CSF Flashcards
(108 cards)
1
Q
CSF is first recognized by
A
Cotugno(1764)
2
Q
CSF is
A
third major body component
3
Q
Functions of csf
A
Supply nutrients to CNS
Remove metabolic wastes
Mechanical barrier
4
Q
csf is produced by
A
Choroid Plexuses of the
2 lumbar ventricles
3rd ventricle
4th ventricle
5
Q
csf is Reabsorbed in
A
blood capillaries in the Arachnoid Villi/Granulation
6
Q
TOTAL VOLUME (ADULT)
A
90-150 mL
7
Q
TOTAL VOLUME (NEONATES)
A
10-60 mL
8
Q
RATE OF REABSORPTION/production
A
20 mL
9
Q
tight-fitting junctures of endothelial cells in choroid plexuses that prevent passage of many molecules
A
Blood-Brain Barrier
10
Q
20 mL collected through
A
lumbar puncture
11
Q
Site of collection: (between) of csf
A
third and fourth OR fourth and fifth lumbar vertebra
12
Q
Tube 1
A
chemistry/serology;freezing
13
Q
tube 2
A
microbiology; RT
14
Q
tube 3
A
hematology, RT
15
Q
tube 4
A
ADDITIONAL TEST
16
Q
if one tube only
A
- Microbiology
- Hematology
- Chemistry or Serology
- Other Tests
17
Q
color of csf
A
colorless
18
Q
viscosity of csf
A
same with water
19
Q
clarity of csf
A
crystal clear
20
Q
S.G of csf
A
1.006-1.008
21
Q
pH of csf
A
7.30-7.35
22
Q
pressure of csf
A
50 to 200 mm H20
23
Q
SLIGHTLY HAZY
A
200-500 wbc/uL
24
Q
cloudy
A
> 500 wbc/uL
25
turbid/milky
wbc,rbc,proteins, increased lipid concentration, microorganisms, aspirated epidurial fats, radiographic contrast media
26
CLOTTED
FROIN’S DISEASE
27
BLOODY
hemorrhage
28
VISCOUS
CRYPTOCCOCAL MENINGITIS
29
OILY
radiographic contrast media
30
PELLICLE FORMATION
tubercular Meningitis/ web-like upon refrigeration
31
Xanthochroma
presence of RBC degradation product
32
NORMAL CSF WBC COUNTS: adults
0-5 wbc/uL
33
NORMAL CSF WBC COUNTS: children
higher values
34
NORMAL CSF WBC COUNTS:neonates
0-30 mononuclears/uL
35
Slightly hazy
1:10
36
hazy
1:20
37
Slightly Cloudy
1:100
38
Slightly Bloody or Cloudy
1:200
39
Bloody or Turbid
1:10,100
40
wbc for every 700 rbc seen
-1
41
mg/dL TP concentration for every 1,200 RBC/uL
-1
42
mg/dL TP concentration for every 10,000 RBC/uL
-8
43
When performing differential count, the specimen should be:
1st: Concentrated
2nd: Smeared
3rd: Stained
44
methods of centrifugation
1.sedimentation
2.centrifugation (5-10 min)
3. cytocentrifugation
45
cytocentrifugation has
0.1 mL of CSF + 30%albumin
Result: ↑cell yield;↓cellular distortion
46
L: M RATIO IN ADULTS
70:30
47
L:M RATIO IN INFANTS
30:70
48
increased number of normal cells an ABNORMAL state
pleocystosis
49
protein normal values: adults
15-45mg/dL
50
protein normal values: infants
150 mg/dL
51
protein normal values: immature
500 mg/dL
52
Alpha-globulins
Haptoglobin
Ceruloplasmin
53
Beta-globulins
Beta-2 Transferrin/Tau Protein
54
gamma-globulin
IgG and some IgA
55
not found in normal csf
IgA,IgM, IgA, beta-lipoprotein,fibrinogen
56
2 methods in protein determination
turbidimetry production and dye binding
57
adapted in automated instrumentation in the form of NEPHELOMETRY
turbidimetry method
58
precipitates BOTH albumin & globulin;most preferred method
trichloroacetic acid (3%)
59
precipitates albumin ONLY; to precipitate globulins, add sodium sulfate
bSulfosalicylic Acid (3% SSA)
60
dye-binding
Dye: Coomasie Brilliant Blue
protein binds to dye (red to blue)
Result: ↑protein = ↑ blue color
61
Evaluates BBB integrity
CSF/SERUM ALBUMIN INDEX
62
normal index value
<9 = intact rbc
63
9-14 index
SLIGHTLY IMPAIRMENT
64
5-30 INDEX
MODERATE IMPARTMENT
65
>30
SEVERE IMPARTMENT
66
100 INDEX
COMPLETE DAMEGE
67
Measures IgG synthesis within the CNS
CSF IgG INDEX
68
NORMAL CSF IGg INDEX
<0.77
69
IGg PRODUCTION WITHIN CNS
>0.77
70
METHOD OF CHOICE when it is necessary to determine if the fluid is CSF.
