CNS Infectious Test 3- 5th Year- PMU

Which meningitis is characterized by the following CSF findings – lymphocytic pleocytosis, normal or slightly elevated protein and normal glucose level?

Meningeal irritation includes

Characteristic clinical manifestation of enteroviral infections is

Which of the following statements regarding enteroviruses as causative agents of aseptic meningitis are NOT TRUE?

Poliomyelitis is characterised by

The most common causative agents of pyogenic meningitis are

Which of the following statements regarding the use of neuroimaging techniques (CT, MRI) in the diagnosis of HSV1 encephalitis are correct?

The causative agents of poliomyelitis are

Antivirals are used for therapy of

Tetanus is characterised by

Treatment of cerebral oedema includes

40-year old man was admitted to the ED because of progressive worsening headache and drooping right eyelid for the last 6 hours. Over the last week he felt uneasy, with throbbing headache, vomited twice. On presentation he was alert, T-37,4°C, with normal vital signs, mild nuchal rigidity, right n. abducens palsy, the remainder of physical examination was without abnormalities. His CXR showed a right apical opacity and ipsilateral hilar lymphadenopathy.

Below are the results of the CSF examination and Gram stain:
Appearance - turbid
Cells- 159.10^6/l (90% neutrophils)
Protein- 1.2 g/l
Glucose- 1,5 mmol/l (blood glucose — 5,9 mmol/l)
Gram stain- no bacteria seen
Acid-fast stain- no bacteria seen
Cryptococcus antigen- negative
Culture- no bacterial growth
Mycobacteria PCR- genus negative/ M. tuberculosis complex negative
Mycobacteria culture- continuing

Which specific infection needs to be considered in this clinical setting?

40-year old man was admitted to the ED because of progressive worsening headache and drooping right eyelid for the last 6 hours. Over the last week he felt uneasy, with throbbing headache, vomited twice. On presentation he was alert, T-37,4°C, with normal vital signs, mild nuchal rigidity, right n. abducens palsy, the remainder of physical examination was without abnormalities. His CXR showed a right apical opacity and ipsilateral hilar lymphadenopathy.

Below are the results of the CSF examination and Gram stain:
Appearance - turbid
Cells- 159.10^6/l (90% neutrophils)
Protein- 1,2 g/l
Glucose- 1,5 mmol/l (blood glucose — 5,9 mmol/l)
Gram stain- no bacteria seen
Acid-fast stain- no bacteria seen
Cryptococcus antigen- negative
Culture- no bacterial growth
Myeobacteria PCR- genus negative/ M. tuberculosis complex negative
Mycobacteria culture- continuing

Do the results of microscopy rule out this diagnosis?

Which type of meningitis is characterized by the following CSF findings – lymphocytic pleocytosis, elevated protein and decreased glucose level

The rash of meningococcemia is

The specific CNS complication of Chickenpox is

Which of the following statements regarding tetanus is correct

A 4 year-old girl presents with a macularpapular rash on her hands and feet and painful ulcers distributed anteriorly on her lips , tongue, palate and buccal mucosa. Systemic features and lymphadenopathy are absent. Which of the following viruses is most likely to have caused these disorder?

Empirical therapy for bacterial meningitis includes

Serotherapy (antibodies based medications) is used for

Which of the following statements regarding leptospirosis IS NOT true

Which of the following ARE NOT common clinical manifestations of HSV1 encephalitis

A 19-year-old freshman, living in a dormitory accommodation, took to his bed early one Friday evening, complaining of a flu-like illness and headache. The next morning he was found unresponsive with a widespread non-blanching rash. He was taken to the ED. Physical examination revealed unresponsive patient with signs of meningeal irritation, T-39,5°C,blood pressure 120/70 mmHg, heart rate 100 beat/min. A lumbar puncture was done after CT scan.
Below are the results of the CSF examination and Gram stain:
Appearance - turbid
Cells - 800.10^6/l, neutrophils
Glucose — 0.5 mmol/l (blood glucose - 7,0 mmol/l)
Gram stain — no bacteria seen
The whole freshman year had received a meningococcal vaccine prior to starting their course

What do your think is the cause of this infection?

