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ANURBF FINALS > CEREBROSPINAL FLUID > Flashcards

CEREBROSPINAL FLUID Flashcards

1
Q

1st recognized by

A

Cotugno (1764)

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2
Q

3rd MAJOR FLUID IN THE BODY

A

CSF

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3
Q

produced in the [?] and serves several functions

A

brain

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4
Q

serves as a protective fluid, cushioning and lubricating the brain and spinal column.

A

CSF

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5
Q

The brain and spinal cord are enclosed in three layers of membrane, the meninges:

A

DURA MATER
ARACHNOID MATER/ARACHOIDEA
PIA MATER

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6
Q

”hard mother”- Outermost membrane

A

DURA MATER

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7
Q

”spider-web-like”- Middle

A

ARACHNOID MATER/ARACHOIDEA

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8
Q

”gentle mother”- Innermost layer and adheres to the surface of neural tissue.

A

PIA MATER

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9
Q

Produced by

A

CHOROID PLEXUSES

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10
Q

flows through

A

SUBARACHNOID SPACE

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11
Q

reabsorbed by

A

ARACHNOID VILLI/GRANULATION

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12
Q

VOLUME:

A

20mL/hour
Adults: 140-170ml
Neonates: 10-60ml

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13
Q

used to represent the control and filtration of blood components to the CSF and to the brain

A

BLOOD-BRAIN BARRIER(BBB)

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14
Q

SPECIMEN COLLECTION AND HANDLING SITES

ADULTS:

A

Between 3rd and 4th (or lower) lumbar vertebrae

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15
Q

SPECIMEN COLLECTION AND HANDLING SITES

CHILDREN:

A

Between 4th and 5th lumbar verebrae

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16
Q

most common position

A

LUMBAR PUNCTURE (fetal position/Lateral Decubitus Position)

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17
Q

: sub-occipital region

A

Cisternal Puncture

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18
Q

: infants with open fontanels

A

Ventricular Puncture

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19
Q

collection positions

A

LUMBAR PUNCTURE (fetal position/Lateral Decubitus Position)
Cisternal Puncture
Ventricular Puncture
Lateral cervical puncture

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20
Q

Chemical & serological tests

A

1

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21
Q

Frozen at -15 to -30oC

A

1

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22
Q

Microbiological tests

A

2

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23
Q

Room Temp at 19 to 26 oC

A

2

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24
Q

Cell count /Hematology

A

3

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25
Q

Refrigerated at 2 to 8 oC

A

3

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26
Q

Microbiology /chemistry/serology

A

4

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27
Q

LOW-VOLUME Specimens –

A

Microbiology > Hematology > Chemistry/Serology

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28
Q

STAT basis (WITHIN [?])

A

30 MINUTES

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29
Q

—most frequently performed chemical test on CSF

A

Protein

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30
Q

Protein Normal values:
6 months to adults =
Newborn =
> 60 y/o =

A

15 to 45 mg/dl
75 to 150 mg/dl
>60 mg/dl

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31
Q
A

ALBUMIN > PREALBUMIN > HAPTOGLOBIN AND CERULOPLASMIN > TRANSFERRIN

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32
Q

DECREASED IN PROTEINS

A

Leakage fluid in CNS
Recent puncture
Water intoxication
Rapid CSF production

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33
Q

QUALITATIVE TESTS

A

NONNE-APELT
ROSE JONES
PANDY’S
NOGOCHI

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34
Q

NONNE-APELT
Reagent:
Product:

A

Ammonium sulfate
Cloudy precipitate

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35
Q

ROSE JONES
Reagent:
Product:

A

Ammonium sulfate
White ring

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36
Q

PANDY’S
Reagent:
Product:

A

Phenol
Bluish white cloud

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37
Q

NOGOCHI
Reagent:
Product:

A

10% Butyric acid
Precipitate

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38
Q

QUANITATIVE TESTS

A
  1. TURBIDIMETRIC
  2. DYE-BINDING TECHNIQUES
  3. NEPHELOMETRY
  4. ELECTROPHORESIS
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39
Q
  1. TURBIDIMETRIC REAGENTS
A

TRICHLOROACETIC ACID(TCA)
SULFOSALICYLIC ACID(SSA)

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40
Q
  1. DYE-BINDING TECHNIQUES REAGENTS
A

COOMASSIE BRILLIANT BLUE(CBB) G250
PONCEAU S

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41
Q
  1. NEPHELOMETRY REAGENTS
A

Benzalkonium chloride

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42
Q
  1. ELECTROPHORESIS
A
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43
Q

“Protein Error of indicators”

