AIPGMEE 2016 MCQ Medicine CNS

An adult male suffering from chills, fever, headache, nausea,
vomiting, and pain in the back was admitted to the
emergency room and diagnosed as having meningococcal
meningitis. Which of the following changes are most
likely in the composition of the cerebrospinal fl uid of this
patient?
a. Increased protein, decreased glucose, and increased
polymorphonuclear white blood cells
b. Increased protein, normal glucose, and excessive
number of lymphocytes
c. Increased protein, normal glucose, and a few white
blood cells
d. Increased protein, normal glucose, and presence of
tumor cells and white blood cells
e. Increased protein, increased glucose, and a few white
blood cells
Answer: a
Increased protein, decreased glucose, and increased polymorphonuclear
WBCs are observed in the cerebrospinal fl uid
(CSF) of patients with bacterial meningitis. The glucose levels
in CSF decrease because the bacteria present in CSF (usually
meningococcus, pneumococcus, and Haemophilus infl uenzae
organisms) use glucose. The CSF glucose levels are low in
tubercular meningitis also; however, in this condition, the cells
in CSF are predominantly lymphocytes. In viral meningitis, the
glucose levels in CSF remain normal because, in this condition,
the viruses do not use glucose. In addition, the number of
lymphocytes present in the CSF is excessive.