Neurology: viral meningitis: practice question

A General Medicine 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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General Medicine · Neurology: viral meningitis

Sample item

A 20-year-old has fever, headache and neck stiffness. CSF shows 120 lymphocytes per microlitre, protein 70 mg/dL and glucose 60 mg/dL with a blood glucose of 90 mg/dL. What is the most likely diagnosis?

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

The answer and the reasoning

C. Viral (aseptic) meningitis

Viral meningitis typically shows a lymphocytic pleocytosis, mildly raised protein and normal glucose. Enteroviruses are the commonest cause, and recovery is usually spontaneous. Bacterial meningitis shows neutrophils with low glucose, and tuberculous disease shows high protein with low glucose.

Option by option

  • A. Cryptococcal meningitis

    Cryptococcal meningitis occurs in immunosuppression and shows low glucose with positive India ink or antigen.

  • B. Tuberculous meningitis

    Tuberculous meningitis causes very high protein and low glucose.

  • C. Viral (aseptic) meningitis (correct)

    Correct. Lymphocytes with normal glucose point to viral meningitis.

  • D. Pyogenic meningitis

    Pyogenic meningitis causes neutrophilia and low glucose.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Viral (aseptic) meningitis. Viral meningitis typically shows a lymphocytic pleocytosis, mildly raised protein and normal glucose.

Why is "Cryptococcal meningitis" not the answer?

Cryptococcal meningitis occurs in immunosuppression and shows low glucose with positive India ink or antigen.

Why is "Tuberculous meningitis" not the answer?

Tuberculous meningitis causes very high protein and low glucose.

Why is "Pyogenic meningitis" not the answer?

Pyogenic meningitis causes neutrophilia and low glucose.

What concept does this question test?

It tests Neurology: viral meningitis in General Medicine. Enteroviruses are the commonest cause, and recovery is usually spontaneous. Bacterial meningitis shows neutrophils with low glucose, and tuberculous disease shows high protein with low glucose.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: viral meningitis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.