CHEM PATH Flashcards
Contraindications to Lumbar puncture (4).
- raised ICP
- coagulopathy/thrombopoenia
- local infection
Normal CSF glucose relative to plasma glucose in an adult patient.
N= 60-80%
decrease glucose CSF:plasma ratio (<0.6) is common seen in what cause of meningitis.
Bacterial meningitis (<0.4 typical)
Tuberculosis meningitis
Fungal meningitis
Hypoxia (anaerobic metabolism of glucose = less ATP/glucose)
how to prevent spurous decrease in a CSF chemistry collection for glucose.
Must be collected in NaF tube
Chloride is usually Decreased in patients with ___ due to very high –ve proteins
TB
The two negative charge ion in the CSF?
Cl- and HCO3-
Give three (3) conditions where lactate is increased.
Cerebral hypoxia – infarctions, seizures
Diffuse meningeal conditions esp bacterial meningitis (hypoxia dt inflammation and cerebral oedema)
Markedly elevated with certain IMDs e.g. PDH; mitochondrial myopathies
Plasma concentration of the protein (directly proportional)
Protein↑ with increased permeability - infection or inflammation
Protein is highly elevated in TB menigitis
yes
GLUT-1 in the brain does not need insulin to transport glucose.
yes,
GLUT-1 also occurs in RBC
The protein in the CSF increases as it goes down.
as it travelled down, water leave. leaving the protein.
NaF tubes- inhibit glycolytic enzymes
to colllect for glucose test also use for plasma
CSF glucose:plasma Ratio ______ in viral meningitis
normal
The IgG Index is used to screen for ______.
intrathecal (local) IgG production
NB!! must know the formula
______________is a good indicator of BBB permeability
Albumin
An increased ratio means increased permeability
