Accepted at 5:56 p.m. Apr, 19, 2025 by Ahmed7
Author: docox123
Related Note: 1535922156637
Rationale for change

added nbme12 tag b/c directly answers the Q:

A previously healthy 57-year-old man comes to the emergency department 1 hour after the sudden onset of severe occipital headache. His temperature is 37.2°C (99°F), pulse is 92/min, respirations are 18/min, and blood pressure is 180/98 mm Hg. He is mildly lethargic but oriented to person, place, and time. Neurologic examination shows no other abnormalities. A CT scan of the head shows no abnormalities. Which of the following is the most appropriate next step in management?

Ans: Cerebrospinal fluid analysis

Explanation: Noncontrast CT scan of the head has a high but not perfect rate of sensitivity for the
detection of subarachnoid hemorrhage (SAH). Patients with a presenting history concerning for SAH who have a negative CT scan should undergo emergent lumbar puncture for cerebrospinal fluid analysis, which may reveal xanthochromia, increased opening pressure, and/or a persistently increased cerebrospinal fluid concentration of red blood cells.

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#AK_Step2_v12::#NBME::Form12
#AK_Step2_v12::#Resources_by_rotation::Surgery::pestana_dorian #AK_Step2_v12::#CMS::Surgery::Form_06 #AK_Step2_v12::#Subjects::Neurology::06_Intracranial_Hemorrhage::Subarachnoid_Hemorrhage::Management #AK_Step2_v12::#OME::02_Neurology::01_Stroke #AK_Step2_v12::#UWorld::Step::18516 #AK_Step2_v12::#Resources_by_rotation::IM::emma #AK_Step2_v12::#OME::Clinical::02_Neurology::01_Stroke #AK_Step2_v12::#UWorld::Step::7018 #AK_Step2_v12::!Shelf::#Cards_AnKing_Did::1surgery #AK_Step2_v12::#Resources_by_rotation::FM::ome::neuro::stroke #AK_Step2_v12::#SketchyNeurology::07_Neurovascular::01_Hemorrhagic_Stroke::01_Subarachnoid_Hemorrhage #AK_Step2_v12::#SketchySurgery::02_Trauma,_Burns,_Critical_Care::04_Head_and_Neck_Trauma::04_Moderate_and_Severe_Traumatic_Brain_Injury_1_Presentation_and_Workup #AK_Step3_v12::#UWorld::5758 #AK_Step2_v12::#OME::06_Surgery::03_Surgical_Subspecialties::12_Neuro_Brain_Bleeds #AK_Step2_v12::!Shelf::Surgery::no_dupes::only_step2 #AK_Step2_v12::#AMBOSS::YO0nIT #AK_Step2_v12::#B&B::10_Neuro::01_Stroke_and_Hemorrhage::03_Intracranial_Bleeding #AK_Step2_v12::#UWorld::COMLEX::103897 #AK_Other::#AK_Original_Decks::Step_2::Cheesy_Dorian_(M3) #PANCE::EOR::Surgery #AK_Step2_v12::#Resources_by_rotation::Neuro::uw::zanki #AK_Step2_v12::#UWorld::COMLEX::103939 #AK_Other::!AK_UpdateTags::AnKing_Image::!Subjects::Neurology::Intracranial_hemorrhages #AK_Step2_v12::#FirstAid::09_Neuro::04_Vascular_Disorders::03_Subarachnoid_Hemorrhage #AK_Step2_v12::#Resources_by_rotation::Neuro::ome::stroke #AK_Other::!AK_UpdateTags::AnKing_Image::Mujeeb::Stroke #AK_Other::Card_Features::^One_By_One #AK_Step2_v12::#Subjects::Neurology::06_Intracranial_Hemorrhage::Subarachnoid_Hemorrhage #AK_Step2_v12::Original_decks::Dorian::surg::pestana #AK_Other::!AK_UpdateTags::AnKing_Image::Mujeeb::Intracranial_hemorrhages #AK_Step2_v12::#UWorld::#UWSA2 #AK_Step1_v12::#Bootcamp::Neurology::21_Aneurysms_and_Intracranial_Hemorrhage::04_Epidural_and_Subdural_Hematoma,_Subarachnoid_Hemorrhage #AK_Step2_v12::#AMBOSS::NO0-sT #AK_Other::!AK_UpdateTags::AnKing_Image::!Subjects::Neurology::Stroke #AK_Step2_v12::#AMBOSS::wl0h_T #PANCE::EOR::Family_med #AK_Step2_v12::#UWorld::Step::18417 #AK_Step2_v12::!Shelf::EM #AK_Step2_v12::#CMS::EM::Form_02 #AK_Step2_v12::#CMS::Neurology::Form_05