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  #1  
Old 02-21-2012
tyagee's Avatar
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Default CI to lp

A 2-month-old infant comes to the emergency center with fever for
2 days, emesis, a petechial rash, and increasing lethargy. In the ambulance
he had a 3-minute generalized tonic/clonic seizure that was aborted with
lorazepam. He does not respond when blood is drawn or when an IV is
placed, but he continues to ooze blood from the skin puncture sites. On
examination, his anterior fontanelle is open and bulging. His CBC shows a
WBC of 30,000 cells/μL with 20% band forms. Which of the infantís problems
listed below is a contraindication to lumbar puncture?
a. Uncorrected bleeding diathesis
b. Bulging fontanelle
c. Dehydration
d. History of recent seizure
e. Significantly elevated WBC count consistent with bacteremia
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  #2  
Old 02-21-2012
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b. Bulging fontanelle

means increased intra cranial pressure lp > herniation
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  #3  
Old 02-21-2012
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it can be A,,,im confused between A n B
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  #4  
Old 02-21-2012
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Default Ans. A

A. Uncorrected bleeding diathesis; coagulopathies are a relative contraindication to LP.
Bulging fontanelle is a sign of meningitis in infants, LP is mandatory in this case.
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  #5  
Old 02-21-2012
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a. Uncorrected bleeding diathesis
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Learning is like to row your boat upstream, if you stop learning, you will be pushed back by the current.
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  #6  
Old 02-21-2012
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bleeding diathesis is the answer.
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