UPPSC 2023: Which of the following statement is correct about cerebrospinal fluid in Acute Bacterial Meningitis?

UPPSC 2023

Medical & Surgical Nursing

Easy

Appeared in: UPPSC 2023

Explanation

In bacterial meningitis, the body's inflammatory response to the infection is a critical factor.
Inflammatory cytokines like TNF-α and IL-1β are released, which disrupt the integrity of the blood-brain barrier.
This increased permeability allows large molecules, including proteins from the blood, to leak into the cerebrospinal fluid (CSF).
Consequently, a hallmark finding of bacterial meningitis is a significantly increased protein concentration in the CSF, often exceeding 100 mg/dL.

Option A: In bacterial meningitis, glucose content is markedly decreased, not increased. This condition is known as hypoglycorrhachia.
Option B: The opening pressure during a lumbar puncture is typically elevated (greater than 180 mm H₂O) due to inflammation, cerebral edema, and obstruction of CSF flow by purulent exudate.
Option C: The white blood cell count is significantly increased, a condition called pleocytosis. The CSF is flooded with neutrophils (polymorphonuclear leukocytes) in response to the bacterial infection.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Cerebrospinal Fluid (CSF) analysis in Acute Bacterial Meningitis as background academic context rather than a clinical decision trigger.
Prompt analysis of CSF via lumbar puncture is critical for the differential diagnosis of meningitis, as treatment varies significantly based on the causative agent (bacterial vs. viral).
The classic CSF profile for bacterial meningitis (high protein, low glucose, high neutrophils) is a medical emergency that necessitates immediate administration of empirical intravenous antibiotics and adjunctive dexamethasone, even before culture results are available.
Nurses must continuously monitor for signs of increased intracranial pressure (e.g., deteriorating consciousness, bradycardia, hypertension), which is a life-threatening complication of bacterial meningitis.

How to Approach the Question

First, identify the core of the question, which is asking for a correct statement about CSF findings in acute bacterial meningitis.
This is a factual recall question that tests knowledge of a classic disease presentation.
Mentally review the pathophysiology: bacteria in the CSF trigger a massive inflammatory response.
Consider how this inflammation affects each parameter: a) Bacteria and WBCs consume glucose (↓ Glucose). b) Inflammation and swelling increase pressure (↑ Pressure). c) The body sends WBCs (neutrophils) to fight the infection (↑ Cell Count). d) The blood-brain barrier becomes leaky, allowing proteins in (↑ Protein).
Evaluate each option against this pathophysiological understanding to find the one correct statement.

Concept Tested & Keywords

Concept Tested: Cerebrospinal Fluid (CSF) analysis in Acute Bacterial Meningitis
Stem keywords: cerebrospinal fluid, Acute Bacterial Meningitis
Lead-in keywords: correct

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1565-1567

E6 Medicine Harrison 22e Part 1 pp. 1161-1163, 1165-1167