A 13-year-old female presents with lethargy, fever, severe headache, and a stiff neck. On examination, a unilateral fixed, dilated pupil and papilledema is noted. Each of the following would be appropriate in initial management, EXCEPT:
Correct Answer: Lumbar puncture
Description: This case most likely represents an adolescent with meningitis who has developed increased intracranial pressure. Intubation and hyperventilation is indicated immediately. Hyperventilation is the most appropriate immediate, non-surgical treatment of intracranial hypeension. By hyperventilating this patient you will decrease the pCO2 resulting in vasoconstriction of the central nervous system. Decreasing the pCO2 5 to 10 mm Hg will decrease intracranial pressure 25 to 30%. Administering antibiotics, preferably after blood cultures are obtained, is appropriate. Obtaining computerized tomography of the head may reveal intracranial lesions, which require additional therapy Ref: Ropper A.H., Samuels M.A. (2009). Chapter 2. Special Techniques for Neurologic Diagnosis. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e.
Category:
Medicine
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now