Ritta DePaolo: Lab Tests
NOTE: Remember that unnecessary laboratory testing wastes precious time and increases health costs for all of us!
Laboratory test results:
- Routine laboratory work: Within normal limits.
- Skull x-ray study: No evidence of skull fracture or impacted sinuses.
- Lumbar puncture
- Opening pressure: 220 cm H2O (normal: 50-180 mm H2O)
- Closing pressure: 220 cm H2O (normal: 50-180 mm H2O)
| Cerebrospinal fluid (CSF) examination | |
|---|---|
| Blood | Negative |
| Color | Clear and colorless |
| Lymphocytes | 0-2/mm3 (Normal: <5/mm3) |
| Polymorphonuclear lymphocytes | None (Normal: none) |
| Protein | 80 mg/dl (normal: 15-45 mg/dl) |
| Glucose | 50 mg/dl (Normal: 50-75 mg/dl) |
| Chloride | 115 mEq/l (Normal: 110 to 125 mEq per liter) |
| Cytology | No evidence of malignant cells |
| Serologic test for venereal disease | Negative (Normal: negative) |
- Electroencephalography (EEG) indicates focal slowing of wave pattern in right parietal lobe (Normal: regular, rhythmic, electrical waves)
- CT (computerized tomography) scanning indicates a soft tissue mass arising out of the dura covering the parietal lobe
Click here for more information on Diagnostic and Laboratory Tests
Questions:
Please email your answers to your instructor or write the answers down in your case log book. NOTE: For multiple choice questions, clicking on the word or phrase will provide feedback.
Just complete this form. Click on Submit when ready to send.
- Your name:
- Email address:
- 1. What potential causes of Ms. DePaolo's headaches were ruled out or confirmed by the skull x-ray?
- 2. The increased intracranial pressure (ICP) indicated by the lumbar puncture may indicatea(n) ____________. (Select all answers that apply).
- Brain tumor
- Infectious brain disease (i.e. encephalitis or meningitis)
- Migraine headache
- Subarachnoid hematoma
- 3. Cerebrospinal fluid analysis excluded the possibility of _____. (Select all answers that apply.)
- A brain tumor
- Migraine headache
- Infectious brain disease (i.e. meningitis or encephalitis)
- Subarachnoid hemorrhage
- 4. Why are computerized tomography (CT) and magnetic resonance imaging (MRI) useful techniques for the diagnosis of a brain tumor?
- 5. Do the laboratory results confirm your preliminary assessment? Which neurological disorder(s)is/are affecting Ms. DePaolo? Select all that apply.
- A brain tumor
- Infectious brain disease
- Migraine headache
- Subarachnoid hemorrhage
- 6. How is the pathophysiology and symptoms of a migraine headache different from these headaches? Please list three distinguishing features for each type of headache.
- Encephalitis
- Headache associated with head trauma
- Sinus headache
- Tension-type headache
- 7. Ms. DePaolo was diagnosed with a benign meningioma that was surgically removed. List 4 characteristics of benign tumors.
- Bonus: Ms. DePaolo's physical examination indicated papilledema, which is a sign of increased intracranial pressure. In real life, lumbar punctures are avoided if there is any evidence of increased ICP. Why is that?
Next step: Solve the Case »