Microbio

Question 1

Gram negative diplococci in a patient with low glasgow coma score and positiev kernigs sign?

Answer 1

Neisseria meningitidis

Question 2

What is the treatment for neisseria meningitidis?

Answer 2

Ceftriaxone 2g twice daily IV

For 5 days

(As sensitive to penicillin and ceftriaxone has a long half life)

Question 3

If a patient with known menigitidis was at flat party for 4hrs previous to his treatment should public health contact them?

Answer 3

Yes

Spread through saliva….

Question 4

How is neisseria meningitidis transmitted?

Answer 4

Via droplets in saliva so thorugh kissing, sharing cups, coughing

Question 5

Contact tracing and prophylaxis should be offered to whome and how long before onset of illness in the setting of neisseria meningitidis?

Answer 5

Those with prolonged close contact in household setting up to 7days before onset of illness

Inc. partners, uni halls sharing kitchen, dorms

Transient contact only prophylaxis if likely directly exposed around time of admission to hospital

Question 6

Prophylaxis in the adult for neisseria meningitidis is what?

Answer 6

Ciprofloxacin 500mg single dose

Question 7

What is the treatment for encephalitis?

Answer 7

IV aciclovir 10mg/kg 8hrly

Question 8

Gram positive diplococci in elderly likely to be what?

Answer 8

Strep pneumo

Question 9

What epidemiological groups are most likely to get strep pneumo?

Answer 9

Hospitilised
CSF skull fractures
Diabetics
Alcoholics
Asplenic
Cochlear impalnts

Question 10

What is bug is a gram positive cocci?

Answer 10

Strep pneumo

Question 11

Gram positive rod shaped bacteria is what bug?

Answer 11

Listeria

Question 12

What bug causing meningitis are HIV patients most likely to get?

Answer 12

Cryptococcus neoformans

Question 13

Pneumococcus is gram positive or negative?

Answer 13

Gram positive cocci

Question 14

What is the prophylactic regime for pyogenic meningitis?

Answer 14

Ciprofloxacin 500mg orally single dose

Or rifampicin

Public health need to be informed

Question 15

What is the diagnostic criteria for meningitis?

Answer 15

2/4 of headache, fever, neck stiffness, mental state change

Could also have photophobia, rash

Question 16

What bugs are neonates with meningitis likely to get?

Answer 16

Listeria

Question 17

What bug are children with meningitis likely to be infected with?

Answer 17

Neisseria meningitides

Question 18

Patient has pneumococcus meningitis how do you treat?

Answer 18

Ceftriaxone IV 2g twice daily for 10days

4 days dexamethasone

Question 19

Patient has new onset confusion and headache. He doesnt have his MMR vaccine. What is the likely diagnosis?

Answer 19

Encephalitis

Question 20

Treatment for encephalitis by HSV?

Answer 20

IV aciclovir 10mg/kg 8hrly for 14days

Question 21

A patient has meningitis, you dont yet know what organism he has. What do you treat with? He has no recent travel

Answer 21

Ceftriaxone IV 2g BD

Dexamethasone IV10mg 4tds

Duration and whether dexamethasone continued depends on what culture. If travel to penicillin resistant country then add vaconmycin IV