A 25-year-old man with a history of intravenous drug use comes to the emergency department because o

Discussion in 'USMLE Step 2 CK' started by samuel, Dec 23, 2014.

  1. samuel

    samuel New Member

    A 25-year-old man with a history of intravenous drug use comes to the emergency department because of a progressive diffuse headache, generalized malaise, and low-grade fever for 2 months. During this period, he has had a poor appetite resulting in a 6.8-kg (15-lb) weight loss. His temperature is 38 C (100.4 F). Examination shows ¬¬neck stiffness. Mental status examination shows no abnormalities. Cranial nerve examination shows weakness of the lateral rectus muscle on the right and bilateral papilledema. A CT scan of the head with and without contrast shows moderate ventricular enlargement. Examination of cerebrospinal fluid shows:

    Opening pressure 220 mm H2O
    Glucose 35 mg/dL
    Protein 150 mg/dL
    WBC 100/mm3
    Lymphocytes 100%
    RBC 1/mm


    A
    ) Bacterial meningitis

    B
    ) Cerebral infarction

    C
    ) Cryptococcal meningitis

    D
    ) Glioblastoma multiforme

    E
    ) Herpes simplex encephalitis

    F
    ) Hypertensive encephalopathy

    G
    ) Idiopathic intracranial hypertension

    H
    ) Intracerebral hemorrhage

    I
    ) St. Louis encephalitis

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