A young adult goes to the emergency department complaining of headache, dizziness, stiff neck, and purpura with a petechial skin rash. What two tests should the physician immediately perform?

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The symptoms listed are indicative of meningitis, and the purpura with a petechial skin rash suggests meningococcal meningitis specifically. Therefore, the most important tests to perform immediately would be blood and cerebrospinal fluid (CSF) cultures to confirm the diagnosis and identify the causative organism. Skin scraping and pupil dilation would not be helpful in this scenario. Genital and throat cultures may be useful for ruling out sexually transmitted infections or streptococcal pharyngitis, but would not be the most immediate concern. Urine and blood cultures could be helpful in ruling out other infections or determining the severity of the patient's illness, but would not be the most important tests to perform immediately.

A Young Adult Goes to the Emergency Department Complaining of Headache