October 15th, 2012
We asked you about this 27 year old female who presented with a 3-day headache. After looking at her lumbar puncture results, the diagnosis is….
a. Benign Intracranial Hypertension
The pressure is very high! The CT was normal essentially excluding raised intracranial pressure secondary to an obstructive hydrocephalus (e.g. meningioma obstructing the 4th ventricle draining CSF). The red cells are high in the first sample of CSF but as further CSF is tapped off, this clears. This supports a slightly “traumatic” tap. Xanthochromia testing in the sample is negative, providing no evidence of a prior bleed into the CSF which has then been broken down into xanthochromia.
To diagnose a S.A.H. you have to have either blood or altered blood in the CSF. As a rule of thumb you should have “no” red cells in the CSF if its not a traumatic tap and there is no other pathological processes.
The diagnosis is BIH. This is reasonably common in young people and is not benign: untreated it can threaten sight. Treatment is via means to reduce CSF pressure e.g. repeated lumbar punctures.
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September 29th, 2012
A 27 year old female presents with a headache. She has had it for 3 days. She has no other symptoms. She has a normal CT brain.
Her lumbar puncture shows the following.
| CSF Opening Pressure (10-20cm H20) |
42 |
| Macroscopic appearance |
Clear |
| Bottle 1Bottle 3 |
RBC 150 mm3, WCC 0mm3RBC 0mm3,WCC 0mm3 |
| Gram stain |
Negative |
| MCS |
No growth |
| Glucose |
4.5 |
| Xanthochromia |
negative |
What is the most likely diagnosis?
a. Benign Intracranial Hypertension
b. Tension headache with traumatic Lumbar Puncture
c. Sub arachnoid haemarrage missed on CT
d. Stroke
e. Sub Arachnoid Haemorrage
f. TB Meningitis
Leave your answer below!
August 1st, 2012
A medical student sustains a needlestick injury from an intravenous drug user. Unfortunately this user is Hepatitis C positive.
Regarding Hepatitis C which of the following statements is true?
- a. Vaccination to hepatitis C is routinely available to healthcare professionals and confers some protection
- b. The chance of transmission of hepatitis C is around 3%
- c. The chance of transmission is around 0.3%
- d. Hepatitis C if transmitted will lead to liver failure in that individual
- e. The chance of transmission is around 30%
Leave your answer as a comment below; answer in a few days!
July 24th, 2012
Bupa have launched a series of apps covering a wide range of topics and health queries that many of us have on a daily basis.
As a medical student, making sure your brain is in tip-top condition is useful to make sure all of that revision sinks in! And what better way to work on understanding your current brain health than a free app which prompts you daily.
Designed to help people monitor and improve their Brain-Heart health, the new app (which was created by Alzheimer’s Australia and Bupa Health Foundation) is the first of its kind to help you rate and track your brain health.
Download the app then start by taking a Brain Health Survey, which gives you a brain health score. Completing the suggested activities in BrainyApp will then help you increase and improve on your score – and if you aren’t keeping the white matter tested with activities, your brain-heart health score will decrease.
Once you have a score you will be able to email yourself your results and begin to keep track of any improvements. This follows the trend of many self-help apps nowadays that try and put the user in a position of more education and control.
The app includes brain games, which give your brain a work out with interesting and challenging games. You can also set yourself activities – add to your brain health points with a range of activities including exercise, eating well, getting health checks, keeping your mind active and managing your smoking and alcohol intake.
The app also sends a daily fact alert to keep your score front of mind so to speak.
Whether it’s a gimmick, or whether it will actually help you in the long term with your revision – we will leave you to be the judge of that! Do let us know if you have tried it and what you think with comments below.
To download the brainy app click here.
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June 28th, 2012
From the following list select the 3 tumour markers that are of clinical use in the “work up” of a patient with an unknown suspected primary malignancy: (e.g. weight loss/ malaise)
Please select 3 answers only: 3 marks available
a. Beta HCG
b. CA 19-9
c. AFP (alfa fetoprotein)
d. CA 153
e. Thyroglobulin
f. PSA (prostate specific antigen)
g. CA125
Add your answers as a comment – the real answer will come in a few days…
