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nbme 1 sec 2 #9 - doke
#1

9. A previously healthy 16-year-old boy is brought to the emergency department 20 minutes after an episode of left arm shaking that lasted approximately 3 minutes. Over the past 2 days, he has had fever and emotional lability. On arrival, his temperature is 38.9 C (102 F). He is somnolent and disoriented to person, place, and time. He responds poorly to pain. Neurologic examination shows no other abnormalities. Laboratory studies show:


Hematocrit 34%
Leukocyte count 6000/mm3
Segmented neutrophils 50%
Lymphocytes 50%
Platelet count 280,000/mm3



Analysis of cerebrospinal fluid shows:
Leukocyte count 120/mm3
Segmented neutrophils 20%
Lymphocytes 80%
Erythrocyte count 300/mm3
Glucose 60 mg/dL
Protein 400 mg/dL

Which of the following is the most likely cause of this patient's neurologic findings?

A
) Bacterial infection

B
) Congenital malformation

C
) Fungal infection

D
) Hemorrhage

E
) Immune-mediated demyelination

F
) Parasitic infection

G
) Viral infection
PL help.
thanks
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#2
viral

hamorrhaic destruction of temporal lobes leading to rbc in csf and other findings
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#3
thanks
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#4
Lymphocytes 80% - one more clue that its VIRAL
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#5
why pr is high??
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