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Topic: Subarachnoid Hemorrhage
Subject: Medicine
A 25-year-old male presents 5 hours after the onset of the worst headache of my life. His temperature is 37.0°C (98.6°F), blood pressure 140/90 mm Hg, respiratory rate 20/min, and pulse rate 90 beats/min. The patient is lethargic but oriented; there are no focal neurologic findings, but neck stiffness is present. Unenhanced CT of the head is negative. You elect to perform a lumbar puncture. At this time, which one of the following findings in bloody spinal fluid would indicate a diagnosis of subarachnoid hemorrhage?

A. Yellow-orange cerebrospinal fluid supernatant

B. A WBC:RBC ratio of 1/1000

C. A protein (g/L) to RBC (count/L) of 1/1000

D. A glucose level below 2.2 mmol/L

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