Lumbar Puncture MCQ Quiz | Procedures & Instruments

1. In adults, a lumbar puncture is typically performed at which of the following vertebral levels to avoid spinal cord injury?

2. What is the highest acceptable vertebral level for performing a lumbar puncture in an infant?

3. When performing an LP, which structure is pierced immediately after the supraspinous ligament?

4. A distinct “pop” is often felt as the spinal needle passes through which final ligamentous layer before entering the epidural space?

5. The L4-L5 interspace can be reliably located by palpating a line between which two anatomical landmarks?

6. What is the most common diagnostic indication for performing a lumbar puncture?

7. In a patient with a suspected subarachnoid hemorrhage (SAH) and a negative initial CT scan, what finding on LP is diagnostic?

8. Which of the following is a therapeutic (treatment) indication for a lumbar puncture?

9. Which of the following is considered an absolute contraindication to performing an immediate lumbar puncture?

10. An LP is contraindicated without a prior CT scan in a patient with suspected meningitis if they present with which sign, suggesting high risk of cerebral herniation?

11. What is the most common patient position for performing a lumbar puncture?

12. The primary purpose of asking the patient to assume a fetal position (maximal flexion) is to:

13. Use of which type of spinal needle is associated with a lower incidence of post-dural puncture headache (PDPH)?

14. What is the range for a normal CSF opening pressure in an adult in the lateral decubitus position?

15. The presence of xanthochromia (yellowish tinge) in centrifuged CSF is most indicative of:

16. Which set of CSF findings is most characteristic of acute bacterial meningitis?

17. CSF analysis in a patient with viral meningitis would most likely show:

18. The classic CSF finding in Guillain-Barré syndrome is known as albuminocytologic dissociation, which refers to:

19. When collecting CSF, why is it important to use the fourth tube (or the last one collected) for cell count and differential?

20. What is the single most common complication following a lumbar puncture?

21. The initial conservative management for a post-dural puncture headache typically includes all of the following EXCEPT:

22. What is the most feared and severe complication of performing an LP in a patient with significantly elevated intracranial pressure?

23. A “dry tap” (failure to obtain CSF) during an LP can be caused by all of the following EXCEPT:

24. Low CSF glucose (hypoglycorrhachia) is a feature of many conditions but is NOT typically seen in:

25. During an LP, if the needle hits bone early in its insertion, what is the most likely cause and appropriate next step?