[MCQ] Viral Encephalitis- Part 2

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Viral Encephalitis- Part 2

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Question 1

Typical visual deficit seen in progressive multifocal leukoencephalopathy is ?

A	Achromatopia
B	Homonymous hemianopia
C	Cortical blindness
D	Amaurosis fugax

Question 1 Explanation:

Patients of progressive multifocal leukoencephalopathy present with visual deficits, typically homonymous hemianopia.

Question 2

Subacute sclerosing panencephalitis occurs after a latent interval of how many years after measles infection ?

A	1 - 2 years
B	2 - 4 years
C	4 - 6 years
D	6 - 8 years

Question 2 Explanation:

SSPE occurs after a latent interval of 6 - 8 years after measles infection.

Question 3

Which of the following is not a manifestation of subacute sclerosing panencephalitis ?

A	Fever and headache
B	Progressive intellectual deterioration
C	Focal and/or generalized seizures
D	Ataxia

Question 3 Explanation:

Signs of a CNS viral infection - fever & headache do not occur in SSPE.

Question 4

Which of the following diagnostic modalities are useful in SSPE ?

A	EEG
B	CSF
C	MRI
D	All of the above

Question 5

CSF finding in SSPE is ?

A	Acellular
B	Elevated gamma globulin level
C	Elevated CSF antimeasles antibody level
D	All of the above

Question 5 Explanation:

In SSPE, CSF is acellular with markedly elevated gamma globulin level (>20% of total CSF protein). CSF antimeasles antibody levels are invariably elevated & oligoclonal antimeasles antibodies are present.

Question 6

Which of the following drugs is used in the treatment of SSPE ?

A	Acyclovir
B	Isoprinosine
C	Cytarabine
D	Foscarnet

Question 6 Explanation:

Isoprinosine (100 mg/kg/day), alone or in combination with intrathecal or intraventricular -interferon prolongs survival with clinical improvement.

Question 7

Which of the following is true for the capsule of a brain abscess ?

A	Fibrous
B	Vascularized
C	No capsule
D	Any of the above

Question 7 Explanation:

Brain abscess is a focal, suppurative infection within brain parenchyma, typically surrounded b

Question 8

In immunocompetent individuals the most common pathogen that causes brain abscess is ?

A	Streptococcus
B	Klebsiella
C	Staphylococcus
D	E. coli

Question 9

In immunocompromised hosts the most common pathogen that causes brain abscess is ?

A	Taenia solium
B	Mycobacterium tuberculosis
C	Nocardia
D	E. coli

Question 10

Which of the following is false about hematogenous brain abscesses ?

A	At the junction of gray & white matter
B	Predilection for MCA territory
C	Multiple
D	Encapsulated

Question 10 Explanation:

Hematogenous abscesses are often poorly encapsulated

Question 11

Most common symptom of brain abscess is ?

A	Headache
B	Fever
C	Seizure
D	Focal neurologic deficit

Question 11 Explanation:

Most common symptom in patients with a brain abscess is headache

Question 12

When should a lumbar puncture performed in patients suspected of brain abscess ?

A	As early as possible
B	On day 3
C	On day 10
D	Should not be performed

Question 12 Explanation:

LP should not be performed in those with known or suspected focal intracranial infections (abscess / empyema) as CSF analysis contributes nothing to diagnosis or therapy, & LP increases the risk of herniation.

Question 13

Conditions that can cause headache, fever, focal neurologic signs, and seizure activity include ?

A	Bacterial meningitis
B	Superior sagittal sinus thrombosis
C	Acute disseminated encephalomyelitis
D	All of the above

Question 13 Explanation:

Conditions that can cause headache, fever, focal neurologic signs & seizures are brain abscess, subdural empyema, bacterial meningitis, viral meningoencephalitis, superior sagittal sinus thrombosis & acute disseminated encephalomyelitis

Question 14

Anticonvulsant therapy is continued for at least how many months after resolution of brain abscess ?

