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CNS Infections

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CNS Infections given by Dr Mooka on 11/9/2018
Matthew Coulson
Quiz by Matthew Coulson, updated more than 1 year ago
Matthew Coulson
Created by Matthew Coulson about 6 years ago
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Resource summary

Question 1

Question
Bacterial meningitis' are known as [blank_start]pyogenic[blank_end] meningitis, whereas meninigitis caused by other organisms (e.g. viruses) is known as [blank_start]aseptic[blank_end] meningitis.
Answer
  • aseptic
  • pyogenic
  • suppurative

Question 2

Question
Suppurative meningitis simply refers to a meningitis whereby pus is involved. Which cell type is abundant in these cases of meningitis?
Answer
  • Neutrophils
  • Basophils
  • Eosinophils

Question 3

Question
Which of the following bacteria are most commonly associated with meningitis? (2 answers)
Answer
  • Streptococcus pneumoniae
  • Neisseria Meningitidis (Meningococcus)
  • Staphylococcus Aureus
  • Pseudomonas Aeruginosa

Question 4

Question
The standard treatment for a community acquired bacterial meningitis is a combination of which two drugs?
Answer
  • Ceftriaxone IV
  • Ciprofloxacin IV
  • Dexamethasone IV
  • Beclomethasone IV

Question 5

Question
However, if the bacterial meningitis is caused by Listeria, which drug should be given for 21 days as treatment?
Answer
  • Amoxicillin
  • Gentamicin
  • Metronidazole
  • Ceftriaxone alone

Question 6

Question
Which 3 investigations are routinely conducted in order to diagnose a viral meningitis?
Answer
  • CSF PCR
  • Salival PCR
  • Viral Stool Culture
  • Throat Swab
  • Blood test
  • CSF Culture

Question 7

Question
Encephalitis usually has a bacterial cause
Answer
  • True
  • False

Question 8

Question
The most common virus causing encephalitis is [blank_start]herpes simplex[blank_end] virus
Answer
  • herpes simplex

Question 9

Question
Which of the following symptoms tend to occur in encephalitis patient but not in meningitis patients? (2 answers)
Answer
  • Confusion
  • Seizures
  • Headache
  • Stiff neck

Question 10

Question
Migraine pain is due to [blank_start]vasodilation[blank_end] whereas headache pain is due to [blank_start]vasoconstriction[blank_end]
Answer
  • vasodilation
  • vasoconstriction
  • vasoconstriction
  • vasodilation

Question 11

Question
A non-blanching purpuric rash is indicative of which condition? [blank_start]Meningitis[blank_end]
Answer
  • Meningitis

Question 12

Question
In ages 10-21, the most common cause of community acquired bacterial meningitis is...
Answer
  • Neisseria Meningitidis
  • Streptococcus Pneumonia
  • Listeria

Question 13

Question
In those over 21, the most common cause of community acquired bacterial meningitis is...
Answer
  • Neisseria Meningitidis
  • Streptococcus Pneumoniae
  • Listeria

Question 14

Question
In children, the most common cause of community acquired bacterial meningitis is...
Answer
  • Haemophilus Influenzae
  • Streptococcus Influenzae
  • Neisseria Meningitidis
  • E.coli

Question 15

Question
Streptococcus pneumoniae is a normal part of the microbiota of the ...
Answer
  • Oropharynx
  • Nasopharynx
  • Laryngopharynx

Question 16

Question
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)
Answer
  • Streptococcus Pneumoniae
  • Neisseria Meningitidis
  • Listeria
  • Staphylococcus Aureus

Question 17

Question
Haemophilus Influenzae is a normal part of the microbiota of the ...
Answer
  • Nasal cavity
  • Large Intestine
  • Stomach
  • Throat

Question 18

Question
Which organism is shown in the picture?
Image:
Picture35 (binary/octet-stream)
Answer
  • Streptococcus Pneumoniae
  • Neisseria Meningitidis
  • Listeria
  • Staphylococcus Aureus

Question 19

Question
Which organism is shown in the picture?
Image:
Picture36 (binary/octet-stream)
Answer
  • Streptococcus Pneumoniae
  • Neisseria Meningitidis
  • Listeria
  • Staphylococcus Aureus

Question 20

Question
Streptococcus Pneumoniae are gram [blank_start]positive[blank_end] cocci that are arranged [blank_start]in pairs[blank_end]
Answer
  • positive
  • negative
  • in pairs
  • in threes
  • as single, unbound cocci

Question 21

Question
Neisseria Meningitidis are [blank_start]intracellular[blank_end] gram [blank_start]negative[blank_end] [blank_start]cocci[blank_end].
Answer
  • intracellular
  • extracellular
  • negative
  • positive
  • cocci
  • bacilli

Question 22

Question
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?
Answer
  • Meningitis
  • Encephalitis
  • Hydrocephalus

Question 23

Question
Haemophilus Influenzae are
Answer
  • gram negative coccobacilli
  • gram positive coccobacilli
  • gram negative cocci
  • gram positive cocci

