Lumbar puncture Flashcards
1
Q
Name contraindications for an LP
A
Decr LOC Signs of incr ICP Focal deficit Unstable Septicaemia w/ petechiae/purpura Coagulopathy Local skin infection
2
Q
Name indications for imaging before an LP
A
Immunocompromised Known CNS lesion Seizures Abn LOC Focal deficit Signs of raised ICP
3
Q
What imaging findings contraindicate an LP?
A
Midline shift Obstructive hydrocephalus Loss of cisterns Cerebral oedema Mass in post. fossa Herniation
4
Q
What guage do you need for a paediatric LP?
A
22
5
Q
What tests do you want performed on the CSF?
A
Dipstick Cell count Gram stain Capsular antigen Culture Biochemistry
6
Q
What are normal CSF findings?
A
WCC 0 neutrophils, 0-6 lymphocytes
Protein 0.15-0.45
Glucose 3.6-5.6
7
Q
What are bacterial meningitis CSF findings?
A
WCC predominantly neutrophils
Protein moderately incr
Glucose decr
8
Q
What are viral meningitis CSF findings?
A
WCC predominantly lymphocytes
Protein mildly incr
Glucose normal
9
Q
What are TBM CSF findings?
A
WCC predominantly lymphocytes
Protein massively incr
Glucose decr
10
Q
Name complications of an LP
A
Herniation Headache Cardiorespiratory arrest Local/referred pain Bleeding Infection CSF leakage Subarachnoid epidermal cysts
