Lumbar Puncture and CSF Analysis

Question 1

Where are LPs done in the spine?

Answer 1

Between L3/L4 or L4/L5

Question 2

LP is used to diagnose what 4 things

Answer 2

Suspected meningitis (fever, headache, altered mental status)
CNS malignancies
Demyelinating disease
SAH

Question 3

Contraindications of an LP

Answer 3

Raised ICP
Local infection at puncture site
Severe degenerative vertebral joint disease
Clinically unstable patient
Relative contraindications: anticoagulation, low PLT count

Question 4

Should you delay antibiotic therapy for LP or CT in suspected meningitis?

Answer 4

NO

If you can do the LP STAT then maybe, but generally N.O.

Question 5

3 main bacteria and 3 main viruses that cause meningitis

Answer 5

Bacteria: S pneumo, N meningitidis, H flu
Viruses: HSV, VZV, Enterovirus

Question 6

What 2 bacterial meningitis causes would require close contacts to have chemoprophylaxis

Answer 6

N meningitidis

H flu

Question 7

Adverse events from LP

Answer 7

Headache
Backache
Radicular pain
Rarely: paraparesis, bleeding, infection, herniation

Question 8

What is the function of tube
1.
2.
3.
4.
from LP

Answer 8

1. Biochemistry
2. Microbiology
3. Cell count
4. Miscellaneous