CNS Infections

Question 1 of 44

1

Bacterial meningitis' are known as ❌ meningitis, whereas meninigitis caused by other organisms (e.g. viruses) is known as ❌ meningitis.

Select option below to complete the highlighted text

aseptic

pyogenic

suppurative

Explanation

Question 2 of 44

1

Suppurative meningitis simply refers to a meningitis whereby pus is involved. Which cell type is abundant in these cases of meningitis?

Select one of the following:

Neutrophils
Basophils
Eosinophils

Explanation

Question 3 of 44

1

Which of the following bacteria are most commonly associated with meningitis? (2 answers)

Select one or more of the following:

Streptococcus pneumoniae
Neisseria Meningitidis (Meningococcus)
Staphylococcus Aureus
Pseudomonas Aeruginosa

Explanation

Question 4 of 44

1

The standard treatment for a community acquired bacterial meningitis is a combination of which two drugs?

Select one or more of the following:

Ceftriaxone IV
Ciprofloxacin IV
Dexamethasone IV
Beclomethasone IV

Explanation

Question 5 of 44

1

However, if the bacterial meningitis is caused by Listeria, which drug should be given for 21 days as treatment?

Select one of the following:

Amoxicillin
Gentamicin
Metronidazole
Ceftriaxone alone

Explanation

Question 6 of 44

1

Which 3 investigations are routinely conducted in order to diagnose a viral meningitis?

Select one or more of the following:

CSF PCR
Salival PCR
Viral Stool Culture
Throat Swab
Blood test
CSF Culture

Explanation

Question 7 of 44

1

Encephalitis usually has a bacterial cause

Select one of the following:

True
False

Explanation

Question 8 of 44

1

Fill the blank space to complete the text.

The most common virus causing encephalitis is virus

Explanation

Question 9 of 44

1

Which of the following symptoms tend to occur in encephalitis patient but not in meningitis patients? (2 answers)

Select one or more of the following:

Confusion
Seizures
Headache
Stiff neck

Explanation

Question 10 of 44

1

Select from the dropdown lists to complete the text.

Migraine pain is due to ( vasodilation, vasoconstriction ) whereas headache pain is due to ( vasoconstriction, vasodilation )

Explanation

Question 11 of 44

1

Fill the blank space to complete the text.

A non-blanching purpuric rash is indicative of which condition?

Explanation

Question 12 of 44

1

In ages 10-21, the most common cause of community acquired bacterial meningitis is...

Select one of the following:

Neisseria Meningitidis
Streptococcus Pneumonia
Listeria

Explanation

Question 13 of 44

1

In those over 21, the most common cause of community acquired bacterial meningitis is...

Select one of the following:

Neisseria Meningitidis
Streptococcus Pneumoniae
Listeria

Explanation

Question 14 of 44

1

In children, the most common cause of community acquired bacterial meningitis is...

Select one of the following:

Haemophilus Influenzae
Streptococcus Influenzae
Neisseria Meningitidis
E.coli

Explanation

Question 15 of 44

1

Streptococcus pneumoniae is a normal part of the microbiota of the ...

Select one of the following:

Oropharynx
Nasopharynx
Laryngopharynx

Explanation

Question 16 of 44

1

A woman with a fractured cribriform plate subsequently develops meningitis during her time in hospital. Which organism has most likely caused her meningitis?
(See explanation for why)

Select one of the following:

Streptococcus Pneumoniae
Neisseria Meningitidis
Listeria
Staphylococcus Aureus

Explanation

Question 17 of 44

1

Haemophilus Influenzae is a normal part of the microbiota of the ...

Select one of the following:

Nasal cavity
Large Intestine
Stomach
Throat

Explanation

Question 18 of 44

1

Which organism is shown in the picture?

Select one of the following:

Streptococcus Pneumoniae
Neisseria Meningitidis
Listeria
Staphylococcus Aureus

Explanation

Question 19 of 44

1

Which organism is shown in the picture?

Select one of the following:

Streptococcus Pneumoniae
Neisseria Meningitidis
Listeria
Staphylococcus Aureus

Explanation

Question 20 of 44

1

Select from the dropdown lists to complete the text.

Streptococcus Pneumoniae are gram ( positive, negative ) cocci that are arranged ( in pairs, in threes, as single, unbound cocci )

Explanation

Question 21 of 44

1

Select from the dropdown lists to complete the text.

Neisseria Meningitidis are ( intracellular, extracellular ) gram ( negative, positive ) ( cocci, bacilli ).

Explanation

Question 22 of 44

1

A 35 year old man presents with a fever, altered consciousness and a stiff neck. What is the most likely diagnosis from the options below?

Select one of the following:

Meningitis
Encephalitis
Hydrocephalus

Explanation

Question 23 of 44

1

Haemophilus Influenzae are

Select one of the following:

gram negative coccobacilli
gram positive coccobacilli
gram negative cocci
gram positive cocci

Explanation

Question 24 of 44

1

Another way to differentiate bacterial meningitis from aseptic meningitis via the CSF is by looking at the WBC count.
Pyogenic Meningitis shows a ❌
Aseptic Meningitis shows a ❌

Select option below to complete the highlighted text

high WBC count

low WBC count

Explanation

Question 25 of 44

1

Fill the blank space to complete the text.

