Pathology EMQ template.

Theme 1: CNS / Meningitis: Chris Bell: used in mock: 151-155

OPTION LIST

 

A

Eschericha Coli

 

I

Streptococcus pneumoniae

B

Haemophilus influenzae

 

J

Subarachnoid haemorrhage

C

Meningioma

 

K

Subdural haemorrhage

D

Migraine

 

L

Viral meningitis

E

Mycobacterium tuberculosis

 

M

Extradural haemorrhage

F

Neisseria meningitis

 

N

 

G

Poliovirus

 

O

 

H

Protozoal meningitis

 

P

 

 

 

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 30-year-old gentleman presents with headache, neck stiffness, fever and general malaise. Examination reveals a blanching skin rash. A lumbar puncture revealed clear CSF with no neutrophils present, a high number of lymphocytes and protein of 0.75g/L. CSF glucose was within normal range.

 

2. A 42-year-old woman presents with haemoptysis and neck stiffness and photophobia and subsequent impairment of consciousness. On questioning it is revealed that she has been feeling unwell for a couple of weeks. CSF from a lumbar puncture was turbid with a high level of protein (2.3g/L).

 

3. A 3 year old girl with incomplete vaccinations presents with insidious symptoms of meningism over the course of a couple of days. Blood culture revealed presence of Gram negative coccibacilli.

 

4. A 73 year old gentleman presents with high fever and neck stiffness of acute onset. A lumbar puncture revealed Gram positive cocci.

 

5. An 18 year old student presents to his GP with a sore throat and headache. He also admitted to being more irritable recently. A complete examination revealed a mixed petechial and maculopapular rash on his extremities. CSF sample showed infection with a Gram negative diplococcus.

 

 

 

ANSWERS

1. L

2. E

3. B

4. I

5. F