Meningitis, Encephalitis, and Other Infections of the Central Nervous System  chapter 71

908.e1

8. Which of the following causes of pediatric meningitis was

Chapter Review significantly reduced as the result of an effective vaccination
program?
1. Which of the following are specialized structures of the meninges
a. group B Streptococcus
that function to absorb the spinal fluid and allow it to pass into the
b. Escherichia coli
blood?
c. Haemophilus influenza type b
a. leptomeninges
d. Listeria monocytogenes
b. pia mater
c. arachnoid villi 9. When a physician suspects Cryptococcus neoformans as the
d. dura mater etiologic agent of a CNS infection, what is the best way to test for it?
a. India ink stain
2. What bacteria are responsible for outbreaks of meningitis among
b. cryptococcal antigen test
neonates in hospital nurseries?
c. culture
a. Chryseobacterium meningosepticum
d. molecular testing by PCR
b. Haemophilus influenza type b
c. group B streptococci 10. The cerebrospinal fluid that surrounds the brain and spinal fluid
d. Neisseria meningitides functions to:
a. carry essential metabolites into the neural tissue
3. All of the following are pathogenic sources capable of causing brain
b. protect the central nervous system against microbial invasion by
abscesses except:
phagocytosis
a. Taenia solium
c. provide a means by which the brain monitors changes in the
b. Borrelia burgdorferi
internal environment
c. Toxoplasma gondii
d. Both a and c are correct
d. Plasmodium falciparum
11. True or False
4. When processing CSF specimens for laboratory diagnosis, the
_____ In cushioning and providing buoyancy for the bulk of the
specimen appears red in some of the tubes, a sign of red blood
brain, the effective weight of the brain is reduced by a factor
cells and bleeding; to determine whether the blood is due to a
of 30.
bloody tap or a subarachnoid hemorrhage, cell counts are done on
_____ The three layers of protective membranes, which surround
which of the following tubes:
the brain and spinal column, are called the meninges.
a. tubes 1 and 2
_____ The elderly population of patients have the highest
b. tubes 3 and 4
prevalence of meningitis.
c. tubes 2 and 3
_____ Encephalitis is an inflammation of the brain parenchyma and
d. tubes 1 and 4
is normally caused by bacteria.
5. Refer to the previous question. Which tube is used for chemistry _____ The first Hib vaccine was not efficacious in children younger
and immunologic studies? than 18 months of age.
a. tube 1 _____ The normal CSF glucose serum ratio is 0.6, or 50% to 70%
b. tube 2 of the blood glucose normal value.
c. tube 3 _____ A component of syphilis infections is aseptic meningitis.
d. tube 4 _____ CSF cultures from patients suffering from brain abscesses
6. Culture for the determination of the etiologic agent causing are typically positive for anaerobes or viridians streptococci.
meningitis is set up from which tube of CSF? _____ CSF is found in the subdural spaces of the brain.
a. tube 1 _____ The entire volume of CSF is exchanged every 5 to 6 hours.
b. tube 2 _____ When collecting CSF for culture studies, it is imperative to
c. tube 3 collect the correct volume of CSF.
d. tube 4 _____ When transporting CSF to the laboratory for bacterial
7. Which of the following organisms is a parasite that grows studies, the CSF must be refrigerated and kept at a
intracellularly, destroys brain parenchyma, and is a common CNS temperature of 2° to 8°C.
affliction in HIV-infected patients with AIDS? _____ If a physician orders viral studies on a CSF and the transport
a. Naegleria fowler to the laboratory will be longer than 2 to 3 hours after
b. Entamoeba histolytica collection, the CSF specimen must be frozen at −20°C.
c. Taenia solium _____ The most sensitive method for detecting encephalitis-
d. Toxoplasmosis causing viruses in the CSF is PCR.

Copyright © 2014 by Mosby, Inc., an affiliate of Elsevier Inc.

908.e2 PART VII  Diagnosis by Organ System
12. Matching: Match the term with the appropriate definition.
_____ leptomeninges
_____ dura mater
_____ arachnoid membrane
_____ pia mater
_____ ventriculitis
_____ aseptic meningitis
_____ encephalitis
_____ meningoencephalitis
_____ phycomycosis
_____ spinal tab
_____ cysticercus
_____ choroid plexus
_____ blood-brain barrier
_____ meninges
_____ meningitis
13. Short Answer
a. concomitant meningitis with 1. Name the least common route of CNS infection caused by an
encephalitis organism?
b. membrane covering the brain and 2. Name a unique property of the HIV virus that predisposes
spinal cord infected individuals to viral encephalitis?
c. secretory cells that produce CSF 3. What is a cytospin centrifuge, and how does it assist in
d. rapidly progressive fungal processing CSF specimens?
infection 4. What is diagnostic in the smear when using the India ink stain
e. self-limiting viral caused for the presence of Cryptococcus neoformans?
meningitis 5. What is the purpose of the pretreatment REAP procedure? What
f. larval form of Taenia solium does REAP stand for?
g. defense mechanism for the CNS 6. What population of patients has the highest prevalence of
h. pia mater and the arachnoid meningitis? Describe the associated predisposing factors.
membrane 7. What is one of the most critical steps in processing CSF for
i. outermost membrane of the culture?
meninges 8. Explain the reasoning behind using tubes 3 and 4 in CSF
j. between the dura mater and pia collection for cell count and differential.
mater
k. adheres to the outer surface of
the brain and spinal cord
l. purulent meningitis involving the
ventricles
m. infection within the subarachnoid
space of the meninges
n. inflammation of the brain
parenchyma
o. lumbar puncture
Copyright © 2014 by Mosby, Inc., an affiliate of Elsevier Inc.