MKSAP ID UPDATED Exam Questions and
CORRECT Answers
<250
50-1k
lymphocytes
>45
<200
negative
negative - CORRECT ANSWER - viral meningitis
-opening pressure
-leukocyte count
-differential
-glucose
-protein
-Gram stain
-culture
200-500
1k-5k
neutrophils
<40
100-500
positive
positive - CORRECT ANSWER - bacterial meningitis
-opening pressure
-leukocyte count
-differential
,-glucose
-protein
-Gram stain
-culture
Strep pneumo agn and PCR - CORRECT ANSWER - test that should be obtained in
addition to LP before starting abx for suspected meningitis
IV ceftriaxone OR cefotaxime
IV vanc - CORRECT ANSWER - empiric abx for bacterial meningitis in
immunocompetent host with community acquired meningitis
IV ampicillin
IV ceftriaxone OR cefotaxime
IV vanc - CORRECT ANSWER - empiric abx for bacterial meningitis in pt >50 yo or
those with altered cell mediated immunity
IV moxifloxacin
-IV bactrim - CORRECT ANSWER - should be substituted for cephalosporins in empiric
coverage for meningitis if allergic to beta lactams
-for ampicillin
IV vanc
IV ceftazidime OR cefepime OR meropenem - CORRECT ANSWER - empiric abx for
bacterial meningitis in pt with suspected hospital acquired dz (head trauma, NSGY or ventricular
drains)
decadron for 4 days - CORRECT ANSWER - should be given in addition to abx if treating
pneumococcal meningitis
, supportive - CORRECT ANSWER - tx of viral meningitis
MRI
-aspiration for culture
-IV vanc + metronidazole + ceftriaxone - CORRECT ANSWER - initial dx for brain
abscess
-definitive dx
-empiric tx
>2.5 cm - CORRECT ANSWER - when should brain abscesses be excised
LP - CORRECT ANSWER - contraindicated in pt with brain abscess
herpes simplex encephalitis - CORRECT ANSWER - fever, AMS, headache, seizure, focal
neuro deficit
lymphocytic pleocytosis
-HSV PCR of CSF
-temporal lobe abnormalities - CORRECT ANSWER - LP finding of HSV encephalitis
-dx
-imaging finding
IV acyclovir for 14-21 days - CORRECT ANSWER - tx of HSV encephalitis
summer-early fall
-acute asymmetric flaccid paralysis
-IgM to WNV in serum and CSF
-supportive - CORRECT ANSWER - time period for West Nile virus
CORRECT Answers
<250
50-1k
lymphocytes
>45
<200
negative
negative - CORRECT ANSWER - viral meningitis
-opening pressure
-leukocyte count
-differential
-glucose
-protein
-Gram stain
-culture
200-500
1k-5k
neutrophils
<40
100-500
positive
positive - CORRECT ANSWER - bacterial meningitis
-opening pressure
-leukocyte count
-differential
,-glucose
-protein
-Gram stain
-culture
Strep pneumo agn and PCR - CORRECT ANSWER - test that should be obtained in
addition to LP before starting abx for suspected meningitis
IV ceftriaxone OR cefotaxime
IV vanc - CORRECT ANSWER - empiric abx for bacterial meningitis in
immunocompetent host with community acquired meningitis
IV ampicillin
IV ceftriaxone OR cefotaxime
IV vanc - CORRECT ANSWER - empiric abx for bacterial meningitis in pt >50 yo or
those with altered cell mediated immunity
IV moxifloxacin
-IV bactrim - CORRECT ANSWER - should be substituted for cephalosporins in empiric
coverage for meningitis if allergic to beta lactams
-for ampicillin
IV vanc
IV ceftazidime OR cefepime OR meropenem - CORRECT ANSWER - empiric abx for
bacterial meningitis in pt with suspected hospital acquired dz (head trauma, NSGY or ventricular
drains)
decadron for 4 days - CORRECT ANSWER - should be given in addition to abx if treating
pneumococcal meningitis
, supportive - CORRECT ANSWER - tx of viral meningitis
MRI
-aspiration for culture
-IV vanc + metronidazole + ceftriaxone - CORRECT ANSWER - initial dx for brain
abscess
-definitive dx
-empiric tx
>2.5 cm - CORRECT ANSWER - when should brain abscesses be excised
LP - CORRECT ANSWER - contraindicated in pt with brain abscess
herpes simplex encephalitis - CORRECT ANSWER - fever, AMS, headache, seizure, focal
neuro deficit
lymphocytic pleocytosis
-HSV PCR of CSF
-temporal lobe abnormalities - CORRECT ANSWER - LP finding of HSV encephalitis
-dx
-imaging finding
IV acyclovir for 14-21 days - CORRECT ANSWER - tx of HSV encephalitis
summer-early fall
-acute asymmetric flaccid paralysis
-IgM to WNV in serum and CSF
-supportive - CORRECT ANSWER - time period for West Nile virus
