This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
[{'content': 'A 13-year-old female presents with lethargy, fever, severe headache, and a stiff neck. On examination, a unilateral fixed, dilated pupil and papilledema is noted. Each of the following would be appropriate in initial management, EXCEPT: \nSelect and explain. \nA. Intubation and hyperventilation, B. Mannitol administered intravenously, C. Computerized tomography of the head, D. Lumbar puncture', 'role': 'user'}, {'content': "Answer: D \nExplanation: This case most likely represents an adolescent with meningitis who has developed increased intracranial pressure. Intubation and hyperventilation is indicated immediately. Hyperventilation is the most appropriate immediate, non-surgical treatment of intracranial hypeension. By hyperventilating this patient you will decrease the pCO2 resulting in vasoconstriction of the central nervous system. Decreasing the pCO2 5 to 10 mm Hg will decrease intracranial pressure 25 to 30%. Administering antibiotics, preferably after blood cultures are obtained, is appropriate. Obtaining computerized tomography of the head may reveal intracranial lesions, which require additional therapy Ref: Ropper A.H., Samuels M.A. (2009). Chapter 2. Special Techniques for Neurologic Diagnosis. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e.", 'role': 'assistant'}]