A 54-year-old female is admitted with a history of
headaches and feeling drowsy. She describes the headaches as affecting the
entire head, they are worse in the morning on awakening. The symptoms had been
present for about a week and started after she developed an upper respiratory
tract infection. She gives a history of breathlessness on exertion for some
time .she had no significant medical history and was not on any medication.
On examination she was obese, weight 130 kgs height 1.63
m. Apart from a blood pressure of 150/ 90 there were no other abnormalities
Chest x-ray was normal
Blood gases (on air) pH 7.4, pO2 10.4 kPa,
pCO2 6.6 kPa, bicarbonate 32 mmol/L
In this patient which one of the following is the best
management for this patient?
Inhaled bronchodilator and inhaled steroid
Lumbar puncture and drainage of CSF