MENINGITIS

Question 1

In neonates and infants can diarrhoea also be a presentation of acute bacterial meningitis

Answer 1

Yes

Question 2

How common is neck stiffness in acute bacterial meningitis in neonates and infants

Answer 2

Uncommon

Question 3

What physical sign can we look for in an infant while suspecting acute bacterial meningitis

Answer 3

Bulging anterior fontanelle

Question 4

When do the maternal immunoglubulins cross the placenta

Answer 4

After 32 weeks

Question 5

why are premature borns at a higher risk for infections

Answer 5

Because the maternal immunoglobulns only cross the placenta after 32 weeks

Question 6

Neonates has an immature immune system, WHY?

Answer 6

poor phagocytic ability of the Neutrophis and the monocytes

Question 7

Can back pain also present as meningitis

Answer 7

Yes

Question 8

How common are seizures as a presentation of Acute bacterial meningitis

Answer 8

20%

Question 9

Name the organism to cause bacterial meningitis in older adults

Answer 9

Listeria Monocytogenes

Question 10

For how long should a bacterial culture be held in Bacterial meningitis

Answer 10

5 days.
To detect slow growing organism like Listeria Monocytogenes.

Question 11

What meds can be empirically started for acute bacterial meningitis

Answer 11

Vancomycin with Meropenem or ceftazidime, cefepime.

Question 12

Where does the adult spinal cord end

Answer 12

T12 - L2

Question 13

In Infants the spinal cord parenchyma may descend upto

Answer 13

L2

Question 14

If a patient is having a bleeding tendency or is anticoagulated what is the risk of a Lumbar puncture

Answer 14

Localised SAH or Epidural hematoma

Question 15

Puncture of which blood vessel can cause a Localised SAH

Answer 15

Radicular veins

Question 16

Bacterial meningitis per se itself can cause Brain herniation. Is this true

Answer 16

Yes

Question 17

Temporal lobe herniation can cause damage to which adjacent structures

Answer 17

Hemorrhage, necrosis and infarction of the upper brain stem because of involvement of the basilar artery.

Question 18

Brain herniation can occur how soon after an LP

Answer 18

Within 5 hours

Question 19

After an LP how much CSF can flow out from the puncture site

Answer 19

Several 100 ml

Question 20

Ideally how soon after an LP should the CSF be analysed

Answer 20

Within 30 minutes.
The WBCs in the CSF begin to deteriorate after 30 minutes.

Question 21

The highest incidence of S. Pneumoniae meningitis is in which age group

Answer 21

Children and adults

Question 22

Name two mechanisms by which the S. Pneumoniae causes Pneumococcal meningitis

Answer 22

1. Pili
2. Polysaccharide

Question 23

What does the PILI do in S. Pneumoniae meningitis

Answer 23

It attaches to the nasopharyngx.

Question 24

What is the role of the Polysaccharide capsule in S. Pneumoniae

Answer 24

It interferes with phagocytosis.

Question 25

Why are the Neutrophils in the CSF incapable of launching a good phagocytic response.

Answer 25

Because the CSF is poor in complements.