Pathology EMQ template.

Name: Kangni Chen

Theme: CNS infections & Meningitis

 

OPTION LIST

 

A	Haemophilus influenzae	I	Giardia lamblia
B	Myobacteria tuberculosis	J	Brucella melitensis
C	Neisseria meningitidis	K	Salmonella enterica
D	E. coli	L	Clostridium botulinum
E	Listeria monocytogenes	M	Group B haemolytic streptococci
F	Leptospira interrogans	N	Staph. aureus
G	Streptococcus pneumoniae	O	Epstein-Barr (EBV)
H	Cryptococcs neoformans	P	Bacillus anthracis

 

 

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

 

1.  A confused 28 years old male comes to A&E. You find out from the girlfriend he had a two days history of headache, fever and nausea/vomiting. On examination you notice neck stiffness and positive Kernig’s sign.

 

 

2. A 78 years old patient who had a kidney transplant recently presents with temperature of 38˚C, headache and photophobia on the post-op ward roubd. CSF culture reveals gram positive bacilli.

 

 

3. A patient with suspected meningitis was referred by his GP urgently to A&E. There is no disturbance in their level of consciousness but the CSF shows high lymphocyte count and normal glucose levels.

 

 

4. A sewage worker with a 5 days history of flu-like symptoms which resolved a week ago comes to his GP. He is ill again and now has a range of symptoms such as headache, yellowing of the skin, abdominal pain.

 

 

5.  A worried mum brings her 4 months old baby to the hospital. She tells you that her daughter has been vomiting and crying in an odd way. On examination there is neck stiffness and the fontanelle is tense. They have recently migrated from Iraq and do not have the baby record of vaccinations.

 

 

 

ANSWERS

1. C

2. E

3. O

4. F

5. A