Repeated USMLE Questions Step 2 CK- 319

A 12 year old boy is brought to the emergency room by his father for complaint of high fever and general pain. He also has severe headache and photophobia for 2 days. On examination, his temperature is 102.4 F, his pulse is 100 and his neck is rigid and very painful on movement. Kernig's and Brudzinski's signs are positive.

Which of the following indicates positive Kernig's sign?

A- Flexion of the neck leads to involuntary flexion of hips and knees

B- Painful extension of the knee when the thigh is bent at the hip and the knee at right angles

C- Involuntary elevation of the legs when lifting the head off the bed

D- Involuntary flexion of the opposite leg when the other leg is flexed

E- Rising and flexion of the forearm after applying pressure to the cheek

Answer:






Kernig’s sign is positive when flexion of the thigh at the hip and the knee at right angles causes painful partial extension of the knee. The patient cannot fully extend his knee. Brudzinski sign is considered positive if flexion of the neck leads to flexion of the hips and knees (Choice A).

The correct answer is B