Tau identification' Beta2-transferrin
71
a demyelinating disorder
multiple sclerosis
72
findings in multiple sclerosis
Findings:
✓ (+) Anti-myelin Sheath Autoantibody
✓ (+) Oligoclonal band in CSF but not in serum
✓ (+) Myelin Basic Protein
✓ ↑ IgG Index
73
protein component of lipid protein complex that isolates the nerve fibers; presence of this in csf indicates destruction of myelin sheaths used to measure multiple sclerosis
MBP (myelin basic proteins)
74
oligoclonal banding in csf NOT in serum
Multiple Sclerosis
Neurosyphilis
Encephalitis
Neoplastic disorder
Guillaine-Barre Syndrome
75
oligoclonal bonding in serum NOT IN CSF
Leukemia
Lymphoma
Viral Infection
76
oligoclonal banding in serum and csf
HIV
77
NORMAL VALUE OF GLUCOSE
50-80 mg/dL (60-70%)
78
glucose is normal in
viral meningitis
79
normal value for lactate
10-22 mg/dL
80
lactate is elevated in
bacterial meningitis (>35 mg/dL)
tubercular menigitis (25mg/dL)
hypoxia
81
lactate is normal in
viral meningitis
82
glutamine product
ammonia
a-ketoglutarate
83
Indirect test for the presence of excess ammonia in the CSF;
glutamine
84
NORMAL VALUE OF GLUTAMINE
8-18mg/dL
85
other name for glutamine
Reye's syndrome
86
normal serum ldh
2>1>3>4>5
flipped pattern: 1>2>3>4>5
87
normal csf ldh
1>2>3>4>5
neurological abnormalities: 2>1>3>4>5
bacterial meningitis: 5>4>3>2>1
88
CSF LDH Isoenzymes:
1 and 2 = BRAIN TISSUES
2 and 3 = Lymphocytes
4and 5 = Neutrophils
89
CK ELEVATED IN:
Stroke
MS
degenerative disorders
brain tumors
viral & bacterial meningitis
seizures
90
if ↑ in post-cardiac arrest patients if CK-BB BRAIN;CK MB-HEART;CK-MM S MUSCLES (<17 mg/dL) [recovery]
91
POOR CARDIAC ARREST PATIENTS --> POOR PROGNOSIS
92
AST is elevated in
intracerebral hemorrhage
subarachnoid hemorrhage
bacterial meningitis
93
recommended by CDC for the detection of NEUROSYPHILIS
Veneral Disease Research Lab (VDRL)
94
test for detection of neurosyphilis (VDRL)
Latex Agglutination test- bacterial antigen
ELISA
FTA-Abs>VDRL>RPR (Rapid Plasma Reagin)
95
CONFIRMATORY test;to identify the causative agent in meningitis
csf culture
96
csf culture incubation period
Incubation:
24 hours = bacterial meningitis
6 weeks = tubercular meningitis
97
CENTRIFUGE GRAM STAINING AT
1,500G FOR 15 MIN
98
GRAM STAINING IN CSF DETECTS
Can detect:
* Streptococcus pneumoniae
* Haemophilus influenzae
* Escherichia coli
* Neisseria meningitidis
* Streptococcus agalactiae
* Listeria monocytogenes
99
Performed routinely on concentrated CSF to detect suspected CASES OF MENINGITIS
GRAM STAINING
100
Not routinely performed, unless TUBERCULAR MENINGITIS is suspected
ACID FAST STAINING AND FLUORESCENT ANTIBODY STAINING
101
For detection of Cryptococcus neoformans (fungal/cryptococcal
meningitis)
INDIA INK
102
parasite that is detected by india ink
cryptococcus neoformans
103
More sensitive; higher sensitivity than India ink
IMMUNOLOGIC ASSAY
104
Detect presence of CRYPTOTOCCUS NEOFORMANS ANTIGEN in serum
LATEX AGGLUTINATION TEST
105
Rapid test (reagent strip coated with monoclonal antibodies that react with cryptococcal polysaccharide capsule
Lateral Flow Assay (LFA)
106
Rapid test (rapid test kits)
ELISA
107
ELISA DETECTS:
Detects:
* Group B Streptococcus
* H.influenzae Type B
* S.pneumoniae
* N.meningitidis A,B,C,Y, and W135
* M.tuberculosis
* C.immitis
* E.coli KI antigens
108
SENSITIVE and SPECIFIC
Can detect the cause of meningitis with a small amount of pathogen’s DNA
Nucleic Acid Amplification Tests
