Paediatric infections: lumbar puncture contraindications: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric infections: lumbar puncture contraindications

Sample item

A 4-year-old with fever and neck stiffness has a Glasgow Coma Score of 8, papilloedema, and an irregular breathing pattern. Bacterial meningitis is suspected. What is the best approach?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Stabilise, start ceftriaxone and defer lumbar puncture

Signs of raised intracranial pressure, depressed consciousness or cardiorespiratory instability make lumbar puncture unsafe because of the risk of herniation. Antibiotics should not be delayed for imaging or LP, and the child is stabilised first. LP is done later if it becomes safe.

Option by option

  • A. Perform lumbar puncture before any antibiotic

    LP in a child with signs of raised pressure risks coning.

  • B. Wait for CT before giving antibiotics

    Delaying antibiotics for imaging worsens outcome.

  • C. Stabilise, start ceftriaxone and defer lumbar puncture (correct)

    Correct. Treat promptly and delay LP while signs of raised ICP persist.

  • D. Give oral antibiotics and observe

    Oral drugs are inadequate for suspected meningitis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Stabilise, start ceftriaxone and defer lumbar puncture. Signs of raised intracranial pressure, depressed consciousness or cardiorespiratory instability make lumbar puncture unsafe because of the risk of herniation.

Why is "Perform lumbar puncture before any antibiotic" not the answer?

LP in a child with signs of raised pressure risks coning.

Why is "Wait for CT before giving antibiotics" not the answer?

Delaying antibiotics for imaging worsens outcome.

Why is "Give oral antibiotics and observe" not the answer?

Oral drugs are inadequate for suspected meningitis.

What concept does this question test?

It tests Paediatric infections: lumbar puncture contraindications in Pediatrics. Antibiotics should not be delayed for imaging or LP, and the child is stabilised first. LP is done later if it becomes safe.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: lumbar puncture contraindications?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.