What are the other types of meningitis?

  • Viral
  • Chronic (tuberculosis)
  • Fungal
  • Chemical/drug induced
  • Carcinomatous

Pass Criteria:

  • 3 out of 5 including bold

What organisms commonly cause bacterial meningitis in the different age groups?

  • Neonates: Escherichia Coli and Group B Streptococcus
  • Children: Streptococcus Pneumoniae, Haemophilus Influenzae (now less common)
  • Adolescent/young adult: Neisseria meningiditis, Streptococcus Pneumoniae
  • Older adults: Streptococcus Pneumoniae, Listeria

Pass Criteria:

  • 1 per age group
  • Must mention bold


Name some common bacteria that cause wound infections.

  • Staphylococcus aureus
  • Streptococcus pyogenes
  • Clostridium perfringens
  • Aerobic Gram negative bacilli
  • Pseudomonas aeruginosa
  • Clostridium tetani

Pass Criteria:

  • Bold + 1 other

What diseases are cause by Staphylococcus aureus?

  • Skin/soft tissue:
    • Cellulitis
    • Impetigo
    • Abscess (furuncle, carbuncle)
    • Folliculitis
    • Paronychia
    • Felon
    • Lymphadenitis
    • Necrotising soft tissue infection
    • Scalded skin syndrome

Pass Criteria:

  • 3 skin
  • 3 non-skin infections

Describe the clinical features of Staph. Aureus toxic shock syndrome.

  • Hypotension (shock)
  • Renal failure
  • Coagulopathy
  • Liver disease
  • Respiratory failure
  • Generalised erythematous rash
  • Soft tissue necrosis at site of infection

Pass Criteria:

  • 4/7 (must have specific organs)


Outline the natural history and spectrum of TB.
Prompt: What can happen after primary infection?

  1. Primary infection.
  2. Primary complex (localised caseation) (Ghon complex is primary TB with mediastinal nodes).
  3. Primary complex may heal (organisms not viable) or lead to a latent infection (organisms viable).
  4. Latent period or progressive primary TB (latter of which may lead to miliary TB).
  5. Latent lesion reactivated leading to secondary TB (reinfection may also lead to secondary TB).
  6. Secondary TB occurs as localised (pulmonary or extra-pulmonary) caseating destructive lesions or progressive secondary TB.
  7. Progressive secondary TB may lead to miliary TB.

Pass Criteria:

  • 4/4 bold criteria to pass.

How is TB diagnosed?

  • Clinical features in at risk patients (Hx and Examination) and apical lung consolidation/cavitation on CXR
  • Microbiological confirmation:
    • Acid fast smears and cultures (3-6 weeks solid agar media, 2 weeks liquid media)
    • PCR
  • Other (e.g. Mantoux test)

Pass Criteria:

  • Must have bold criteria to pass.


How does Neisseria meningiditis cause infection?

  1. Common coloniser of the oropharynx – 10% of population at any one time can be carriers for months.
  2. Spread by respiratory droplets.
  3. Most people develop an immune response and clear it – they are then protected against future infection from this serotype (>13 serotypes).
  4. Invasive disease when a new serotype is encountered.
  5. Invades the respiratory epithelium, then invade the bloodstream.
  6. The capsule of the bacterium allows it to evade the immune system by prevention of opsonisation and complement destruction.
  7. Mortality is still approximately 10% despite antibiotic treatment.

Pass Criteria:

  • Need to have at least 4/7 to pass.

What are the clinical consequences of N. meningiditis infection?

  • Death
  • Generalised sepsis
  • Necrotising vasculitis
  • Seizures
  • CVA
  • Hydrocephalus
  • Meningitis
  • Sensorineural hearing loss
  • Cognitive impairment

Pass Criteria:

  • Need to have at least 4 to pass.

Apart from N. meningiditis, what else can cause meningitis?

  • Other bacteria:
    • E. coli and Group B streptococcus (infants)
    • Streptococcus pneumoniae
    • Listeria monocytogenes
    • Haemophilus influenzae
  • Viral:
    • Enterovirus
    • Measles
  • Other
    • TB
    • Rickettsia
    • Carcinoma
    • Autoimmune
    • Chemical

Pass Criteria:

  • Must have two specific bacteria plus viral as a group to pass.


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