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CASE 19- MENING > Med micro > Flashcards

Med micro Flashcards

1
Q
  • Streptococcus agalactiae (Group B Streptococcus)
  • Listeria monocytogenes
  • E. coli
  • Other gram negative bacilli: Klebsiella pneumoniae

Are causes of meningitis in neonates.
What empirical drug used if you suspect meningitis in NEONATES.

A
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2
Q

Treatment of aseptic meningitis
a) HSV, VZV-?
b) Fungal meningitis (cryptococcal meningitis)- ?

A

a) Acyclovir
b) amphotericin B, flucytosine

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3
Q

streptococcus pneumoniae

Gram stain:
Drug susceptible:

A

Gram stain: positive diplococci
Drug treatment: * Penicillin-sensitive: Intravenous (IV) penicillin
* Penicillin-resistant: IV ceftriaxone
* Ceftriaxone-resistant: IV vancomycin
* Duration: 10 days

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4
Q

Listeria monocytogenes

Gram stain:
Treatment:

A

Gram stain: positive bacilli
Treatment: Ampicillin +/- gentamicin
* NOT penicillin or ceftriaxone!

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5
Q

Neisseria meningitis

Gram stain:
Treatment:

A

Gram negative cocci
IV penicillin for 7 days

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6
Q

Which bacteria that causes “Meningococcal meningitis”, Rapidly progressive, and its associated with DIC, Petechiae in children.

a. L. monocytogens
b. N. meningitidis
c. S. pneumoniae
d. haematobacterial diseases
e. Haemophilus influenza tybe B

A

N. meningitidis

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7
Q

Haemophilus influenzae

Gram stain:
Treatment:

A

Gram negative bacilli
IV ceftriaxone for 10 days

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8
Q

what is the pathogenesis of Listeria monocytogenes in neonates?

A

Transplacental spread

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9
Q

When meningitis is suspected in neonates,
______ is used instead of ceftriaxone

A

Cefotaxime

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10
Q

Which of the following bacterial species is the most common causative agent of bacterial meningitis in newborns and infants?
a) Streptococcus pneumoniae
b) Neisseria meningitidis
c) Escherichia coli
d) Haemophilus influenzae type b

A

c) Escherichia coli

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11
Q

Which virulence factor of Neisseria meningitidis is responsible for the development of purpura fulminans in some cases of meningococcal meningitis?
a) Polysaccharide capsule
b) IgA protease
c) Endotoxin (lipopolysaccharide)
d) Type IV pili

A

c) Endotoxin (lipopolysaccharide)

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12
Q

Which of the following laboratory tests is essential for the definitive diagnosis of bacterial meningitis?
a) Blood culture
b) Cerebrospinal fluid (CSF) culture
c) Latex agglutination test
d) Gram stain of CSF

A

b) Cerebrospinal fluid (CSF) culture

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13
Q

Which bacterial species is commonly associated with meningitis in adults, especially those over the age of 50 or immunocompromised individuals?
a) Streptococcus agalactiae
b) Listeria monocytogenes
c) Staphylococcus aureus
d) Streptococcus pneumoniae

A

b) Listeria monocytogenes

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14
Q

Which of the following is a recommended vaccine to prevent bacterial meningitis caused by Haemophilus influenzae type b?
a) Meningococcal conjugate vaccine
b) Pneumococcal conjugate vaccine
c) Meningococcal polysaccharide vaccine
d) Haemophilus influenzae type b conjugate vaccine

A

d) Haemophilus influenzae type b conjugate vaccine

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15
Q

Which bacterial species is the most common cause of community-acquired bacterial meningitis in adults?

A

Streptococcus pneumoniae (pneumococcus) is the most common bacterial species responsible for community-acquired bacterial meningitis in adults.

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16
Q

What is the recommended empirical antibiotic therapy for suspected bacterial meningitis in neonates up to 28 days old?

A

For neonates up to 28 days old with suspected bacterial meningitis, the recommended empirical antibiotic therapy includes ampicillin plus gentamicin or cefotaxime. This regimen provides coverage against common pathogens, such as Group B Streptococcus, Escherichia coli, and Listeria monocytogenes.

17
Q

What are the characteristic cerebrospinal fluid (CSF) findings in bacterial meningitis?

A

In bacterial meningitis, the cerebrospinal fluid (CSF) typically shows the following characteristic findings:

Elevated white blood cell count (predominantly neutrophils).
Elevated protein levels.
Decreased glucose levels (compared to blood glucose levels).

18
Q

What is the most common long-term complication associated with bacterial meningitis?

A

Sensorineural hearing loss

19
Q

What is the recommended vaccination strategy for preventing bacterial meningitis caused by Streptococcus pneumoniae?

A

The recommended vaccination strategy for preventing bacterial meningitis caused by Streptococcus pneumoniae includes routine immunization with the pneumococcal conjugate vaccine (PCV) in infancy, followed by a booster dose in early childhood. Additionally, a pneumococcal polysaccharide vaccine (PPSV23) is recommended for certain high-risk individuals, such as older adults and individuals with specific medical conditions.

20
Q

Which age group is most susceptible to infection with Neisseria meningitidis?

