TYK359
Contraindications to an LP include all of the following EXCEPT:
a) Cellulitis overlying LP site
b) Severe thrombocytopenia <10,000/μL
c) Leukemic blast crisis
d) Suspected epidural abscess
e) Infratentorial brain tumor
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Contraindications to an LP include all of the following EXCEPT:
a) Cellulitis overlying LP site
b) Severe thrombocytopenia <10,000/μL
c) Leukemic blast crisis
d) Suspected epidural abscess
e) Infratentorial brain tumor
Answer c. The presence of blasts in peripheral blood is not a contraindication for an LP and, in fact, the LP is a standard part of tumor staging when the diagnosis of leukemia is suspected. It should be noted, however, that performing a “bloody tap” while blasts are present in the peripheral blood changes the risk status of the leukemia and can alter the subsequent chemotherapeutic regimen, underscoring the importance of providing optimal procedural conditions.