A	3
B	6
C	9
D	12

Question 15

Most common parasitic disease of the CNS worldwide is ?

A	Neurocysticercosis
B	Toxoplasmosis
C	Schistosomiasis
D	Amebiasis

Question 15 Explanation:

Neurocysticercosis is the most common parasitic disease of the CNS worldwide.

Question 16

Most common manifestation of neurocysticercosis is ?

A	New-onset partial seizures
B	New-onset generalized seizures
C	Focal neurologic deficit
D	Headache

Question 16 Explanation:

Most common manifestation of neurocysticercosis is new-onset partial seizures with or without secondary generalization

Question 17

Which of the following findings on neuroimaging calls for treatment with anticysticidal drugs ?

A	Cysticerci appearing as cystic lesions in brain
B	Cysticerci appearing as enhancing lesions in brain
C	Cysticerci appearing as enhancing lesions in subarachnoid space
D	All of the above

Question 17 Explanation:

Cysticerci appearing as cystic lesions or as enhancing lesions in the brain parenchyma or in the subarachnoid space at the convexity of the cerebral hemispheres should be treated with anticysticidal therapy.

Question 18

The superior sagittal sinus drains into ?

A	Transverse sinus
B	Sigmoid sinus
C	Internal jugular vein
D	Cavernous sinus

Question 18 Explanation:

Superior sagittal sinus drains into the transverse sinuses which becomes sigmoid sinus before draining into internal jugular vein.

Question 19

Headache & earache are the most frequent symptoms of ?

A	Transverse sinus thrombosis
B	Internal jugular vein thrombosis
C	Superior sagittal sinus thrombos
D	Cavernous sinus thrombosis

Question 19 Explanation:

Headache and earache are the most frequent symptoms of transverse sinus thrombosis.

Question 20

Gradinego’s syndrome is due to thrombosis in which of the following intracranial sinuses ?

A	Transverse sinus
B	Sigmoid sinus
C	Internal jugular vein
D	Cavernous sinus

Question 20 Explanation:

Transverse sinus thrombosis may present with otitis media, sixth nerve palsy & retroorbital or facial pain (Gradinego’s syndrome).

Question 21

Which of the following does not pass through the cavernous sinus ?

A	III, IV & VI cranial nerves
B	Ophthalmic & maxillary branches of V cranial nerve
C	Middle cerebral artery
D	Internal carotid artery

Question 21 Explanation:

III, IV & VI and ophthalmic & maxillary branches of V cranial nerve, along with internal carotid artery pass through the cavernous sinus.

Question 22

Retroorbital pain is a feature of ?

A	Viral meningitis
B	Transverse sinus thrombosis
C	Cavernous sinus thrombosis
D	All of the above

Question 22 Explanation:

Headache of viral meningitis is usually frontal or retroorbital and is often associated with photophobia & pain on eye movement.

Question 23

Chronic meningitis is diagnosed when ?

A	> 4 weeks duration
B	Persistent CSF WBC count > 5/μL
C	Chronic & persistent or recurrent & discrete headache
D	All of the above

Question 24

Which of the following is best related to resorbption of CSF ?

A	Choroid plexus
B	Arachnoid villi
C	Virchow-Robin spaces
D	All of the above

Question 24 Explanation:

CSF is resorbed by arachnoid villi projecting into superior sagittal sinus. Virchow-Robin spaces are arachnoid cuffs surrounding blood vessels that penetrate brain tissue.

Question 25

Recurrent meningitis is a feature of all except ?

A	Vogt-Koyanagi-Harada syndrome
B	Behçet’s syndrome
C	Wegener’s granulomatosis
D	Mollaret’s meningitis

Question 26

Recurrent meningitis is a feature of ?

A	Neurocysticercosis
B	Drug hypersensitivity
C	Syphilis
D	Mumps

Question 26 Explanation:

Exposure to ibuprofen, sulfonamides, isoniazid, tolmetin, ciprofloxacin, phenazopyridine lead to recurrent episodes with recurrent exposure. Improvement occurs after discontinuation of drug.

Question 27

Uveitis is a feature of ?

A	Vogt-Koyanagi-Harada syndrome
B	Sarcoid
C	CNS lymphoma
D	All of the above

Question 27 Explanation:

Uveitis is a feature of Vogt-Koyanagi-Harada syndrome, sarcoid or CNS lymphoma. 1544 Iridocyclitis is a feature of ? Harrison’s 18th Ed. 3438 A. Systemic lupus erythematosus B. CNS sarcoidosis C. Wegener’s granulomatosis D. Behçet’s syndrome Iridocyclitis is a feature of Behçet’s syndrome. 1545 Which of the following is a feature of Behçet’s syndrome ? Harrison’s 18th

Question 28

Which of the following is a feature of Behçet’s syndrome ?

A	Aphthous oral lesions
B	Genital ulcers
C	Hypopyon
D	All of the above

Question 28 Explanation:

Aphthous oral lesions, genital ulcers and hypopyon suggest Behçet’s syndrome.

Question 29

Fatal levels of raised ICP can occur without enlarged ventricles in ?

A	Lyme disease
B	CNS sarcoidosis
C	Cryptococcal meningitis
D	Chronic benign lymphocytic meningitis

Question 29 Explanation:

In cryptococcal meningitis, fatal levels of raised ICP can occur without enlarged ventricles.

Question 30

Anti-Ro / SSA positivity is associated with ?

A	Sensorineural hearing loss
B	Raynaud’s phenomenon
C	Congenital heart block
D	All of the above

Question 30 Explanation:

Congenital heart block in newborn due to damage to developing conducting system of heart results from transfer of anti-Ro antibody from mother to child.

Question 31

Most useful empirical therapy for chronic meningitis is ?

A	Antituberculous therapy
B	Antifungal medication
C	Glucocorticoids
D	Ventricular-peritoneal shunt

Question 31 Explanation:

Most useful empirical therapy for chronic meningitis is administration of glucocorticoids rather than antituberculous therapy.

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See all quizzes of Viral Encephalitis here:

1 Typical visual deficit seen in progressive multifocal
leukoencephalopathy is ?
A. Achromatopia
B. Homonymous hemianopia
C. Cortical blindness
D. Amaurosis fugax

2 Subacute sclerosing panencephalitis occurs after a latent interval
of how many years after measles infection ?
A. 1 – 2 years
B. 2 – 4 years
C. 4 – 6 years
D. 6 – 8 years

3 Which of the following is not a manifestation of subacute sclerosing
panencephalitis ?
A. Fever and headache
B. Progressive intellectual deterioration
C. Focal and/or generalized seizures
D. Ataxia

4 Which of the following diagnostic modalities are useful in SSPE ?
A. EEG
B. CSF
C. MRI
D. All of the above
5 CSF finding in SSPE is ?
A. Acellular
B. Elevated gamma globulin level
C. Elevated CSF antimeasles antibody level
D. All of the above

6 Which of the following drugs is used in the treatment of SSPE ?
A. Acyclovir
B. Isoprinosine
C. Cytarabine
D. Foscarnet

7 Which of the following is true for the capsule of a brain abscess ?
A. Fibrous
B. Vascularized
C. No capsule
D. Any of the above

8 In immunocompetent individuals the most common pathogen
that causes brain abscess is ?
A. Streptococcus
B. Klebsiella
C. Staphylococcus
D. E. coli
9 In immunocompromised hosts the most common pathogen that
causes brain abscess is ?
A. Taenia solium
B. Mycobacterium tuberculosis
C. Nocardia
D. E. coli
10 Which of the following is false about hematogenous brain
abscesses ?
A. At the junction of gray & white matter
B. Predilection for MCA territory
C. Multiple
D. Encapsulated

11 Most common symptom of brain abscess is ?
A. Headache
B. Fever
C. Seizure
D. Focal neurologic deficit

12 When should a lumbar puncture performed in patients suspected
of brain abscess ?
A. As early as possible
B. On day 3
C. On day 10
D. Should not be performed

