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CSF Flashcards

1
Q

3 Layers of the Meninges

A

Dura mater, arachnoid mater, pia mater

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2
Q

outer layer; lines the skull and vertebral
canal

A

Dura mater

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3
Q

filamentous (spider-like) inner
membrane.

A

Arachnoid mater

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4
Q

thin membrane lining the surfaces of the
brain and spinal cord.

A

Pia mater

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5
Q

Choroid Plexuses of the 2 lumbar ventricles & the 3rd and 4th ventricles

A

site of production of CSF.

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6
Q

approximate volume of CSF produce every hour.

A

20 mL

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7
Q

tight-fitting structure of the
endothelial cells in the choroid plexuses

A

Blood-Brain-Barrier

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8
Q

method used to routinely collect CSF.

A

Puncture between the 3rd, 4th Or 5th Lumbar Vertebra

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9
Q

left over after each section has performed its tests may also be used for additional chemical or serologic tests.

A

Supernatant Fluid

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10
Q

should not be discarded and should be frozen until there is no further use for it.

A

Excess Fluid

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11
Q

usually determine whether the blood is the result of hemorrhage or a traumatic tap.

A

Three visual examinations of the collected specimens

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12
Q

routinely performed on CSF specimens

A

White Blood Cell Count (WBC)

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13
Q

usually determined only when a traumatic tap has occurred

A

Red Blood Cell Count

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14
Q

should be performed immediately.

A

Any cell count

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15
Q

routinely used for performing CSF cell counts.

A

Improved Neubauer counting chamber

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16
Q

have not been used for performing CSF cell counts.

A

Electronic cell counters

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17
Q

made with normal saline

A

Dilutions for total cell counts

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18
Q

Counted in the four corner squares and the center
square on both sides of the hemocytometer.

A

TOTAL CELL COUNT

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19
Q

Lysis of RBCs must be obtained

A

WBC COUNT

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20
Q

Counted in the four corner squares, and the center square on both sides of the hemocytometer and the number is multiplied by the dilution factor to obtain the number of WBCs per microliter.

A

WBC COUNT

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21
Q

for spinal fluid RBC and WBC counts.

A

Liquid commercial controls

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22
Q

must be soaked in a bactericidal solution for at least 15 minutes and then thoroughly rinsed with water and cleaned with isopropyl alcohol.

A

Non-disposable counting chambers

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23
Q

should be checked biweekly for contamination by examining them in a counting chamber under 400× magnification.

A

All diluents

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24
Q

Performed on a stained smear.

