USMLE Forum Archives - USMLE Step 3 - CSF FINDING ?
CSF FINDING ?
harry206 - 05-04-09 16:14
A 34-year-old Caucasian female presents to the emergency department (ED) with a 24-hour history of headaches, myalgias and low-grade fever. She grades the intensity of her headaches as 6-7 on a 10-grade scale, and states that she has never had such symptoms before. She does not know what could have brought these symptoms on. Nobody in her family, or among her co-workers, has recently had similar symptoms. She has no history of recent travel. Her past medical history is significant for an episode of severe pyelonephritis one year ago. CT scan of the head without contrast does not reveal any abnormality. A lumbar puncture is performed, and the CSF findings are as follows:
Xanthochromia
Absent
RBCs
11,000/mm3
WBCs
100/mm3
Protein
50 mg/dL
Glucose
90 mg/dL
CSF analyses on cryptococcal antigen, Lyme titer, bacterial stains, as well as bacterial cultures, are pending. Which of the following is most consistent with the CSF findings in this patient?
harry206 - 05-04-09 16:14
A 34-year-old Caucasian female presents to the emergency department (ED) with a 24-hour history of headaches, myalgias and low-grade fever. She grades the intensity of her headaches as 6-7 on a 10-grade scale, and states that she has never had such symptoms before. She does not know what could have brought these symptoms on. Nobody in her family, or among her co-workers, has recently had similar symptoms. She has no history of recent travel. Her past medical history is significant for an episode of severe pyelonephritis one year ago. CT scan of the head without contrast does not reveal any abnormality. A lumbar puncture is performed, and the CSF findings are as follows:
Xanthochromia
Absent
RBCs
11,000/mm3
WBCs
100/mm3
Protein
50 mg/dL
Glucose
90 mg/dL
CSF analyses on cryptococcal antigen, Lyme titer, bacterial stains, as well as bacterial cultures, are pending. Which of the following is most consistent with the CSF findings in this patient?
The correct answer and explanation will be available after you answer.
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#4
Re: CSF FINDING ? usmlefever3 - 05-05-09 01:29 My answer is: a.
glucose should be normal but in this case it is increased......dont know the CSF picture of cryptococcal meningit
#7
Re: CSF FINDING ? InSitu - 05-05-09 14:54 
posted by meduploader on 05-05-09 14:49
a. Viral meningitis
a. Viral meningitis
Same here please use the new feature doc.
#8
Re: CSF FINDING ?
harry206 - 05-06-09 03:34 EXPLANATION:
A RBC count exceeding 6,000/mm3 may indicate traumatic LP, but other important causes, mainly subarachnoid hemorrhage (SAH), should be ruled out.
WBC elevation in traumatic LP is commonly explained by the blood leak if approximately one WBC is present per 750-1000 RBCs.
The protein level is elevated in the presence of traumatic LP, and the glucose level is typically high
#24
Re: CSF FINDING ? babbu5508 - 07-28-10 05:34 My answer is: e.
CT scan of the head without contrast does not reveal any abnormality.Xanthochromia
Absent
RBCs
11,000/mm3
#25
Re: CSF FINDING ? bingousmle - 07-28-10 06:51 the values correlate with traumatic lumbar puncture though what is the primary cause od her headache is not known as is the indication for LP
#28
Re: CSF FINDING ? babbu5508 - 08-30-10 02:30 Absolute contraindications to lumbar puncture are as follows:
Unequal pressures between the supratentorial and infratentorial compartments, usually inferred by characteristic findings on the brain CT scan:
Midline shift
Loss of suprachiasmatic and basilar cisterns
Posterior fossa mass
Loss of the superior cerebellar cistern
Loss of the quadrigeminal plate cistern
Infected skin over the needle entry site
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