Bradycardia, Systolic Hypertension and irregular, decreased respirations are the three constituents of triad

Explanation

Question 26 of 44

1

All adult patients with suspected meningitis (expect those with clear contraindications) should undergo which investigative procedure?

Select one of the following:

Lumbar Puncture
Stool Culture
Throat Swab
CT scan of the head

Explanation

Question 27 of 44

1

Select from the dropdown list to complete the text.

Give steroids to all patients with suspected ( pyogenic meningitis, aseptic meningitis, encephalitis ) before or with the first dose of antibiotics then every 6 hours for 4 days.

Explanation

Question 28 of 44

1

All new cases of Meningitis must be reported directly to Public Health.

Select one of the following:

True
False

Explanation

Question 29 of 44

1

Select from the dropdown list to complete the text.

The contact prophylaxis regimen for those exposed to an individual with meningitis is 500mg ( ciprofloxacin, ceftriaxone, co-amoxiclav ) orally as a single dose for all adults and children over 12.

Explanation

Question 30 of 44

1

Select from the dropdown lists to complete the text.

Typical CSF Findings:
Viral Meningitis - Protein levels ( normal, high, low ), glucose level ( normal, high, low )
Bacterial Meningitis - Protein levels ( high, normal, low ), glucose level ( low, high, normal )

Explanation

Question 31 of 44

1

The normal level of glucose in the CSF is around ...

Select one of the following:

60-70% of blood glucose concentration
80-90% of blood glucose concentration
120-130% of blood glucose concentration
140-150% of blood glucose concentration

Explanation

Question 32 of 44

1

In terms of CSF:
High concentration of Polymorphs (Neutrophils, etc) = ❌
High concentration of Lymphocytes (B & T cells) = ❌

Select option below to complete the highlighted text

Pyogenic Meningitis

Aseptic Meningitis

Explanation

Question 33 of 44

1

Which of the following describes the normal range values of a CSF sample?

Select one of the following:

Red Blood Cells <5mm3
White Blood Cells <5mm3
Protein 150-450mg/L
Glucose 60-70% of blood glucose
Red Blood Cells <5mm3
White Blood Cells <12mm3
Protein 150-450mg/L
Glucose 60-70% of blood glucose
Red Blood Cells <5mm3
White Blood Cells <12mm3
Protein 250-500mg/L
Glucose 60-70% of blood glucose
Red Blood Cells <15mm3
White Blood Cells <5mm3
Protein 150-450mg/L
Glucose 120-130% of blood glucose
Red Blood Cells <15mm3
White Blood Cells <5mm3
Protein 250-500mg/L
Glucose 60-70% of blood glucose

Explanation

Question 34 of 44

1

Select from the dropdown lists to complete the text.

The most common cause of viral meningitis is ( enteroviruses, herpes simplex virus ) and this typically affects children. ( Herpes simplex virus, Enteroviruses ) on the other hand is less common and typically causes viral meningitis in adolescents and adults.

Explanation

Question 35 of 44

1

Select from the dropdown lists to complete the text.

( Herpes Simplex Virus, Enteroviruses ) is the most common cause of Encephalitis and has an overall ( worse, better ) prognosis than viral meningitis

Explanation

Question 36 of 44

1

The occurrence of which type of meningitis is an indication for HIV testing of a patient?

Select one of the following:

Pyogenic Meningitis
Aseptic Meningitis

Explanation

Question 37 of 44

1

Typically, viral meningitis has to be treated conservatively due to lack of treatment options for most of the causative organisms. Despite this however, viral meningitis caused by which virus can be treated by antivirals?

Select one of the following:

Herpes Simplex Virus
Enteroviruses
Epstein Barr Virus

Explanation

Question 38 of 44

1

Fill the blank space to complete the text.

Name the antiviral typically given to patients suffering from Herpes Simplex Virus Meningitis.

Explanation

Question 39 of 44

1

After draining any pus, the treatment of a brain abscess should be via which two of the following medications?

Select one or more of the following:

Ceftriaxone
Metronidazole
Ciprofloxacin
Dexamethasone
Gentamicin
Amoxicillin

Explanation

Question 40 of 44

1

Fungal meningitis typically concerns which organism?

Select one of the following:

Cryptococcus Grattii
Cryptococcus Neoformans
Cryptococcus Albicans
Cryptococcus Tremellaceae

Explanation

Question 41 of 44

1

Cryptococcus Meningitis typically occurs in patients with ...

Select one of the following:

HIV/AIDS
Crohn's Disease
Addison's Disease
Cushing's Disease
Wilson's Disease
Ulcerative Colitis

Explanation

Question 42 of 44

1

Select from the dropdown lists to complete the text.