A

DYE-BINDING TECHNIQUES

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44
Q

Most frequently performed

A

ELECTROPHORESIS

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45
Q

Method of choice for the determination of CSF

A

ELECTROPHORESIS

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46
Q

Detection of OLIGOCLONAL BANDS

A

ELECTROPHORESIS

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47
Q

MULTIPLE SCLEROSIS

A

ELECTROPHORESIS

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48
Q

Encephalitis, neurosyphilis, Guillain-Barre Syndrome and Neoplastic Disorders

A

ELECTROPHORESIS

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49
Q

:
- comparison between serum and CSF levels of albumin and IgG must be made

A

PROTEIN FRACTIONS

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50
Q

Evaluates BBB integrity

A

CSF-Serum Albumin Index

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51
Q

Determines IgG production within the CNS

A

CSF-Serum IgG Index

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52
Q

CSF-Serum Albumin Index Index Value

A

< 9: intact BBB
>9: damaged BBB

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53
Q

CSF-Serum IgG Index Value

A

> 0.77: IgG production within the CNS

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54
Q

Cerebrospinal Fluid Glucose
NORMAL VALUE:
Neonates:

A

60-70%
80%

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55
Q

Cerebrospinal Fluid Glucose INCREASED IN:

A

Plasma glucose elevation
DM
Encephalitis and conditions associated with intracranial pressure

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56
Q

Cerebrospinal Fluid Glucose DECREASED IN:

A

Aids in determining the causative agent of
meningitis

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57
Q

GLUCOSE CONCENTRATION IN BACTERIAL

A

DECREASED

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58
Q

GLUCOSE CONCENTRATION IN TUBERCULAR

A

DECREASED

59
Q

GLUCOSE CONCENTRATION IN VIRAL

A

NORMAL

60
Q

GLUCOSE CONCENTRATION IN FUNGAL

A

NORMAL OR DECREASED

61
Q

INCREASED NEUTROPHILS

A

BACTERIAL

62
Q

INCREASED LYMPHOCYTES

A

TUBERCULAR AND VIRAL

63
Q

+ INDIA INK(C.neoformans)

A

FUNGAL

64
Q

Aids in the diagnosis and management of meningitis

A

Cerebrospinal Fluid Lactate

65
Q

Used to evaluate effectiveness of antibiotic therapy

A
66
Q

Used to monitor severe head injuries

A

Cerebrospinal Fluid Lactate

67
Q

< 25 mg/dL:

A

VIRAL MENINGITIS

68
Q

> 25 mg/dL:

A

TUBERCULAR AND FUNGAL MENINGITIS

69
Q

> 35mg/dL:

A

BACTERIAL MENINGITIS

70
Q

Cerebrospinal Fluid Glutamine

NORMAL VALUE:

A

8-18mg/dL

71
Q

Frequently performed in CSF but not in blood

A

Cerebrospinal Fluid Glutamine

72
Q

INDIRECT measure of CSF AMMONIA

A

Cerebrospinal Fluid Glutamine

73
Q

Aids in the diagnosis of meningitis

A

Cerebrospinal Fluid LD Isoenzymes

74
Q

LD1 and LD2 :

A

brain tissue destruction

75
Q

LD2 and LD3 :

A

viral meningitis

76
Q

LD4 and LD5 :

A

bacterial meningitis

77
Q

CK-BB
>17mg/dL
<17mg/dL

A
78
Q

WBC: COUNT:

A

routinely perfomed

79
Q

RBC COUNT:

A

traumatic tap and correction for leukocytes or proteins

80
Q

RBC count=

A

Total Cell count-WBC count

81
Q

TOTAL CELL COUNT:

A

hemocytometer

82
Q

Diluent:

A

Normal saline solution(NSS)

83
Q

Disturbance in consciousness (>35mg/dl)

A

Glutamine

84
Q

Coma of unknown origin (results from ↑ usage of α-ketoglutarate)

A

Glutamine

85
Q

Reye’s syndrome (75% of diagnosed children)

A

Glutamine

86
Q

in post-cardiac arrest indicates poor prognosis

A

CK-BB Isoenzyme >17mg/dL

87
Q

indicates recovery from cardiac arrest after resuscitation

A

CK-BB Isoenzyme <17mg/dL

88
Q

predominant in adults

A

Lymphocytes

89
Q

lymphocyte to monocyte ratio

A

70:30

90
Q

predominant in children

A

monocytes

91
Q

lymphocyte to monocyte ratio

A

30:70

92
Q

: rare normal cell component

A

neutrophils

93
Q

: ↑numbers of normal cells (abnormal finding)

A

Pleocytosis

94
Q

Abnormal CSF Cells:

A

immature WBCs, eosinophils, plasma cells, macrophages, increased tissue cells and malignant cells

95
Q

Performed when there is: (1) traumatic tap, (2) a need for leukocyte correction, and (3) a need for protein correction

A

RBC Count

96
Q

𝑹𝑩𝑪 𝑪𝒐𝒖𝒏𝒕 =

A

𝑹𝑩𝑪 𝑪𝒐𝒖𝒏𝒕 = 𝑻𝒐𝒕𝒂𝒍 𝑪𝒆𝒍𝒍 𝑪𝒐𝒖𝒏𝒕 − 𝑾𝑩𝑪 𝑪𝒐𝒖𝒏𝒕

97
Q

Total Cell Count
 Cells are counted in the four corner squares and the center square of the [?]
 [?] is used to load the hemocytometer
 Diluent: [?]

