Ivonne
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45 yo M c/o clear, watery discharge from his left ear. He was involved in a MVA 2 days ago. He suffered a head injury but a CT of the head didn't reveal any significant abnormalities. Today the patient also complains of a mild headache. BP: 120/80, T: 36.7C(98 F). RR: 16, HR: 80. Physical exam is unremarkable except for watery discharge from the left ear. Leakage of CSF(cerebrospinal fluid) is suspected. What is the initial rapid test that would allow confirmation of this suspicion?
a.-Beta-2- transferrine
b.-Glucose level
c.-Protein analysis
d.-Salt content
e.-Specific gravity
Explain your answer pz
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| Korotkoff
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Ahhh... I remember this question from my clinical year exam. It is A. It is long time ago. I am not sure if anything is changed.
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| RX 135
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glucose level
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| Korotkoff
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the question is asking for rapid test.
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| hero
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remember from Goljan's lecture for step 1 that it's glucose.
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| mildus
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yes, I also think it's glucose level, don't forget that the taste of CSF is sweet (due to glucose) while the taste of blood and other body fluids is salty (due to NaCl)
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| farnsworth
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B - glucose level (you can use the glucometers/AccuStats -> 30sec!)
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| SmokyWaters
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its transferrin level A
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| SmokyWaters
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beta 2 transferrin level is the most sensitive indicator of CSF
it is present in CSF
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| farnsworth
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how fast is beta 2-transferrin? ('What is the initial rapid test that would allow confirmation of this suspicion?')
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| Ivonne
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The correct answer is B
One rapid but highly unreliable test that allows the detection of CSF leakage is glucose content determination via the use of glucose oxidase paper.
Glucose testing can be used as a first line diagnostic test in a patient with a history of head injury. All positive tests should be confirmed with the more reliable beta-2-transferrin test.
We got to know the timing of these tests!
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| Korotkoff
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Good to know
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| doc_clotaire
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good question Ivonne
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| inkspot
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good one thanks!
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