A

Neisseria meningitidis primarily affects adolescents and young adults. This age group has the highest incidence of meningococcal disease, particularly during outbreaks in closed communities like college dormitories.

21
Q

Which of the following organisms is commonly associated with brain abscesses?
a) Nocardia
b) Toxoplasma gondii
c) Naegleria fowleri
d) Plasmodium spp.

A

a) Nocardia

Explanation: Nocardia is a branching gram-positive bacillus commonly associated with brain abscesses.

22
Q

Which of the following antibiotics should be used to cover anaerobic organisms in the treatment of brain abscess?
a) Metronidazole
b) Penicillin
c) Cotrimoxazole
d) Dexamethasone

A

a) Metronidazole

Explanation: Metronidazole, also known as “Flagyl,” is effective in covering anaerobic organisms, which are commonly involved in brain abscesses.

23
Q

What is the recommended treatment for tuberculoma?
a) Drainage
b) Antibiotics
c) Albendazole
d) Surgical debridement

A

b) Antibiotics

Explanation: Tuberculoma, a caseating granuloma in the brain parenchyma, is typically treated with antibiotics.

24
Q

Neurocysticercosis is caused by which parasite?
a) Taenia solium
b) Plasmodium spp.
c) Toxoplasma gondii
d) Naegleria fowleri

A

a) Taenia solium

Explanation: Neurocysticercosis is caused by the larval cysts of Taenia solium, the pork tapeworm.

25
Q

Which imaging modality is commonly used for the diagnosis of neurocysticercosis?
a) X-ray
b) Ultrasound
c) CT scan
d) MRI

A

d) MRI

Explanation: MRI (Magnetic Resonance Imaging) is commonly used to diagnose neurocysticercosis, as it provides detailed imaging of the brain and can identify the presence of cystic lesions.

26
Q

Which of the following is the recommended treatment for live cysts in neurocysticercosis?
a) Anti-epileptics
b) Albendazole
c) Dexamethasone
d) Surgical debridement

A

b) Albendazole

Explanation: Albendazole, sometimes combined with praziquantel, is the recommended treatment for live cysts in neurocysticercosis.

27
Q

Toxoplasma gondii is reactivated in which type of hosts?
a) Healthy individuals
b) Immunocompromised hosts
c) Individuals with diabetes
d) Individuals with hydrocephalus

A

b) Immunocompromised hosts

Explanation: Toxoplasma gondii, the causative agent of toxoplasmosis, can reactivate in immunocompromised hosts, such as those with HIV infection.

28
Q

Which of the following is a characteristic feature of cerebral malaria?
a) Decreased level of consciousness
b) Severe headache
c) Nasal congestion
d) Skin rash

A

a) Decreased level of consciousness

Explanation: Cerebral malaria, usually caused by Plasmodium falciparum, is characterized by a decreased level of consciousness, along with other symptoms such as agitation, confusion, and seizures.

29
Q

Naegleria fowleri is commonly acquired through which route?
a) Ingestion of contaminated food
b) Inhalation of airborne particles
c) Contact with infected animals
d) Entry through the cribriform plate

A

d) Entry through the cribriform plate

Explanation: Naegleria fowleri, also known as the “brain-eating amoeba,” is acquired through entry into the brain via the cribriform plate, along the olfactory nerve.

30
Q

Which of the following is the treatment of choice for rhinocerebral fungal infection?
a) Surgical debridement
b) Amphotericin B
c) Metronidazole
d) Albendazole

A

b) Amphotericin B

Explanation: Amphotericin B is the treatment of choice for rhinocerebral fungal infection, also known as mucormycosis or zygomycosis.

31
Q

VP shunt infection is commonly caused by which of the following bacteria?
a) Staphylococcus aureus
b) Streptococcus anginosus
c) Enterococcus faecium
d) Pseudomonas aeruginosa

A

a) Staphylococcus aureus

Explanation: VP shunt infections can be caused by various bacteria, but Staphylococcus aureus is one of the common pathogens involved.

32
Q

What is the recommended treatment for VP shunt infection?
a) Removal of the shunt
b) IV antibiotics
c) Intraventricular antibiotics
d) All of the above

A

d) All of the above

Explanation: Treatment of VP shunt infection typically involves removing the shunt and administering IV antibiotics. In some cases, intraventricular antibiotics may also be necessary.

33
Q

What is the main cause of hydrocephalus?
a) Obstruction to CSF flow
b) Increased production of CSF
c) Impaired re-absorption of CSF
d) All of the above

A

d) All of the above

Explanation: Hydrocephalus can be caused by obstruction to CSF flow, increased production of CSF, or impaired re-absorption of CSF.

34
Q

Which of the following is a risk factor for hydrocephalus?
a) Diabetes
b) Immunocompromise
c) Head trauma
d) Exposure to contaminated water

A

c) Head trauma

Explanation: Head trauma is a known risk factor for the development of hydrocephalus.

35
Q

What is the primary treatment for neurosurgery-related infections?
a) Antibiotics
b) Surgical debridement
c) Ventriculoperitoneal shunt
d) Neuroimaging

A

) Surgical debridement

Explanation: Neurosurgery-related infections often require surgical debridement as the primary treatment approach.

36
Q

The MCQs may have incorrect answers please go back to the slides

A

CASE 19- MENING (7 decks)

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