In which one of the following conditions, Kerning's sign is considered as a positive indicator?

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

Kernig's sign is a test for meningeal irritation, which is a hallmark of meningitis.
The test is performed by flexing the patient's hip and knee to a 90-degree angle and then attempting to extend the leg.
A positive sign is characterized by pain and resistance in the hamstring muscles, preventing full extension of the leg.
This response is caused by the stretching of inflamed meninges and nerve roots.

Option B: Hepatitis is an inflammation of the liver. Its signs and symptoms (like jaundice, fatigue, and abdominal pain) are related to liver dysfunction, not meningeal irritation.
Option C: Deep vein thrombosis (DVT) is a blood clot in a deep vein. The classic, though often unreliable, sign associated with DVT is Homan's sign (calf pain on dorsiflexion of the foot), not Kernig's sign.
Option D: Typhoid is a systemic bacterial infection (enteric fever). Its primary symptoms are high fever, abdominal pain, and weakness. It does not typically cause meningeal signs.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of meningeal irritation (Kernig's sign) as background academic context rather than a clinical decision trigger.
Recognizing Kernig's sign is a critical nursing skill for the early detection of meningitis, a medical emergency.
A positive Kernig's sign, especially when accompanied by fever, headache, and neck stiffness, warrants immediate medical attention and escalation to the physician.
What if? If a patient has a positive Kernig's sign but a normal temperature, the nurse should still suspect meningeal irritation. Other causes like a subarachnoid hemorrhage must be considered, and a full neurological assessment is crucial.

How to Approach the Question

First, identify the key term in the question: 'Kernig's sign'.
Recall the definition and clinical significance of this sign. It is a test for meningeal irritation.
Analyze the options provided. Evaluate which of the conditions listed is directly associated with inflammation of the meninges.
Meningitis is, by definition, inflammation of the meninges. Therefore, Kernig's sign is a direct indicator.
Rule out the other options by recalling their primary pathology: Hepatitis (liver), DVT (veins), and Typhoid (systemic infection), none of which primarily involve the meninges.

Concept Tested & Keywords

QpUAceLKaEQaqfPZQmss-h

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1568-1570

E6 Medicine Davidson Principles Practice 24e p. 205-207

Practise the full SCTIMST Staff Nurse - 2015 (Set-A)

Attempt every question from this paper in a timed mock, then review the full solution for each one.