Question 24

Question
Another way to differentiate bacterial meningitis from aseptic meningitis via the CSF is by looking at the WBC count. Pyogenic Meningitis shows a [blank_start]high WBC count[blank_end] Aseptic Meningitis shows a [blank_start]low WBC count[blank_end]
Answer
  • high WBC count
  • low WBC count

Question 25

Question
Bradycardia, Systolic Hypertension and irregular, decreased respirations are the three constituents of [blank_start]Cushing's[blank_end] triad
Answer
  • Cushing's

Question 26

Question
All adult patients with suspected meningitis (expect those with clear contraindications) should undergo which investigative procedure?
Answer
  • Lumbar Puncture
  • Stool Culture
  • Throat Swab
  • CT scan of the head

Question 27

Question
Give steroids to all patients with suspected [blank_start]bacterial meningitis[blank_end] before or with the first dose of antibiotics then every 6 hours for 4 days.
Answer
  • pyogenic meningitis
  • aseptic meningitis
  • encephalitis

Question 28

Question
All new cases of Meningitis must be reported directly to Public Health.
Answer
  • True
  • False

Question 29

Question
The contact prophylaxis regimen for those exposed to an individual with meningitis is 500mg [blank_start]ciprofloxacin[blank_end] orally as a single dose for all adults and children over 12.
Answer
  • ciprofloxacin
  • ceftriaxone
  • co-amoxiclav

Question 30

Question
Typical CSF Findings: Viral Meningitis - Protein levels [blank_start]normal[blank_end], glucose level [blank_start]normal[blank_end] Bacterial Meningitis - Protein levels [blank_start]high[blank_end], glucose level [blank_start]low[blank_end]
Answer
  • normal
  • high
  • low
  • normal
  • high
  • low
  • high
  • normal
  • low
  • low
  • high
  • normal

Question 31

Question
The normal level of glucose in the CSF is around ...
Answer
  • 60-70% of blood glucose concentration
  • 80-90% of blood glucose concentration
  • 120-130% of blood glucose concentration
  • 140-150% of blood glucose concentration

Question 32

Question
In terms of CSF: High concentration of Polymorphs (Neutrophils, etc) = [blank_start]Pyogenic Meningitis[blank_end] High concentration of Lymphocytes (B & T cells) = [blank_start]Aseptic Meningitis[blank_end]
Answer
  • Pyogenic Meningitis
  • Aseptic Meningitis

Question 33

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

Question 34

Question
The most common cause of viral meningitis is [blank_start]enteroviruses[blank_end] and this typically affects children. [blank_start]Herpes simplex virus[blank_end] on the other hand is less common and typically causes viral meningitis in adolescents and adults.
Answer
  • enteroviruses
  • herpes simplex virus
  • Herpes simplex virus
  • Enteroviruses

Question 35

Question
[blank_start]Herpes Simplex Virus[blank_end] is the most common cause of Encephalitis and has an overall [blank_start]worse[blank_end] prognosis than viral meningitis
Answer
  • Herpes Simplex Virus
  • Enteroviruses
  • worse
  • better

Question 36

Question
The occurrence of which type of meningitis is an indication for HIV testing of a patient?
Answer
  • Pyogenic Meningitis
  • Aseptic Meningitis

Question 37

Question
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?
Answer
  • Herpes Simplex Virus
  • Enteroviruses
  • Epstein Barr Virus

Question 38

Question
Name the antiviral typically given to patients suffering from Herpes Simplex Virus Meningitis. [blank_start]Aciclovir[blank_end]
Answer
  • Aciclovir

Question 39

Question
After draining any pus, the treatment of a brain abscess should be via which two of the following medications?
Answer
  • Ceftriaxone
  • Metronidazole
  • Ciprofloxacin
  • Dexamethasone
  • Gentamicin
  • Amoxicillin

Question 40

Question
Fungal meningitis typically concerns which organism?
Answer
  • Cryptococcus Grattii
  • Cryptococcus Neoformans
  • Cryptococcus Albicans
  • Cryptococcus Tremellaceae

Question 41

Question
Cryptococcus Meningitis typically occurs in patients with ...
Answer
  • HIV/AIDS
  • Crohn's Disease
  • Addison's Disease
  • Cushing's Disease
  • Wilson's Disease
  • Ulcerative Colitis

Question 42

Question
Treatment of Viral Meningitis by causative organism: Human Enterovirus: [blank_start]Supportive Treatment Only[blank_end] Herpes Simplex/Zoster: [blank_start]Aciclovir[blank_end] Cytomegalovirus: [blank_start]Ganciclovir[blank_end]
Answer
  • Supportive Treatment Only
  • Aciclovir
  • Ganciclovir
  • Aciclovir
  • Supportive Treatment Only
  • Ganciclovir
  • Ganciclovir
  • Supportive Treatment Only
  • Aciclovir

Question 43

Question
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
Answer
  • True
  • False

Question 44

Question
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?
Answer
  • Ceftriaxone
  • Vancomycin
  • Amoxicillin
  • Gentamicin
  • Metronidazole
  • Ciprofloxacin
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