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Question

Lumber punctures can be used to diagnose :

(1) Bacterial meningitis

(2) Viral infections

(3) Brain abcess and tumor

(4) Multiple sclerosis

This question was previously asked in
MH SET 2020 Paper 2 Philosophy Question Paper (27-Dec-2020)
The correct answer is

Only (1), (2), (3) and (4) are true

A lumbar puncture (spinal tap) withdraws cerebrospinal fluid (CSF) from the subarachnoid space, usually between the L3–L4 or L4–L5 vertebrae, for laboratory analysis of cells, protein, glucose, pressure and microbes.

Statement (1) is true: CSF analysis is the definitive way to diagnose bacterial meningitis (raised neutrophils and protein, low glucose, organisms on Gram stain and culture).

Statement (2) is true: viral meningitis and encephalitis are identified from a lymphocytic CSF picture and PCR detection of viruses such as herpes simplex or enteroviruses.

Statement (3) is true in the sense listed in standard medical references: CSF findings (raised pressure, raised protein, abnormal or malignant cells on cytology) can support the diagnosis of intracranial infection such as abscess and of tumours, particularly leptomeningeal spread, once imaging has excluded dangerous mass effect.

Statement (4) is true: oligoclonal IgG bands and a raised IgG index in CSF are classic supporting evidence for multiple sclerosis.

Since all four conditions can be investigated through CSF obtained by lumbar puncture, all the statements are true.

Hence, the answer is Only (1), (2), (3) and (4) are true.

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