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CLINICAL MICROSCOPY > CSF > Flashcards

CSF Flashcards

(103 cards)

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1
Q

a major fluid of the body associated to CNS

A

Cerebrospinal fluid

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2
Q

Csf is produced in the ________ of the two lumbar ventricles and the______ and ____ ventricles

A

Choroid plexus
3rd and 4th

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3
Q

Approx ________ is produced every hour in adults

A

20mL

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4
Q

Maintain the volume of ______ to _______ ml in adults

A

90-150 ml

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5
Q

Volume of csf in neonates

A

10-60 ml

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6
Q

The circulating fluid is reabsorbed back into the blood capillaries in ____________/ at rate to equal to its production

A

Arachnoid granulations

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7
Q

Are capillary networks that form the csf from plasma mechanisms of selective filtration under __________ and _________

A

hydrostatic pressure and active trans port secretion

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8
Q

Are capillary networks that form the csf from plasma mechanisms of selective filtration under hydrostatic pressure and active transport secretion

A

Choroid plexus

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9
Q

Csf specimen is collected by the ___________ between third,fourth or fifth lumbar vetebrate

A

lumbar puncture/ tap

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10
Q

The opening pressure of the CSF taken when the needle first enters the?

A

Subarachnoid space

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11
Q

More preferred site of collection
More Relax

A

Lying position

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12
Q

Less fluid is collected in this position
Higher opening pressure

A

Sitting position

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13
Q

method of puncturing the sub occipital area

A

Cysternal Technique

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14
Q

performed among neonates, FONTANEL is the site of collection

A

Ventricular technique

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15
Q

Tube 1 is for?

A

Chemistry and serology test
Freezing temp

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16
Q
  • these tests are least affected by blood or bacteria introduced as a result of the tap procedure
A

Tube 1

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17
Q

possible contaminants are flushed already in Tube 1

A

Tube 2

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18
Q

Tube 2 is for

A

Microbiology
Room temp

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19
Q

it is least likely to contain cells introduced by the spinal tap procedure

A

Tube 3

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20
Q

Tube 3 is for?

A

Hematology
Refrigrated

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21
Q

A fourth tube may be drawn for the___________ laboratory to provide better exclusion of skin contamination or for additional serologic tests

A

Microbiology lab

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22
Q

Excess fluid should not be discarded and should be _______ until there is no further use for it

A

Frozen

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23
Q

Supernatant fluid that is left over after each section has performed its tests may also be used for additional

