All things Lumbar Punctures

Question 1

What are you looking to obtain when carrying out an LP?

Answer 1

CSF

Question 2

Why might you need to obtain a CSF sample?

Answer 2

If you suspect an infection, Increased ICP, SAH or MS

Question 3

What is the upper limit of normal for WBCs and RBCs in CSF?

Answer 3

5

Question 4

Should protein be high or low in a normal CSF sample?

Answer 4

Low, between 0.5-0.45

Question 5

If your sample has a high PMN count what pathology would this suggest?

Answer 5

Meningitis, bacterial

Question 6

If your sample has a high lymphocyte count, what does this suggest?

Answer 6

Viral meningitis

Question 7

What is a normal opening pressure for a lumbar puncture?

Answer 7

10-20 cm

Question 8

What do you expect to see form you LP results if your patient has MS?

Answer 8

Oligoclonal bands on electrophoesis

Question 9

If your patient has Guillian Barre syndrome, what will their CSF sample show?

Answer 9

Significantly increased protein levels

Question 10

What form of meningitis is more severe?

Answer 10

Bacterial

Question 11

Are glucose levels effected in bacterial meningitis?

Answer 11

Yes, the bacteria eat the glucose, so the glucose levels are low

Question 12

Are protein levels effected in bacterial meningitis?

Answer 12

Yes, the bacteria eat the glucose and poop out the protein, so the protein levels are high

Question 13

What colour is the CSF if the patient has bacterial meningitis?

Answer 13

Cloudy/turbid

Question 14

Name some of the risk factors associated with an LP

Answer 14

• Headaches
• Back pain
• Tingling in legs
• Infections