A 19-year-old freshman, living in a dormitory accommodation, took to his bed early one Friday evening, complaining of a flu-like illness and headache. The next morning he was found unresponsive with a widespread non-blanching rash. He was taken to the ED. Physical examination revealed unresponsive patient with signs of meningeal irritation, T-39,5°C,blood pressure 120/70 mmHg, heart rate 100 beat/min. A lumbar puncture was done after CT scan.
Below are the results of the CSF examination and Gram stain:
Appearance - turbid
Cells - 800.10^6/l, neutrophils
Glucose — 0.5 mmol/l (blood glucose - 7,0 mmol/l)
Gram stain — no bacteria seen
The whole freshman year had received a meningococcal vaccine prior to starting their course

Why was he not protected by the vaccine?

Which meningitis is characterized by the following CSF findings — neutrophilic pleocytosis, elevated protein and decreased glucose level?

A 3-week-old boy developed focal seizures, lethargy and vomiting. Examination shows a bulging fontanelle and nuchal rigidity. Which of the following organisms should be suspected?

The majority of nonimmunized patients infected with poliovirus would be expected to experience which of the following symptoms

Which of the following findings IS NOT characteristic of infant meningitis

Meningeal irritation, prolonged and severe mental status impairment and focal neurological findings are common in

Poliomyelitis is characterized by a

Which patient with suspected bacterial meningitis should undergo CT of the head prior to lumbar puncture?

Typical clinical manifestations of enterovirus infections are

A 45-year-old man was brought to the ED by his wife after a new onset of seizure. He had been well until 48 hours prior when he had the abrupt onset of fever and headache . Over the next 2 days he exhibited bizarre behaviour. On physical examination he was minimally responsive without nuchal rigidity or focal neurological findings. A CT scan of the head showed diffuse inflammatory changes, greates in the left temporal lobe. Blood laboratory results - unremarkable .
Below are the results of the CSF examination and Gram stain
Appearance - turbid
Erythrocytes- 700. 10^6/l
Cells - 43.10^6/l, lymphocyte predominance
Protein- 0.7 g/l
Glucose- normal
Gram stain- no bacteria seen

What is the diagnosis likely to be?

A 45-year-old man was brought to the ED by his wife after a new onset of seizure. He had been well until 48 hours prior when he had the abrupt onset of fever and headache . Over the next 2 days he exhibited bizarre behaviour. On physical examination he was minimally responsive without nuchal rigidity or focal neurological findings. A CT scan of the head showed diffuse inflammatory changes, greates in the left temporal lobe. Blood laboratory results - unremarkable .
Below are the results of the CSF examination and Gram stain
Appearance - turbid
Erythrocytes- 700. 10^6/l
Cells - 43.10^6/l, lymphocyte predominance
Protein- 0.7 g/l
Glucose- normal
Gram stain- no bacteria seen

What antimicrobial agent need to be considered?

Which meningitis is characterized by cranial nerves palsies, CSF — with low glucose level and without response to empirical antibiotic therapy

Which diseases in not vaccine preventable

The antibiotic of choice in treating diphtheria is

Strawberry tongue is characteristic of Ex which disease: - also in Kawasaki's disease

Which disease requires antítoxin serum as a first urgent step in the management of the patient

The desquamation is a characteristic, albeit a late one, of which of the diseases

Invasive infection with Streptecoccus pyogenes is a severe complication of

Chickenpox rash is characterized by

Which virus has teratogenic effect in the first trimester of pregnancy

A 21-old male presented to ED with 2 weeks of low-grade fevers, fatigue. and myalgias. O/P - alert, pharyngeal erythema without exudate. a painful ulcer on the right buccal mucose, cervical lymphadenopahy and a fine erythematous macular rash on his upper chest. He reported he was sexually active with both men and women. Which test should be used to confirm your suspicion

Which disease is vaccine preventable?

