Pathology EMQ template.

Name: Sanjay Cheema

Theme: Meningitis

 

OPTION LIST

 

A	Borrelia Burgdorferi	I	Listeria monocytogenese
B	Cocksackie A virus	J	Mycobacterium tuberculosis
C	Cryptococcus noformans	K	Neisseria meningitidis Group B
D	Escherichia coli	L	Neisseria meningitidis Group C
E	Group B streptococcus	M	Staphlococcus aureus
F	Haemophilus influenza B	N	Streptococcus pneumoniae
G	Herpes simplex virus	O	Treponema pallidum
H	Leptospira interrogans	P	Varicella zoster virus

 

For each scenario below, choose the most likely organism from the list above. Each option may be used once, more than once or not at all.

 

1.       A 60 year old man who had experienced lethargy for the last few weeks presents with acutely disturbed consciousness and opthalmoplegia. CSF analysis shows lymphocytes, a very high protein level and low glucose.

 

2.       A 7 day old child in NICU shows irritability, fluctuating temperature, failure to feed and vomiting. There is a gram positive organism in the CSF.

 

3.       A 25 year old who has just returned from camping presents with a severe headache, neck stiffness and photophobia. On examination he has the classic skin rash erythema migrans associated with this infection.

 

4.       30 year old HIV positive patient with a low CD4 presents with clinical features of meningitis, CSF is described as aseptic however an India ink stain confirms an organism.

 

5.       Vaccines for which organisms (may be multiple answers) are part of the routine childhood immunisation schedule in the UK?

 

 

 

 

ANSWERS

1. N

2. L

3. G

4. 0

5. B,H,I