Bacterial Meningitis Quiz

This is a revision quiz for first year Medicine.

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Last updated: January 6, 2024

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Hint	Answer
Give four symptoms of bacterial meningitis (not age-specific)	Neck stiffness
	Bulging fontanelle
	Decreased level of consciousness
	Convulsive status epilepticus
"A non-blanching rash is always present in an infant or child with bacterial meningitis." True or false?	False
What is the key investigation for a diagnosis of BM?	Isolation of pathogen from CSF sample / Lumbar puncture
Name the special tests which look for meningeal irritation.	Kernig's test
	Brudzinski's test
CSF that is contaminated with BM pathogens will have what appearance?	Cloudy
CSF samples are sent for what tests?	Cell count and differential
	Protein
	Glucose (and serum glucose)
	Microscopy, cultures and sensitivity / MC&S
	Viral PCR
In BM-infected CSF samples, will there be high or low: protein?	High
Glucose?	Low
White cells?	High
What other bedside tests might be performed on a patient with suspected BM?	Throat swab
	Respiratory viral screen / nasopharyngeal swab
Apart from a FBC, U&E and LFTs, what other blood and biochemical tests may be ordered for a patient with suspected BM?	Bone profile
	Coagulation / Coag
	CRP / c-reactive protein
	Blood culture
	VBG / venous blood gas

Hint	Answer
What type of imaging may be used to look for contraindications to the LP?	CT
What are the most common organisms which cause meningitis?	Neisseria meningitidis
	Streptococcus pneumoniae / pneumococcus
	Haemophilus influenzae
	Group B streptococcus / GBS
	Listeria monocytogenes
	Escherichia coli / E. coli
What type of white cell is the most common in an infected CSF sample from a patient with BM?	Neutrophils
Antibiotics should not be administered intra-muscularly to patients with what type of disorders?	Bleeding
Topical antibiotics are prescribed to patients with infections where?	Skin
	Ear
	Eye
"A doctor may wait to prescribe antibiotics until after a blood culture and LP have been taken." Is this true?	Yes
What antibiotic is usually given to babies <3 months old for a bacterial meningitis infection?	Cefotaxime
Which other antibiotics may be given alongside this (i.e. as a dual therapy) to protect against listeria?	Amoxicillin
	Ampicillin
What antibiotic is usually given to children >3 months old for a bacterial meningitis infection?	Ceftriaxone
What is the Route of Administration for this drug?	IV / intravenous
What other type of medication is given alongside antibiotics to help prevent complications from meningitis?	Steroids
What is the main potential complication of bacterial meningitis?	Hearing loss / deafness
What other complications can be caused by this disease?	Seizures / epilepsy
	Cognitive impairment / learning disability
	Memory loss
	Cerebral palsy