Paper II — 2025 March (Supplementary (SAY)) (2019 Scheme) — Qi
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Paper II
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min
Question
What is the probable causative agent for meningitis in this patient
a) Streptococcus agalactiae
c) Staphylococcus aureus
b) Haemophilus influenzae
d) Streptococcus pneumoniae
Qi1.8 marksMCQs
Answer
- [x] d) Streptococcus pneumoniae
The combination of options across this MCQ set is diagnostically specific to pneumococcal meningitis: a capsule as the key virulence factor (ii), the presence of “bile solubility” as a distractor option in the immune-evasion question (iii) — bile solubility is specifically the laboratory confirmatory test used to identify S. pneumoniae, a strong contextual clue pointing to this organism — a “cellular component” (subunit/conjugate, i.e., pneumococcal conjugate) vaccine (iv), and ceftriaxone as the drug of choice (v), consistent with third-generation cephalosporins being the backbone of empirical bacterial meningitis treatment, with particular relevance for pneumococcal disease given rising penicillin resistance. Streptococcus agalactiae and Staphylococcus aureus are less classically associated with this specific combination of features, and Haemophilus influenzae, while also encapsulated and ceftriaxone-treated, does not fit as well given the bile-solubility distractor’s specific relevance to pneumococcus.
