zianab
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can you please expalin answer this qs,after submitting our choice.i will really appreciate the explanations.thankyou.
this is nbme qs
10. A previously healthy 45-year-old woman has had fever and progressive confusion over the past 2 days. She is now unable to perform activities of daily living. Her temperature is 38 C (100.4 F). She is oriented only to person. There is no rash, and the neck is supple. A CT scan of the head shows normal findings. Cerebrospinal fluid analysis
shows:
Leukocyte count 20/mm3
Glucose 45 mg/dL
Protein 110 mg/dL
Erythrocyte count 1000/mm3
Which of the following is the most likely diagnosis?
A) Bacterial meningitis
B) Acute alcohol intoxication
C) Brain stem infarction
D) Cerebral infarction
E) Cryptococcal meningitis
F) Enterovirus infection
G) Hepatic encephalopathy
H) Herpes simplex encephalitis
I) Huntington's disease
J) Hypoglycemia
K) Lyme disease
11. A 57-year-old man with multiple myeloma comes to the physician
because of a 12-hour history of fever, sharp chest pain with deep inspiration, and cough productive of blood-tinged sputum. His temperature is 38.3 C (101 F), blood pressure is 120/78 mm Hg, pulse is 112/min, and respirations are 28/min. Crackles are heard at the
right lung base. His hemoglobin level is 9.2 g/dL, leukocyte count is 2600/mm3, and
platelet count is 96,000/mm3. Empiric antibiotics should be directed against
which of the following organisms?
A) Listeria monocytogenes
B) Neisseria meningitidis
C) Pseudomonas aeruginosa
D) Streptococcus bovis
E) Streptococcus pneumoniae
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| star1
Forum Guru
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Well For Q 10 there is intracranial hemorrhage but I am unable to pick the choice !!!!!!!!!
a bit confused , better someone else explain this
Q11. answer is E) Streptococcus pneumoniae
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| zianab
Forum Elite
Topics: 17
Posts: 282
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star 1 could you please explain why u choose this option.
please anybaody who answers please expalin it too
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| omz2302
Forum Newbie
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Well, i can see star1s logic, there shouldnt be any erythrocytes in the CSF, so the fact that they're present suggest hhge. All other choices may fluctuate the concentrations in the csf (glucose, protein, leukocytes, etc) but they would not add erythrocytes.
However, all i see here is infarction and not hhge. If i had to choose an infarction i would say cerebral, assuming that if she had a brain stem infarction she would be losing life supporting mechanisms rather than a change in behaviour or consciousness.
Im not that great of a student, but these are my two cents, so take it with a grain of salt  until you get a good answer...
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| Aashi
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1)Herpes simplex Encephalitis------>H
2) E -----> (Strep.pneum)
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| AAAAA
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1. The correct answer for question No. 1 is H
The result of viral CSF:
- Acutely, a typical "viral profile" is identified, with mildly elevated protein, normal glucose, and a moderate pleocytosis (mostly mononuclear cells).
- Red blood cells and xanthochromia may be seen.
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| AAAAA
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star1 wrote:
Well For Q 10 there is intracranial hemorrhage but I am unable to pick the choice !!!!!!!!!
a bit confused , better someone else explain this
Q11. answer is E) Streptococcus pneumoniae
Intracranial hemorrhage, the patient CT will be picked by by non-contrast CT
Also patient probably has severe headache, change in mental status can occur and Intracranial hemorrhage can also occur in an alcoholic (many fell)
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| AAAAA
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Difficult because the clinical presentation:
History:
- In HSE, patients may have a prodrome of malaise, fever, headache, and nausea.
- This is followed by acute or subacute onset of an encephalopathy whose symptoms include lethargy, confusion, and delirium.
- Headaches, seizures, aphasia, and other focal deficits also may occur
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| hanialkhadher
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hi zainab: for the q n.10 it seems like an infection (normal ct) ok?
but what is the infection that would cause a bleeding in csf?
the answer is HERPES.
and it is the mcc of sporadic encephalitis.thank you.
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| anjushree
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can listeria be present in pancytopenic pt------ans of Q-11
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| prathapdoctor
Forum Elite
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the answer for first question is HERPES SIMPLEX ENCEPHALITIS
The answer for second question is probably LISTERIA MONOCYTOGENOUS,
but when you give empirical antibiotics you have to cover both str.pnemoniae and listeria.
here the patient has low WBC count, the immunity of patients with multiple myeloma will be grossly impaired because of excessive growth of abnromal antibodies and accelerated destruction of normal antibodies,so i will go with LISTERIA.
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