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| * Question2 |
| | #531188 |
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A 20 year old woman comes to the ER with the complaint of headache for the past 8 hours. She is a sophomore at the local college and admits to partying very hard the night before as it was the the end of the semester. She says she fell asleep on a couch in her friend's room with a couple of other drunk parties. She vaguely recalls that the other couples had been having headache.She is generally healthy, takes no medications and takes a few beers each night. Her temperature is 99F, bp is 120/80mm, pulse is 70/min and respirations are 16/min.she has mild nuchal rigidity. A careful cardiac examination reveals mid systolic click on mitral area. Opthalmalogic examination shows flat optic disc. During the examination she turns to your side and vomits on your shoes. You decide to perform an LP and place her in left lateral decubitus position with her thighs flexed. you introduce the spinal fluid and find that the pressure is 190mm. As you collect the four tubes you realize that fluid is red. You run the tubes to the lab and put them in centrifuge and an hour later see that the supernatant of the CSF is clear. The most likely explanation for these findings is
A. An acute bacterial infection of the meninges
B. And acute viral infection of the meningies
C. A brain tumour
D. A hemorrhage into the subarachnoid space
E. Penetration of meningeal vessel during lumbar puncture |
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