Neurology

Question 1

Signs of raised intracranial pressure

Answer 1

Cushing’s triad:

• Increased systolic BP (pulse pressure)
• Decreased pulse rate
• Cheyne-Stokes breathing (periods of apnoea)

Question 2

Common causes of neonatal bacterial meningitis

Answer 2

E. coli

L. monocytogenes

Question 3

Common ‘big three’ causes of childhood meningitis

Answer 3

H. influenzae
S. pneumoniae
N. meningitidis
(these are all encapsulated orgs)

Question 4

Immune response to encapsulated organisms

Answer 4

Polysaccharide capsule is poorly immunogenic and it is difficult to amount an Ab mediated response. Therefore, the response is thymus independent.
B cell surface Ab binds Ag and Ag itself provides signal for B cell activation. Need macrophages to clear infection as bacteria are opsonised (splenectomy pts high risk for overwhelming infection)

Question 5

Most common bacterial causes of chronic meningitis

Answer 5

TB

Neurosyphilis

Question 6

Most common cause of stroke in children

Answer 6

Varicella

Question 7

How is measles spread?

Answer 7

Respiratory droplets

Question 8

What are the four potential stages/syndromes of measles infection?

Answer 8

1. Acute measles encephalitis
2. Post-infectious encephalitis
3. Measles inclusion bodies encephalitis
4. SSPE