Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinalysis and Body Fluids 4214 > LAB EXAM 2: Body Fluids > Flashcards

LAB EXAM 2: Body Fluids Flashcards

1
Q

What are the three major types of body fluids?

A

 CSF (cerebrospinal, NOT cerebral spinal)
 Synovial
 Serous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The epithelial cell exterior of
choroid plexus is the…

A

“blood-brain barrier”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Produced constantly in brain choroid plexi (“plexuses”, capillary knots that protrude into brain ventricles).

A

Cerebrospinal Fluid (CSF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cerebrospinal Fluid (CSF) is formed via both __________ and ___________ processes.

A

filtration, active transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CSF flows over and around….

A

brain and spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the total CSF volume in adults?

A

90-150 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CSF is produced at a rate of about _____mL/24 hours.

A

500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the three major CSF functions?

A

 Supply nutrients
 Remove waste
 Act as mechanical barrier & cushion for brain & spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

True or false:

All CSF tubes should be treated as highly infectious

A

True!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

“lumbar puncture” is used to collect CSF fluid.
Between what lumbar vertebrae is the puncture done?

A

between 3rd & 4th, or
4th & 5th, lumbar vertebrae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CSF Specimen Collection:

Most hospitals usually collect _____ sterile tubes &
label them in the order withdrawn.

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CSF Specimen Collection:

What is tube #1 used for?***

A

Chemistry & Serology (1st fluid withdrawn; contains skin plug, but this will get centrifuged & removed.)

C/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CSF Specimen Collection:

What is tube #2 used for?***

A

for Micro. (middle of fluid withdrawal; less likely to have skin flora contaminants.)

M

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CSF Specimen Collection:

What is tube #3 used for?***

A

Hematology (last of fluid withdrawn; least likely to have skin cell contamination.)

H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How quickly must CSF samples be processed?

A

Within 1 hour (STAT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If there is a 4th tube of CSF, what is it used for?

A

Gets frozen for extra testing that may be needed later on.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How should Heme tubes be stored if not tested STAT?

A

refrigerate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CSF cell counts MUST be done within ______ hour.

A

one, (One hr. is usual t.a.t. for fluid cell counts,
anyway.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What temp should micro tubes be at for CSF?

A

room temp. and set up ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

_______ CSF tubes may be frozen after centrifugation.

A

Chem./Sero.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why should you never discard leftover CSF fluid?

A

in case more tests are ordered!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the normal appearance of CSF?

A

“crystal clear & colorless”
(appearance must be described in report).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does Xanthochromic mean?

A

ANY color of supernate
left AFTER centrifugation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What can be done to determine CSF supernatant color?

A

To see colors clearly, centrifuge a Hct capillary or other clear tube filled with CSF, then hold supernate up against a white background.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What could cause cloudy, milky, or turbid CSF?

A

May be due to ↑ protein,
lipids, or WBCs!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the cause of clear pink or red Xanthochromia?

A

oxyHgb due to blood degradation (> 2
hrs. but < 2 d.)

(The “2X2 rule”.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the cause of orange xanthochromia?

A

 Heavy hemolysis (> 2 hrs. but < 2 d.), or
 Carotenemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the cause of yellow Xanthochromia?

A

 OxyHgb broken down to unconjugated bili. from:
 Heavy, long-term (> 2 days) hemolysis, or
 Kernicterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the two possible causes of bloody or hemolyzed CSF specimens?

A

 Traumatic tap
- inadvertent blood vessel trauma from puncture.
 Intracerebral or subarachnoid
hemorrhage (ICH or SAH)
- Must be differentiated from traumatic tap!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What can cause oily CSF samples?

A

radiographic contrast media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Blood evenly distributed throughout collection tubes.

Traumatic Tap or Intracerebral Hemorrhage?

A

Intracerebral Hemorrhage***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Siderophages are highly indicative of?

A

Intracerebral Hemorrhage***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Traumatic Tap or Intracerebral Hemorrhage?

Clear supernatant if recent, but: Xanthochromic supernatant if old! (Good clue but not specific!)

A

Intracerebral Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In tubercular meningitis, overnight CSF refrigeration may cause a “weblike pellicle” (scum) to form. This should NOT be confused with __________.

A

clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Traumatic Tap or Intracerebral Hemorrhage?

Serum protein contamination may cause xanthochromic supernatant.

A

Traumatic Tap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Traumatic Tap or Intracerebral Hemorrhage?

Uneven distribution of blood in collection tubes (heaviest in 1st, less in 2nd, etc.)

A

Traumatic Tap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Traumatic Tap or Intracerebral Hemorrhage?

