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Here is a quick mnemonic “CLINICAL PRACTICE to remember about Laboratory Studies & Imaging In Coma

This can be valuable for patients as well as medical doctors, nurses & students doing their clinical rounds. You can also find it very useful for med exams like USMLE, MBBS, NEET PG, FMGE, NExT, MCAT & NCLEX exams

Laboratory Studies & Imaging In Coma : How To Remember Easily ?

  • CComa diagnosis: Chemical-toxicologic analysis, Cranial CT or MRI, EEG, and CSF examination are useful.
  • L – Lung disease and acid-base disorders: Arterial blood gas analysis helps in these cases.
  • I – Impaired mental activity: An ethanol level of 43 mmol/L (0.2 g/dL) causes this.
  • N – Normal CT scan: Does not exclude an anatomic lesion as the cause of coma.
  • I – Imaging detectable causes: CT and MRI focus on detectable causes such as hemorrhage, tumor, or hydrocephalus.
  • C – Coma’s metabolic or toxic origin: Most cases of coma are metabolic or toxic in origin.
  • A – Additional imaging: CT angiography or MRI can be obtained for acute posterior circulation stroke.
  • L – Low diagnostic value: EEG is rarely diagnostic in metabolic or drug-induced states.
  • P – Predominant high-voltage slowing: Indicates metabolic coma, such as hepatic failure.
  • R – Reflection of severity: Generalized slowing of background activity reflects the severity of an encephalopathy.
  • A – Alpha coma: Widespread, variable 8- to 12-Hz activity associated with poor prognosis.
  • C – Coma patterns: “Extreme delta brush” in autoimmune encephalitis, normal alpha activity suppressed by stimulation.
  • T – Test indispensability: Lumbar puncture is indispensable in diagnosing various forms of meningitis and encephalitis.
  • I – Imaging before lumbar puncture: An imaging study should precede lumbar puncture to exclude intracranial mass lesions.
  • C – Cultures and antibiotics: Blood cultures and antibiotics should precede the imaging study if infectious meningitis is suspected.
  • E – Examination of CSF: Lumbar puncture is performed to examine the cerebrospinal fluid.


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department