emergencies. True/False?

Answer 1

True
Brain and spinal cord do not regenerate once injured

Question 2

When is the typical onset of viral meningitis?

Answer 2

Late summer/autumn

Question 3

Which viruses are typically responsible for viral meningitis?

Answer 3

Enteroviruses most common e.g. ECHO
HSV and other microbes also

Question 4

List investigations/diagnostic tools for viral meningitis

Answer 4

Viral stool culture
Throat swab
Lumbar puncture for CSF PCR

Question 5

Outline treatment for viral meningitis

Answer 5

Supportive - paracetamol, fluids, rest, dark room

Question 6

Which part of the brain does viral encephalitis affect?

Answer 6

Infection of brain parenchyma

Question 7

List the main causes of viral encephalitis

Answer 7

Herpes simplex
Varicella zoster
CMV, HIV, measles

Question 8

Which viruses are the only treatable causes of viral encephalitis?

Answer 8

HSV
Varicella zoster

Question 9

List clinical features of viral encephalitis

Answer 9

Meningismus (rigidity, photophobia, headache)
Comatose
Seizures
Paralysis
Confusion, psychosis
Speech and memory deficit

Question 10

List investigations for viral encephalitis

Answer 10

Lumbar puncture
Electroencephalography (EEG)
MRI

Question 11

What is the main treatment for viral encephalitis?

Answer 11

IV aciclovir

Question 12

List the main causes of bacterial meningitis in neonates

Answer 12

Listeria monocytogenes
E. coli

Question 13

Which antibiotic combats Listeria monocytogenes?

Answer 13

Ampicillin/amoxicillin

Question 14

Which organism is the main causes of bacterial meningitis in children?

Answer 14

H. influenzae

Question 15

Which organism is the main cause of bacterial meningitis in 10-21 year olds?

Answer 15

Neisseria meningitides from the throats of healthy carriers

Question 16

List the main causes of bacterial meningitis in adults

Answer 16

Strep. pneumoniae
Neisseria meningitides

Question 17

A fracture of the cribriform plate increases the risk of which bacterial meningitis?

Answer 17

Pneumococcal (Strep. pneumoniae)

Question 18

List the main causes of bacterial meningitis in the immunocompromised

Answer 18

Listeria
Strep. pneumonia

Question 19

List clinical features of bacterial meningitis

Answer 19

Meningismus
Vomiting
Pyrexia
Confusion
Rash

Question 20

Signs of bacterial meningitis are often absent in the very young, very old and immunocompromised. True/False?

Answer 20

True

Question 21

List investigations for bacterial meningitis

Answer 21

Blood cultures
Throat swab (meningococci)
Lumbar puncture for CSF

Question 22

A low ratio of blood sugar : CSF sugar is indicative of bacterial meningitis. True/False?

Answer 22

True

(low glucose)

Question 23

What is aseptic meningitis?

Answer 23

Non-pyogenic bacterial meningitis: low WBC count, normal glucose, small elevated protein

Question 24

List indications for hospital admission for bacterial meningitis

Answer 24

Altered consciousness
Petechial rash
Febrile, headache

Question 25

Which antibiotics are given for bacterial meningitis pre-hospital?

Answer 25

Penicillin
Ceftriaxone

Question 26

A CT scan should delay treatment in bacterial meningitis. True/False?

Answer 26

False
An urgent CT scan should be requested but does not delay treatment

Question 27

Why are steroids given to all patients suspected of bacterial meningitis?

Answer 27

Dampen down cerebral swelling caused by antibiotic treatment

Question 28

If a patient is penicillin-allergic, what antibiotic is given for bacterial meningitis?

Answer 28

Chloramphenicol

Question 29

Is the petechial rash in meningitis blanching or non-blanching?

Answer 29

Non-blanching