1. Refusal of feeding

2. Hyperirritability

3. Respiratory distress

4. Stiff neck

5. Jaundice

Answer: A* Refusal of feeding

***) The following are typical changes in CSF in pyogenic meningitis, except:

1. High protein

2. High glucose

3. High polymorph cells

4. High CSF pressure

5. Turbid CSF

Answer: B* High glucose

***) Characteristic cerebrospinal fluid findings in viral meningitis don’t include:

1. White cell count may be low

2. There may be early polymorphonuclear cell reaction

3. Normal sugar content

4. Elevated protein

5. Positive direct smear for AFB

Answer: E* Positive direct smear for AFB

***) The best treatment of bacterial meningitis in 12 months old patient is:

1. Ampicillin

2. Amikacin and ampicillin

3. Rifampicin

4. Chloramphenicol and ampicillin

5. Cefalotin and gentamycin

Answer: D* Chloramphenicol and ampicillin

***) Empirical treatment of neonatal meningitis is:

1. Ampicillin and vancomycin

2. Vancomycin and ceftriaxone

3. Ampicillin and cefotaxime

4. Amikacin and cefotaxime

5. Cefuroxime and ampicillin

Answer: C* Ampicillin and cefotaxime

***) The following about meningococcal meningitis are true, except:

1. Infection is transmitted by droplet

2. May cause convulsions

3. CSF glucose is low

4. It is the commonest form in adult

5. Causes petechial rash

Answer: D* It is the commonest form in adult

***) The following about meningococcal meningitis are true, except:

1. Causes petechial skin rash

2. CSF is normal

3. Penicillin is the drug of choice

4. Vaccination is helpful

5. Rifampicin is the drug of choice for the close contacts

Answer: B* CSF is normal

***) The most common route of infection of most types of meningitis is the:

1. Blood stream

2. Direct extension from the middle ear

3. Extension from a skull fracture

4. Extension from the cribriform plate

5. Wounds

Answer: A* Blood stream

***) All of the following are indications for lumbar puncture, except:

1. Diagnosis of meningitis

2. Diagnosis of multiple sclerosis

3. Suspicion of a mass lesion in the brain

4. Benign intracranial hypertension

5. Intrathecal injection of drugs

Answer: C* Suspicion of a mass lesion in the brain

26. Encephalitis.

***) Each of the following statements is true about encephalitis, except:

1. CSF sugar is either normal or little raised

2. In most cases the etiology is viral agents

3. Prognosis is generally good

4. CSF cells are mainly segmented neutrophils

5. Some meningeal signs may present

Answer: C* Prognosis is generally good

***) The viral encephalitis is specifically treated with:

1. Penicillin

2. Hyperimmune rabbit serum

3. Gamma globulin

4. Steroids

5. Supportive treatment

Answer: E* Supportive treatment

27. Osteomyelitis.

***) The usual causative microorganism of the hematogenous acute osteomyelitis is:

1. Beta-hemolytic streptococcus

2. E.coli

3. Staphylococcus aureus

4. Mycobacterium TB

5. Clostridium

Answer: C* Staphylococcus aureus

***) The commonest causative organism in osteomyelitis is:

1. Pseudomonas

2. Tubercle bacillus

3. Streptococcus

4. Treponema pallida

5. Staphylococcus

Answer: E* Staphylococcus

***) Regarding acute osteomyelitis all are true, except:

1. Usually caused by hematogenous spread

2. Most commonly caused by staphylococcus aureus

3. Often yields positive blood culture

4. May affect more than one bone

5. X-ray is diagnostic in the early course of the disease

Answer: E* X-ray is diagnostic in the early course of the disease

***) X-ray findings in acute hematogenic osteomyelitis are visible after:

1. 1 week

2. 2 weeks

3. 3 weeks

4. 4 weeks

5. 5 weeks

Answer: B* 2 weeks

***) A school boy who presents with a three days illness caused by acute osteomyelitis is likely to have all of the following, except:

1. Severe localized pain

2. Fever

3. Neutrophil leucocytosis

4. Abnormal limb X-ray

5. A blood culture growth of staphylococci

Answer: D* Abnormal limb X-ray

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