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 BOF 126

 

   

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BOF: 126

A 68 year old male is admitted with a history of headache and confusion. He is known to have mild hypertension controlled with the use of a thiazide diuretic.

Since admission the patient has had two witnessed seizures.

On examination he is febrile confused and agitated. It is not possible to do a full neurological examination but there appears to be a right sided weakness, there is no neck stiffness and Kernig’s sign cannot be elicited.

A CT scan is preformed and this shows diffuse oedema mainly in both temporal lobes.

A lumbar puncture is performed the results are as follows:

Opening pressure 150 mm of H2O

Protein 0.48 g/L

Glucose 4.3 mmol/L (blood glucose 5.5 mmol/L)

Cell count 12 /mL (lymphocytes)

In this patient which one of the following drugs would you commence immediately?

a)    Acyclovir

b)    Dexamethasone

c)     Mannitol

d)    Ceftriaxone

e)    Phenytoin sodium

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