A

DIFFERENTIAL COUNT ON A CSF SPECIMEN

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25
Methods available for specimen concentration
Sedimentation, Filtration,Centrifugation! Cytocentrifugation
26
removed and saved for additional tests
supernatant fluid
27
slides made from the suspended sediment are allowed to air dry and are stained with
Wright’s stain.
28
should be counted, classified, and reported in terms of percentage.
100 cells
29
majority of cells found in normal CSF.
Lymphocytes & Monocytes
30
predominance of lymphocytes to monocytes.
Adults
31
predominance of monocytes to lymphocytes.
Children
32
presence of increased number of these normal cells; considered abnormal
Pleocytosis
33
Immature leukocytes, eosinophils, plasma cells, macrophages, increased tissue cells, and malignant cells
abnormal
34
high CSF WBC Count – majority of the cells (+) Neutrophils
Bacterial Meningitis
35
moderately elevated CSF WBC count with a high percentage of lymphocytes and monocytes.
Viral, fungal, tubercular or parasitic meningitis
36
Increased eosinophils are seen in the CSF in association with:
Parasitic Infections! Fungal Infections (Primarily Coccidioides immitis), Introduction of Foreign Material
37
most frequently seen after diagnostic procedures, Often appear in clusters, (+) Uniform Appearance
Nonpathologically significant cells
38
from the epithelial lining of the choroid plexus.
Choroidal Cells
39
are from the lining of the ventricles and neural canal
Ependymal Cells
40
represent lining cells from the arachnoid
Spindle-Shaped Cells
41
Lymphoblasts, myeloblasts, and monoblasts in the CSF are frequently seen as a serious complication of acute leukemias
HEMATOLOGIC ORIGIN
42
Metastatic carcinoma cells of nonhematologic origin are primarily from lung, breast, renal, and gastrointestinal malignancies
NON-HEMATOLOGIC ORIGIN
43
Nucleoli are often more prominent than in blood smears.
HEMATOLOGIC ORIGIN
44
Cells from primary CNS tumors include astrocytomas, retinoblastomas, and medulloblastomas
NON-HEMATOLOGIC ORIGIN
45
Lymphoma cells are also seen in the CSF and indicate dissemination from the lymphoid tissue.
HEMATOLOGIC ORIGIN
46
They usually appear in clusters and must be distinguished from normal clusters of ependymal, choroid plexus, lymphoma, and leukemia cells.
NON-HEMATOLOGIC ORIGIN
47
They resemble large and small lymphocytes and usually appear in clusters of large, small, or mixed cells based on the classification of the lymphoma.
HEMATOLOGIC ORIGIN
48
Fusing of cell walls and nuclear irregularities hyperchromatic nucleoli are seen in clusters of malignant cells.
NON-HEMATOLOGIC ORIGIN
49
Nuclei may appear cleaved, and prominent nucleoli are present.
HEMATOLOGIC ORIGIN
50
not the same as the plasma values.
Reference values for CSF chemicals
51
result from alterations in the permeability of the blood–brain barrier or increased production or metabolism
Abnormal values
52
most frequently performed chemical test on CSF
Protein Determination
53
Reference values for total CSF protein
15 to 45 mg/dL
54
makes up the most of the CSF protein
ALBUMIN
55
2ND most prevalent fraction in CSF
Pre-Albumin
56
include primary haptoglobin & ceruloplasmin
Alpha Globulins
57
major beta globulin present
Transferrin
58
separate carbohydrate-deficient transferrin fraction, seen in CSF; NOT in serum
TAU
59
primarily immunoglobulin G(IgG)
CSF gamma globulin
60
with only a small amount of immunoglobulin A(IgA)
CSF gamma globulin
61
not found in normal CSF.
Immunoglobulin M (IgM), fibrinogen, and beta lipoprotein
62
calculated after determining the concentration of CSF albumin in milligrams per deciliter and the serum concentration in grams per deciliter
CSF/serum albumin index
63
represents an intact blood-brain- barrier
Index value less than 9
64
a comparison of the CSF/serum albumin index with the CSF/serum IgG index, compensates for any IgG entering the CSF via the blood–brain barrier. performed by dividing the CSF/serum IgG index by the CSF/serum albumin index
Calculation of an IgG index
65
indicate IgG production within the CNS
Values greater than 0.70
66
primary purpose for performing CSF protein electrophoresis
To detect oligoclonal bands (represents inflammation within the CNS)
67
indicates immunoglobulin production
Oligoclonal Bands
68
must be performed simultaneously.
Serum electrophoresis
69
valuable tool in diagnosing multiple sclerosis when accompanied by an increased IgG index
Presence of two or more oligoclonal bands in the CSF that are not present in the serum
70
method of choice when determining whether a fluid is actually CSF
CSF immunofixation electrophoresis (IFE) and isoelectric focusing (IEF) followed by silver staining
71
approximately 60-70% that of the plasma glucose
Reference Value of CSF GLUCOSE
72
must be run for comparison for an accurate evaluation of CSF glucose
Blood Glucose Test
73
should be drawn about 2 hours before the spinal tap to allow time for equilibration between the blood and fluid
Sample for blood glucose
74
Specimens should be tested immediately
CSF GLUCOSE
75
provides more reliable information when the initial diagnosis is difficult
CSF lactate levels greater than 25 mg/dL
76
levels greater than 35 mg/dL
Bacterial Meningitis
77
lower than 25 mg/dL.
Viral Meningitis
78
may be obtained on xanthochromic or hemolyzed fluid
Falsely elevated results
79
can result from any condition that decreases oxygen flow to the tissues
Elevated CSF Lactate: not limited to meningitis
80
frequently used to monitor severe head injuries
CSF lactate levels
81
Normal Concentration: 8 to 18 mg/dL
CSF GULATAMINE
82
result in increased blood and CSF ammonia.
Elevated levels are associated with liver disorders
83
provides an indirect test for the presence of excess ammonia in the CSF
Determining CSF glutamine
84
almost always seen when glutamine levels are more than 35 mg/dL
Some Disturbance of Consciousness
85
have elevated CSF glutamine levels
75% of children with Reye syndrome
86
routinely performed on CSF from all suspected cases of meningitis, although its value lies in detecting bacterial and fungal organisms
Gram Stain
87
should be performed on concentrated specimens
All smears and cultures
88
should be centrifuged at 1500 g for 15 minutes
CSF
89
should be prepared from the sediment
slides and cultures
90
Blood cultures should be taken
CSF ANALYSIS: MICROBIOLOGY TEST
91
Organisms most frequently encountered
Streptococcus pneumoniae (gram-positive cocci), Haemophilus influenzae (pleomorphic gram-negative rods), Escherichia coli (gram- negative rods), and Neisseria meningitidis (gram-negative cocci)
92
not routinely performed
Acid-fast or fluorescent antibody stains
93
performed to detect the presence of thickly encapsulated Cryptococcus neoformans
India Ink Preparation
94
seen more often than a positive India ink
Gram stain for the classic starburst pattern (produced by Cryptococcus)
95
performed to detect the presence of neurosyphilis
Serologic testing of the CSF
96
procedure recommended by CDC to diagnose neurosyphilis
Venereal Disease Research Laboratories (VDRL)
97
not recommended because it is less sensitive than the VDRL
Rapid plasma reagin (RPR) test
98
care must be taken to prevent contamination with blood
the FTA-ABS is used

AUBF LEC (3 decks)

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