A

Improved Neubauer hemocytometer
Pasteur pipet
Normal Saline Solution (NSS)

98
Q

𝑪𝒆𝒍𝒍𝒔/𝒖𝑳 =

A
99
Q

Dilution

A

20

100
Q

 Sample is undiluted and examined using a phase-contrast microscope

A

Fuchs-Rosenthal Counting Chamber

101
Q

 With 16 large squares and 0.2 mm depth

A

Fuchs-Rosenthal Counting Chamber

102
Q

Fuchs-Rosenthal Counting Chamber Cells Formula

A

Number of cells/3

103
Q

 Specimens are concentrated and stained

A

Differential Count

104
Q

 Number of cells counted: 100
 <100 cells: report # of cells counted

A

Differential Count

105
Q

Performed to identify the causative agent in meningitis

A

MICROBIOLOGIC EXAMINATION

106
Q

MICROBIOLOGIC EXAMINATION SPECIMEN:

A

CSF and blood

107
Q

MICROBIOLOGIC EXAMINATION

Specimens should be concentrated by centrifugation at

A

1500xg for 15 minutes

108
Q

 Microorganism must be recovered from CSF by growing it on appropriate culture medium for positive identification

A

Blood Culture

109
Q

Medium for culture

A

Thioglycholate broth and Chocolate agar

110
Q

Blood Culture Duration of incubation:
 bacterial meningitis
 tubercular meningitis

A

24 hours
6 weeks

111
Q

Confirmatory procedure rather than diagnostic

A

Blood Culture

112
Q

Cultures are to what percentage sensitive

A

80% to 90%

113
Q

Gram Staining is to what percentage sensitive

A

60% to 90%

114
Q

Microorganism must be recoverd from CSF by growing appropriate [?] for identification

A

culture medium

115
Q

 Routinely performed on CSF from all suspected cases of meningitis

A

Gram Staining

116
Q

 Recommended method for the detection of organisms

A

Gram Staining

117
Q

of organism should be present for adequate Gram stain results

A

 100,000/ml

118
Q

Organisms most frequently observed:
 Gram (+):
 Gram (-):
 Star burst pattern:

A

Streptococcus pneumoniae (cocci) Streptococcus agalactiae (cocci) in newborns Listeria monocytogenes (bacilli) in newborns

Escherichia coli (bacilli) Neisseria meningitides (cocci) Haemophilus influenza (pleomorphic bacilli)

Cryptococcus neoformans

119
Q

 Performed when tubercular meningitis is suspected

A

Acid Fast/Fluorescent Antibody Stains

120
Q

 Positive report is extremely valuable

A

Acid Fast/Fluorescent Antibody Stains

121
Q

 Detect the presence of a thickly encapsulated Cryptococcus neoformans

A

India Ink

122
Q

 More sensitive method in the detection Cryptococcus neoformans in serum and CSF

A

Reverse Latex Agglutination

123
Q

 Should be confirmed by culture and India ink

A

Reverse Latex Agglutination

124
Q

 False positive reactions occur mainly due to rheumatoid factor

A

Reverse Latex Agglutination

125
Q

 Used in combination with hematology and clinical chemistry results

A

Bacterial Antigen Test

126
Q

 Provide rapid means for detecting and identifying microorganisms in CSF

A

Latex Agglutination Tests and ELISA

127
Q

 Test kits available for the detection of Streptococcus group B, Haemophilus influenzae type B, Streptococcus pneumoniae, Neisseria meningitidis A, B, C, Y, W135, and Escherichia coli K1 antigens.

A

Latex Agglutination Tests and ELISA

128
Q

 Diagnosis of meningitis caused by Gram (-) organisms

A

Limulus Lysate Test

129
Q

 Principle: The endotoxin produced by the cell walls of Gram (-) organisms will coagulate the amebocyte lysate within 1 hour incubated at 37oC.

A

Limulus Lysate Test

130
Q

 Reagent: Blood cells (amebocyte) of horseshoe crabs (Limulus polyphemus)

blue in color due to the presence of a copper complex

A

Limulus Lysate Test

131
Q

 Performed for the diagnosis of neurosyphilis

A

Venereal Disease Research Laboratories (VDRL)

132
Q

 Most sensitive and specific for syphilis diagnosis

A

Fluorescent Treponemal AntibodyAbsorption (FTA-ABS)

133
Q

Confirmatory test for meningitis

A

Culture

134
Q

Causative agent of primary meningoencephalitis

A

Naegleria fowleri

135
Q

Seen in wet preparations

A

Motile trophozoite

136
Q

Cytocentrifuged

A

Non-motile trophozoite

137
Q

Specimens accompanied by increased wbc but no bacteria

A

Non-motile trophozoite

138
Q

Crystal clear

A

Normal

139
Q

Hazy, turbid, milky, cloudy

A

WBCs Microorganisms Protein

140
Q

Oily

A

Radiographic contrast media

141
Q

Bloody

A

RBCs

142
Q

Xanthochromic

A

Hemoglobin Bilirubin Carotene Protein Melanin

143
Q

Clotted

A

Protein Clotting factors

144
Q

Pellicle

A

Protein Clotting factors

ANURBF FINALS (7 decks)

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