Sample often (but not always!) clotted (due to plasma fibrinogen
contamination); may even have bloody streaks.

A

Traumatic Tap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Traumatic Tap or Intracerebral Hemorrhage?

No blood clots

A

Intracerebral Hemorrhage

39
Q

What are the causes of protein in CSF?

A

-Disorders of blood-brain barrier: Ex.:
↑ IgG within CNS = MS
↑ Bld. - brain barrier permeability =
Guillain-Barre syndrome (rarer)
-Old hemorrhage, lysed cells from traumatic tap
-Traumatic tap

40
Q

N. adult CSF = _____ WBCs/uL & ___ RBCs/uL.

A

0-5, 0

41
Q

Why must numerical CSF counts be performed immediately?

A

danger of cell lysis! (40% of WBCs can disintegrate within 1st 2 hrs. following collection!)

42
Q

Typical time limit for CSF analysis is within ____ hour.

A

1

43
Q

What stain is used for CSF differential cell counts?

A

Wright-stained slide prepared from
cytocentrifuge prep

44
Q

What is the principle of Differential Cell Counts on CSF?

A

under slow centrifugal force, body fluid is driven through a cuvette outlet, such that cells are deposited as a monolayer button on slide, &
excess fluid is absorbed by a filter card.

45
Q

What are 2 advantages of Wright-stained slide prepared from
cytocentrifuge prep?

A

 Minimizes cell distortion
 Concentrates cells for counting

46
Q

What should be done if CSF cell counts are low?

A

use hemacytometer for
count, & report only #s of cell types seen.

47
Q

CSF cell counts:

Count _____ cells, classify & report as percentages

A

100

48
Q

What prep can be done to cushion cells for CSF counts?

A

7% albumin can
be added before cytocentrifugation. Take 22% BB albumin & dilute, then add 1 drop 7% albumin to 5
drops of specimen. This only works for CSF & serous
fluids, NOT for synovial fluids!

49
Q

CSF Cell counts:

What cells are normal to be seen?

A

-few lymphs and monos
-very rare segs IF it is a concentrated specimen

50
Q

CSF counts:

-N. adult CSF, majority WBCs = __________

-N. pedi. CSF, majority WBCs = __________

A

lymphs

monos

51
Q

Pleocytosis =

A

↑ #s of otherwise N. cells; an
abnormal finding!

Ex. lymphocytosis or
monocytosis

52
Q

What is the major clinical significance of lymphocytes in CSF?

A

-N. in small numbers
-Lymphocytosis = viral,
tubercular, fungal meningitides
-Multiple sclerosis (but with
leukopenia of < 25/uL, & only
lymphs!) (can be plasma cells in this case)

53
Q

What is the major clinical significance of neutrophils in CSF?

A

N. if very rare (conc. specimens)
Neutrophilia = bacterial
meningitis or early cases viral, tubercular or fungal meningitis Cerebral hemorrhage

54
Q

What is the microscopic finding seen with neutrophils in CSF?

A

Granules may be less
prominent than in p.b.

55
Q

What is the microscopic finding of neutrophilia with cerebral hemorrhage?

A

Cells disintegrate rapidly

56
Q

What is the major clinical significance of monocytes in CSF?

A

N. in small numbers. Monocytosis = chronic bacterial meningitis, viral,
tubercular, & fungal meningitis, MS

-Found mixed with lymphs

57
Q

What is the clinical significance of eosinophils seen in CSF?

A

-Parasitic infections (Ex., Taenia solium)
-Allergic reactions
-Intracranial shunts

58
Q

What is the clinical significance of plasma cells seen in CSF?

A

Multiple sclerosis (MS)*

59
Q

What is the clinical significance of macrophages seen in CSF?

A

Viral & bacterial meningitides.
Also, any RBCs in CSF from
long-term cause

60
Q

What are the microscopic findings with macrophages in CSF?

A

Erythrophages;
siderophages in ICH

61
Q

What is the clinical significance of blasts seen in CSF?

A

Acute leukemia

Microscopic Findings: Lympho- or myeloblasts

62
Q

What is the clinical significance of malignant cells in CSF?

A

Metastatic carcinoma /
leukemia***

63
Q

What are the microscopic findings with malignant cells?

A

Very large; 3-D clusters
with fusing of cell borders, aberrant polyploid nuclei,
cytoplasmic blebbing***

64
Q

What are the microscopic findings with Ependymal &/or Choroidal cells?

A

Normal trauma, diagnostic
procedures***

65
Q

What are the microscopic findings with Ependymal &/or Choroidal cells?