Treatment of Viral Meningitis by causative organism:
Human Enterovirus: ( Supportive Treatment Only, Aciclovir, Ganciclovir )
Herpes Simplex/Zoster: ( Aciclovir, Supportive Treatment Only, Ganciclovir )
Cytomegalovirus: ( Ganciclovir, Supportive Treatment Only, Aciclovir )

Explanation

Question 43 of 44

1

If there is a delay in getting a patient with suspected bacterial meningitis to hospital, it is routine practice to give emergency treatment in the form of intramuscular Benzylpenicillin or Ceftriaxone

Select one of the following:

True
False

Explanation

Question 44 of 44

1

Whilst the CSF is being checked for the causative organism of the Meningitis, empirical treatment should be given in the form of which two drugs?

Select one or more of the following:

Ceftriaxone
Vancomycin
Amoxicillin
Gentamicin
Metronidazole
Ciprofloxacin

	Created by Matthew Coulson almost 6 years ago

CNS Infections given by Dr Mooka on 11/9/2018

CNS Infections

Question 1 of 44

Bacterial meningitis' are known as ❌ meningitis, whereas meninigitis caused by other organisms (e.g. viruses) is known as ❌ meningitis.

Select option below to complete the highlighted text

Explanation

Question 2 of 44

Suppurative meningitis simply refers to a meningitis whereby pus is involved. Which cell type is abundant in these cases of meningitis?

Select one of the following:

Explanation

Question 3 of 44

Which of the following bacteria are most commonly associated with meningitis? (2 answers)

Select one or more of the following:

Explanation

Question 4 of 44

The standard treatment for a community acquired bacterial meningitis is a combination of which two drugs?

Select one or more of the following:

Explanation

Question 5 of 44

However, if the bacterial meningitis is caused by Listeria, which drug should be given for 21 days as treatment?

Select one of the following:

Explanation

Question 6 of 44

Which 3 investigations are routinely conducted in order to diagnose a viral meningitis?

Select one or more of the following:

Explanation

Question 7 of 44

Encephalitis usually has a bacterial cause

Select one of the following:

Explanation

Question 8 of 44

Fill the blank space to complete the text.

The most common virus causing encephalitis is virus

Explanation

Question 9 of 44

Which of the following symptoms tend to occur in encephalitis patient but not in meningitis patients? (2 answers)

Select one or more of the following:

Explanation

Question 10 of 44

Select from the dropdown lists to complete the text.

Migraine pain is due to vasodilation vasoconstriction( vasodilation, vasoconstriction ) whereas headache pain is due to vasoconstriction vasodilation( vasoconstriction, vasodilation )

Explanation

Question 11 of 44

Fill the blank space to complete the text.

A non-blanching purpuric rash is indicative of which condition?

Explanation

Question 12 of 44

In ages 10-21, the most common cause of community acquired bacterial meningitis is...

Select one of the following:

Explanation

Question 13 of 44

In those over 21, the most common cause of community acquired bacterial meningitis is...

Select one of the following:

Explanation

Question 14 of 44

In children, the most common cause of community acquired bacterial meningitis is...

Select one of the following:

Explanation

Question 15 of 44

Streptococcus pneumoniae is a normal part of the microbiota of the ...

Select one of the following:

Explanation

Question 16 of 44

A woman with a fractured cribriform plate subsequently develops meningitis during her time in hospital. Which organism has most likely caused her meningitis? (See explanation for why)

Select one of the following:

Explanation

Question 17 of 44

Haemophilus Influenzae is a normal part of the microbiota of the ...

Select one of the following:

Explanation

Question 18 of 44

Which organism is shown in the picture?

Select one of the following:

Explanation

Question 19 of 44

Which organism is shown in the picture?

Select one of the following:

Explanation

Question 20 of 44

Select from the dropdown lists to complete the text.

Migraine pain is due to ( vasodilation, vasoconstriction ) whereas headache pain is due to ( vasoconstriction, vasodilation )

A woman with a fractured cribriform plate subsequently develops meningitis during her time in hospital. Which organism has most likely caused her meningitis?
(See explanation for why)

Streptococcus Pneumoniae are gram ( positive, negative ) cocci that are arranged ( in pairs, in threes, as single, unbound cocci )

Neisseria Meningitidis are ( intracellular, extracellular ) gram ( negative, positive ) ( cocci, bacilli ).

Another way to differentiate bacterial meningitis from aseptic meningitis via the CSF is by looking at the WBC count.
Pyogenic Meningitis shows a ❌
Aseptic Meningitis shows a ❌

Give steroids to all patients with suspected ( pyogenic meningitis, aseptic meningitis, encephalitis ) before or with the first dose of antibiotics then every 6 hours for 4 days.

The contact prophylaxis regimen for those exposed to an individual with meningitis is 500mg ( ciprofloxacin, ceftriaxone, co-amoxiclav ) orally as a single dose for all adults and children over 12.

Typical CSF Findings:
Viral Meningitis - Protein levels ( normal, high, low ), glucose level ( normal, high, low )
Bacterial Meningitis - Protein levels ( high, normal, low ), glucose level ( low, high, normal )

In terms of CSF:
High concentration of Polymorphs (Neutrophils, etc) = ❌
High concentration of Lymphocytes (B & T cells) = ❌

( Herpes Simplex Virus, Enteroviruses ) is the most common cause of Encephalitis and has an overall ( worse, better ) prognosis than viral meningitis