Which of the following statements is typical for pharyngeal diphtheria

In a case of infectious mononucleosis-like symptoms it is important to consider

A 5-year-old girl recently immigrated with her parents to the USA a month ago presented with low-grade fever, bloody nasal discharge, and extensive neck swelling. Her immunization record was not available. She was difficult to understand because of the language barrier; but she seemed to be having difficulty breathing. O/P in distress, T 38.3°C. RR 40/min, HR 140/min, PR 90/60 mm, swollen neck, oropharynx - dense greyish-white membranes spreading across the tonsils and covering uvula and soft palate.

What is the most likely diagnosis?

A 5-year-old girl recently immigrated with her parents to the USA a month ago presented with low-grade fever, bloody nasal discharge, and extensive neck swelling. Her immunization record was not available. She was difficult to understand because of language barrier; but she seemed to be having difficulty breathing. O/P in distress, T 38,3°C. RR 40/min, HR 140/min, PR 90/60 mm, swollen neck, oropharynx - dense greyish-white membranes spreading across the tonsils and covering uvula and soft palate.

What should be the next step in the management of the patient?

The common complication of Chickenpox is

Tonsillitis, caused by EBV (Infectious mononucleosis) should be differentiated from

The rash of meningococcemia is

Which of the following statements concerning the Varicella-Zoster-Virus (VZV) infection is true?

The rash of Measles is

The evolution of the rash of Chickenpox is

Pregnant in the 2nd LM has moprbilliform rash and negative serological test (RZHA) for Rubella
What is the next step?

The late complications of Scarlet fever the most often are

Typical for Diphtheria are

Which is NOT true of heterophile antibodies and Infectious mononucleosis?

Patients With Chickenpox are contagious

A 2-year-old child was having fever from 5-6 days as well as dry cough and hoarse voice, From the day before he came his skin was turning blue after coughing, his voice became almost silent and he also became very restless. He was brought to the Emergency center. Clinical status: impaired condition, acrocyanosis. temperature to 38,6°C. visibly swollen cervical lymph nodes. View of the throat revealed edema pharynx, dirty gray shiny deposits covering the tonsils, uvula and soft palate, the child cried soundless voice inspiratory tachydyspnea- 40/min, breathing was shallow with a circulation, without audible wheezing, heart rate - 158/ min. The remaining objective examination was normal.

The most likely diagnosis is

A 2-year-old child was having fever from 5-6 days as well as dry cough and hoarse voice, From the day before he came his skin was turning blue after coughing, his voice became almost silent and he also became very restless. He was brought to the Emergency center. Clinical status: impaired condition, acrocyanosis. temperature to 38,6°C. visibly swollen cervical lymph nodes. View of the throat revealed edema pharynx, dirty gray shiny deposits covering the tonsils, uvula and soft palate, the child cried soundless voice inspiratory tachydyspnea- 40/min, breathing was shallow with a circulation, without audible wheezing, heart rate - 158/ min. The remaining objective examination was normal.

The danger, in this case, is determined from

A 2-year-old child was having fever from 5-6 days as well as dry cough and hoarse voice, From the day before he came his skin was turning blue after coughing, his voice became almost silent and he also became very restless. He was brought to the Emergency center. Clinical status: impaired condition, acrocyanosis. temperature to 38,6°C. visibly swollen cervical lymph nodes. View of the throat revealed edema pharynx, dirty gray shiny deposits covering the tonsils, uvula and soft palate, the child cried soundless voice inspiratory tachydyspnea- 40/min, breathing was shallow with a circulation, without audible wheezing, heart rate - 158/ min. The remaining objective examination was normal.

What does the most urgent treatment in case involve?

A 2-year-old child was having fever from 5-6 days as well as dry cough and hoarse voice, From the day before he came his skin was turning blue after coughing, his voice became almost silent and he also became very restless. He was brought to the Emergency center. Clinical status: impaired condition, acrocyanosis. temperature to 38,6°C. visibly swollen cervical lymph nodes. View of the throat revealed edema pharynx, dirty gray shiny deposits covering the tonsils, uvula and soft palate, the child cried soundless voice inspiratory tachydyspnea- 40/min, breathing was shallow with a circulation, without audible wheezing, heart rate - 158/ min. The remaining objective examination was normal.

The most dangerous side effects due to serum were