A

Flattened 2-D sheets,
clustered, with distinct
nuclei & cell membranes***

66
Q

What are the microscopic findings with budding yeast seen in CSF?

A

Cryptococcus neoformans has clear capsule surrounding it on India ink prep.

67
Q

What is the clinical significance of nRBCs in CSF?

A

Bone marrow contamination
from tap

-NOT clinically significant!

68
Q

Neutrophilia in CSF (WBCT in 1000s), think first of ?

A

Bacterial meningitis

69
Q

Blast forms in CSF, think first of ?

A

Acute leukemia (secondarily, metastatic solid cancer)

70
Q

 Lymphocytes in CSF (WBCT in 100s), think first of:

A

Viral meningitis; 2nd = TB meningitis; 3rd = fungal meningitis

71
Q

Plasma cells in CSF, think first of ?

A

MS (Multiple Sclerosis)

72
Q

Eos in CSF, think what 3 conditions ?

A

CNS involvement of parasites; 2nd = overwhelming allergic
reactions; 3rd = intracranial shunts.

73
Q

Normal body cavity lining cell characteristics…

A

 All lie in 1 plane
 Hang together as a “sheet“
 Have distinct cytoplasmic & nuclear margins (“fried
egg” appearance)
 May have vacuoles

74
Q

***Malignant cell characteristics…

A

 3-D clumps
 Indistinct nuclear & cytoplasmic margins
 Bizarre, polyploid nuclei
 ↑ mitotic forms
 Large nucleoli
 Blebbed cytoplasmic edges

75
Q

body cavity lining cells are called __________ cells in all body fluids except in
CSF!

A

mesothelial

76
Q

-Supplies nutrients to cartilage
 Acts as lubricant

A

Synovial Fluid

77
Q

Produced by filtration of plasma across the
synovial membrane, combined with secretion of
a hyaluronate-lubricin complex from same
membrane. (Hyaluronate is just the salt form of hyaluronic
acid.)

A

Synovial Fluid

78
Q

Synovial fluid has the same chemical composition as __________.

A

plasma

79
Q

How are synovial fluid specimens obtained?

A

arthrocentesis

80
Q

What are the four Major Categories of Joint Diseases?

A

-Noninflammatory
-Inflammatory
-septic
-hemorrhagic

81
Q

Example of non inflammatory joint disease?

A

Degenerative joint disorders
(Ex., osteoarthritis)*

-* Even though there is inflammation, it is 2o to degradation, not the 1o cause of the joint disorder!

82
Q

What can cause inflammatory joint disease?

A

Immunologic or crystal
problems (Ex., RA & SLE,
gout & pseudogout)

83
Q

What can cause hemorrhagic joint disease?

A

Traumatic injury, coagulation
deficiencies

84
Q

What is the normal appearance of synovial fluid?

A

 Appears clear & pale yellow
 “Egg white” consistency (forms continuous
“string” when poured!)
 Viscosity is due to polymerization of hyaluronic acid (essential for proper joint lubrication.)

85
Q

Why would synovial fluid viscosity be measured?

A

Unhealthy joints secrete malfunctioning
hyaluronic acid (unable to polymerize), so viscosity ↓

86
Q

Synovial Fluid:

____________ may be mixed in with fluid 1st in order to aid in handling. Also, coverslip can be rimmed with clear nail polish to prevent dehydration during
examination.

A

Hyaluronidase

87
Q

Synovial Fluid:

Normal WBC count = _____ mononuclear cells/uL
(lymphs, monos, macrophages, & a few synovial lining cells)

A

< 200

FYI: WBCT count may reach > 100,000 cells/uL in severe infection!

88
Q

Synovial fluid:

Segs should make up <___% of N. differential.

A

30

89
Q

Why would a microscopic exam be done for crystals in synovial fluid?

A

to diagnose crystal-induced arthritis.

90
Q

What are the three most common crystals causing arthritis?***

A

 Monosodium urate (MSU) (gout)
 Ca pyrophosphate (CPPD) (= pseudogout)
 Cholesterol (chronic effusions such as RA)

91
Q

Synovial crystal:

Large, needle-shaped crystals that may be inside OR outside cells.

A

 Monosodium urate (MSU) (gout)

92
Q

Synovial crystal:

Small rhombic-shaped or rod-shaped crystals, inside cells.

A

 Ca pyrophosphate (CPPD) (= pseudogout)

93
Q

Synovial crystal:

 Large, flat, extracellular notched plates

A

Cholesterol (chronic effusions such as RA)

Urinalysis and Body Fluids 4214 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions