Neurology: bacterial meningitis: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neurology: bacterial meningitis

Sample item

A child has fever, headache, neck stiffness, photophobia, and a rapidly spreading purpuric rash. What is the appropriate principle of management?

AWait for lumbar puncture results before treatmentBTreat only with antipyreticsCDischarge if the rash blanches temporarilyDGive urgent empiric antibiotics after obtaining cultures if this causes no unsafe delay

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Give urgent empiric antibiotics after obtaining cultures if this causes no unsafe delay

Suspected bacterial meningitis with meningococcemia is time critical. Antibiotic treatment and resuscitation must not be delayed by investigations when the child is unstable or procedures would cause an unsafe delay.

Option by option

A. Wait for lumbar puncture results before treatment
Waiting can permit rapid septic and neurologic deterioration.
B. Treat only with antipyretics
Antipyretics do not treat meningitis or septic shock.
C. Discharge if the rash blanches temporarily
Transient rash changes do not exclude serious infection.
D. Give urgent empiric antibiotics after obtaining cultures if this causes no unsafe delay (correct)
Correct. Prompt treatment is essential in invasive bacterial infection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Give urgent empiric antibiotics after obtaining cultures if this causes no unsafe delay. Suspected bacterial meningitis with meningococcemia is time critical.

Why is "Wait for lumbar puncture results before treatment" not the answer?

Waiting can permit rapid septic and neurologic deterioration.

Why is "Treat only with antipyretics" not the answer?

Antipyretics do not treat meningitis or septic shock.

Why is "Discharge if the rash blanches temporarily" not the answer?

Transient rash changes do not exclude serious infection.

What concept does this question test?

It tests Neurology: bacterial meningitis in Pediatrics. Antibiotic treatment and resuscitation must not be delayed by investigations when the child is unstable or procedures would cause an unsafe delay.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: bacterial meningitis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.