1. Anatomy
    2. 1. Spinal cord
    2. Brain stem
    3. Diencephalon Interbrain
    4. Thalamus
    5. Hypothalamus
    6. Cerebellum Little brain
    7. Cerebrum
    8. Internal capsule
    9. Corpus callosum
    10. Sulci and gyri of the cerebrum
    11. Blood supply of brain
    12. Meninges of the brain
    13. Ventricular system and CSF flow
    14. Cranial nerves
    15. Eye
    16. Pharyngeal arches or Branchial arches
    17. Ear
  2. Physiology
    3. 18. Introduction of nervous system
    19. Synapse
    20. Signal transmission
    21. Effects of Drugs on ANS
    22. Motor system and Neuromuscular junction
    23. Reflexes
    24. Sensory system
    25. Maintenance of posture and Reticular formation
    26. Reticular formation
    27. Sleep
    28. Brain
    29. Thalamus
    30. Prefrontal cortex
    31. Higher cortical functions
    32. Speech and Language
    33. Hypothalamus
    34. Cerebellum
    35. Basal ganglia
    36. Limbic system
    37. Eye
    38. Ear
    39. Olfactory system
    40. Gustatory system
  3. Pathology
    4. 41. Meningitis
    42. Encephalitis
    43. Hydrocephalus
    44. Cerebro vascular disease or Stroke
    45. Tumors of CNS
    46. Astrocytoma
    47. Ependymoma
    48. Medulloblastoma
    49. Meningioma
    50. Neurofibroma
    51. Eye
    52. Retinoblastoma
    53. Ear, nose and throat
  4. Pharmacology
    5. 54. Introduction to autonomic pharmacology
    55. Cholinergic drugs
    56. Anti-cholinergic drugs
    57. Adrenergic drugs
    58. Anti-adrenergic drugs
    59. Drugs used in Glaucoma
    60. Drugs used in the treatment of pain
    61. Alcohols
    62. Sedative Hypnotics
    63. Antipsychotics
    64. Antianxiety drugs
    65. Antidepressants
    66. Analeptic agents
    67. Local anaesthetics
    68. General anaesthetics
    69. Anti-parkinsonial drugs
    70. Drugs used to reduce appetite or In the treatment of obesity
    71. Drugs for eye diseases
  5. Microbiology
    6. 72. Neisseria meningitidis
    73. Polio virus
    74. Rabies virus
    75. Japanese B Encephalitis Virus
    76. Laboratory Diagnosis of Meningitis
  6. Biochemistry
    7. 77. Introduction
    78. Acetylcholine neurotransmission steps
    79. Snake venom
    80. Neurotransmitters
Microbiology
72. Neisseria meningitidis
MORPHOLOGY
capsule
Capsule present (Fresh isolates from blood or spinal fluid
motility
Non-motile
spore
Non-sporing
gram-stain
Gram negative
shape
  1. Oval
  2. Diplococci
  3. Unlike Neisseria gonorrhoeae adjacent sides are flattened.
size
0.6-0.8 μm
pili
Piliated
oxygenic
Strictly aerobic
image
    ◈ data:
    ■ attributes:
    ● url: https://upload.wikimedia.org/wikipedia/commons/thumb/b/bf/Neisseria_meningitidis_Charles-Orszag_2018.png/1200px-Neisseria_meningitidis_Charles-Orszag_2018.png
    ● caption: Neisseria gonorrhoea
CLASSIFICATION
serogroups
based_on
Specificity of Capsular polysaccharide antigens
number
13 serogroups
serogroups
A, B, C, D, X, Y, Z, W135, 29E, H, I, K, L
meningococal_disease_associated_serogroups
A, B, C, X, Y and W135
serotypes
based_on
Outer Membrane Protein - A (OMP) and Lipid Polysaccharides (LPS)
number
1-20 serotypes
VIRULENCE_FACTORS
pili
Acts as adhesion factor
capsule
  1. Anti-phagocytic
  2. Principal virulence factor
lipopolysaccharide(LPS)
Endotoxin
IgA_protease
Cleaves IgA molecule
outer_membrane_protein(OMP)
protein-I
por-A
por-B
One strain possess either of them.
transferrin_binding_protein
  1. Helps iron uptake from transferrin
PATHOGENESIS
host
Humans are only natural host
source_of_infection
Contaminated droplets
reservoir_of_infection
Nasopharyngeal carriers
mode_of_transmission
Air borne
incubation_period
3 days
entry_site
Sub-arachnoid space
entry_route
hematogenous_route
mermaid
    direct_spread
    infected_site
    1. Otitis media
    2. Sinusitis
    3. Conjunctivitis
    anatomic_defects
    1. Defect in the CNS structures
    2. Congenital abnormality
    travel_along_nerve
    Peripheral sheath of olfactory nerve leading to the brain
    CLINICAL_MANIFESTATIONS
    1. Meningitis
    2. Afebrile illness
    3. Meningococcal septicaemia
    4. Non-blanching petechial or Purpuric rash
    5. Arthritis
    6. Pneumonia
      7. ◉ Waterhouse-Friderichsen_syndrome:
      ◈ characterized_by:
      1. Disseminated intravascular coagulation (DIC)
      2. Large purpuric rashes
      3. Bilateral adrenal hemorhages
      4. Shock and multiorgan failure
    LAB_DIAGNOSIS
    sample_collection
    specimen
    1. CSF
    2. Blood
    3. Synovial fluid
    4. Nasopharyngeal swab
    examination_of_CSF
    collected_by
    Lumbar puncture
    CSF_morphology
    Turbid due to large number of polymorphonuclear leucocytes
    CSF_division
    1st_portion
    Microscopy
    2nd_portion
    Biochemical_test
    3rd_portion
    Culture
    microscopy
    1. CSF is centrifuged.
    2. Centrifuged deposit is Gram stained.
      3. ◈ neisseria_meningitidis_sn:
      1. Gram negative
      2. Intracellular diplococci
    3. Leukocytes increased with 90-99% neutrophils.
    4. Supernatant is kept for detection of meningococal antigen.
    biochemical_test
    glucose
    Markedly decreased or absent
    protein
    Markedly increased
    fermentation
    Fermentation of glucose and maltose with production of acid only
    catase
    Positive
    oxidase
    Positive
    indole
    Negative
    nitrate
    Nitrate is not reduced
    culture
    fastidious
    Fastidious organism
    culture_medium
    1. Chocolate agar
    2. Blood agar
    3. Muller-Hinton starch casein hydrolysate agar
    culture_environment
    35-36°C in 5-10% CO2 and high humidity for 72 hours