13 Conditions that can cause headache, fever, focal neurologic signs,
and seizure activity include ?
A. Bacterial meningitis
B. Superior sagittal sinus thrombosis
C. Acute disseminated encephalomyelitis
D. All of the above

14 Anticonvulsant therapy is continued for at least how many months
after resolution of brain abscess ?
A. 3
B. 6
C. 9
D. 12

15 Most common parasitic disease of the CNS worldwide is ?
A. Neurocysticercosis
B. Toxoplasmosis
C. Schistosomiasis
D. Amebiasis

16 Most common manifestation of neurocysticercosis is ?
A. New-onset partial seizures
B. New-onset generalized seizures
C. Focal neurologic deficit
D. Headache

17 Which of the following findings on neuroimaging calls for
treatment with anticysticidal drugs ?
A. Cysticerci appearing as cystic lesions in brain
B. Cysticerci appearing as enhancing lesions in brain
C. Cysticerci appearing as enhancing lesions in subarachnoid
space
D. All of the above

18 The superior sagittal sinus drains into ?
A. Transverse sinus
B. Sigmoid sinus
C. Internal jugular vein
D. Cavernous sinus

19 Headache & earache are the most frequent symptoms of ?
A. Transverse sinus thrombosis
B. Internal jugular vein thrombosis
C. Superior sagittal sinus thrombosis
D. Cavernous sinus thrombosis

20 Gradinego’s syndrome is due to thrombosis in which of the
following intracranial sinuses ?
A. Transverse sinus
B. Sigmoid sinus
C. Internal jugular vein
D. Cavernous sinus

21 Which of the following does not pass through the cavernous
sinus ?
A. III, IV & VI cranial nerves
B. Ophthalmic & maxillary branches of V cranial nerve
C. Middle cerebral artery
D. Internal carotid artery

22 Retroorbital pain is a feature of ?
A. Viral meningitis
B. Transverse sinus thrombosis
C. Cavernous sinus thrombosis
D. All of the above

23 Chronic meningitis is diagnosed when ?
A. > 4 weeks duration
B. Persistent CSF WBC count > 5/μL
C. Chronic & persistent or recurrent & discrete headache
D. All of the above
24 Which of the following is best related to resorbption of CSF ?
A. Choroid plexus
B. Arachnoid villi
C. Virchow-Robin spaces
D. All of the above

25 Recurrent meningitis is a feature of all except ?
A. Vogt-Koyanagi-Harada syndrome
B. Behçet’s syndrome
C. Wegener’s granulomatosis
D. Mollaret’s meningitis
26 Recurrent meningitis is a feature of ?
A. Neurocysticercosis
B. Drug hypersensitivity
C. Syphilis
D. Mumps

27 Uveitis is a feature of ?
A. Vogt-Koyanagi-Harada syndrome
B. Sarcoid
C. CNS lymphoma
D. All of the above

28 Iridocyclitis is a feature of ?
A. Systemic lupus erythematosus
B. CNS sarcoidosis
C. Wegener’s granulomatosis
D. Behçet’s syndrome
29 Which of the following is a feature of Behçet’s syndrome ?
A. Aphthous oral lesions
B. Genital ulcers
C. Hypopyon
D. All of the above

30 Fatal levels of raised ICP can occur without enlarged ventricles in ?
A. Lyme disease
B. CNS sarcoidosis
C. Cryptococcal meningitis
D. Chronic benign lymphocytic meningitis

31 Anti-Ro / SSA positivity is associated with ?
A. Sensorineural hearing loss
B. Raynaud’s phenomenon
C. Congenital heart block
D. All of the above

32 Most useful empirical therapy for chronic meningitis is ?
A. Antituberculous therapy
B. Antifungal medication
C. Glucocorticoids
D. Ventricular-peritoneal shunt

Viral Encephalitis

[MCQ] Viral Encephalitis- Part 2

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Viral Encephalitis- Part 2

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