A

Chemical or serologic tests

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24
Q

Lateral position in adult

A

90-180 mmHg

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25
Opening pressure space to infants and children
10-100 mmHg
26
“If the opening pressure is greater than________ for a relaxed patient, NO more than should be collected
200 mmHg No more than 2 mL
27
Avoid_________ because cell adhesion to the glass affects cell count and differentiation
Glasstubes
28
Processing time should be cellular degradation begins _______ after collection
quick/ 1hour
29
Refrigeration is contraindicated for culture specimens (Tube # 2) because fastidious organisms such as ?what organism cannot survived
Hemophilus influenza and Neisseria meningitides will not survive
30
Normally crystal clear. Standard is
h20 or distilled water
31
Cloudy or Turbid CSF
a. Presence of microorganisms b. Increased protein c. Increased WBC, RBC
32
a. Increased carotene b. Intake of rifampin -ANTU-TB DRUG c. Increased protein (>150mg/dL)
Xanthochromic CSF
33
a. Presence of microorganisms b. Increased protein c. Increased WBC, RBC
Cloudy or Turbid CSF
34
non-pathologic
Traumatic tap
35
Internal bleeding, pathologic
Intracranial hemorrhage
36
a. 6,000 RBC/uL b. Traumatic tap – non-pathologic c. Intracranial hemorrhage – Internal bleeding, pathologic
Grossly Bloody CSF
37
term used to describe CSF supernatant that is pink, orange, or yellow. Brought about by hemolysis
XANTHOCHROMIA
38
Very slight amount of oxyhemoglobin Color?
Pink
39
Heavy hemolysis
Orange
40
conversion of oxyhemoglobin to unconjugated bilirubin
Yellow
41
*RBC à Lyse à releasing Hgb causing?
xanthochromic hemolysis
42
is caused by bilirubin due to immature liver function is also commonly seen in infants, particularly in those who are premature
Xanthochromia
43
Disorders affecting bloodbrain barrier Tubular meningitis
Pellicle
44
Disorders affecting bloodbrain barrier Traumatic tap
Clotted
45
Old hemorrhage Lysed cells RBC degradation Elevated bilirubin Increased serum level Disorders affecting bloodbrain barrier Meningeal melanosarcoma
Xanthochromic
46
Turbidity and Cloudiness begins to appear with: - CSF WBC count Turbidity and Cloudiness begins to appear with: - CSF WBC counts >200 cells/uL or - CSF RBC counts >400 cells/uL
>200 cells/uL or >400 cells/uL
47
CSF with cell counts of <50 cells/uL when direct sunlight is directed to the tube at 90 degree angle from the observer appear __________
Sparkling or snowy
48
CSF with cell counts of <50 cells/uL when direct sunlight is directed to the tube at 90 degree angle from the observer appear “sparkling” or “snowy”
TYNDALL EFFECF
49
when CSF clots without presence of blood, there is damage in blood brain barrier
Froin syndrome
50
Grossly bloody CSF can be an indication of intracranial hemorrhage, but it may also be due to the puncture of a blood vessel during the spinal tap procedure
Traumatic tap
51
Uneven distribution of blood?
Traumatic tap
52
Equal redness
Intracranial hemorrhage
53
1 st tube is much red and color diminish
Traumatic tap
54
Introduction of plasma fibrinogen into the specimen
Clot formation
55
Bloody CSF caused by ________does not contain enough fibrinogen to clot
Intracranial hemorrhage
56
RBC contains fibrinogen which is a clotting factor, fresh blood introduced due to
Traumatic tap
57
Diseases in which damage to the blood-brain barrier allows increased filtration of protein and coagulation factors also cause clot formation but do not usually produce a bloody fluid
Meningitis Froin syndrome Blockage of csf
58
A classic web-like pellicle is associated with
Tubular meningitis
59
RBCs must usually remain in the CSF for approximately 2 hours before noticeable hemolysis begins
Xanthochromic supernatant
60
RBCs concentrated at the bottom
Traumatic tap
61
Bloody all throughout
Intracranial hemorrhage
62
1>2>3 Positive (plasma fibrinogen) Clear supernatant Negative to erythrophages
Traumatic tap
63
1=2=3 Negative (fibrinogen is absent Xanthochromic Positive to erythrophages
Intracranial hemorrhage
64
- Subtract ___WBC for every 700 RBC - Subtract___ mg/dL Protein for every 10,000 RBC/uL
1 WBC 8 mg/dl
65
The microscopic finding of macrophages containing ingested RBCs or hemosiderin granules is indicative of
Intracranial hemorrhage
66
are usually determined only when a traumatic tap has occurred and a correction for leukocytes or protein is desired
Rbc count
67
Routinely done
Wbc count
68
Diluent in wbc count
3% acetic acid + Methylene blue
69
increased number of normal cells in csf
Pleocytosis
70
•70% Lymphocytes is for? •80% Monocytes is for?
Adult Neonate
71
Normal in CSF - If increased – seen in viral, fungal and tubercular metastasis
Lymphocyte
72
Normal in CSF - If increased – seen in fungal and tubercular meningitis
Monocyte
73
- Not normal - Indicative of bacterial meningitis - Found in early cases of viral, fungal, and tubercular meningitis
Neutrophil
74
- Macrophages with ingested RBC - Seen in intracranial hemorrhage
Erythrophages
75
Seen in multiple sclerosis – can lead to paralysis
Plasma cells
76
Seen in leukemia
Blast cells
77
RBC in spinal fluid Contrast media
Macrophages
78
Normal Viral, tubercular, and fungal meningitis Multiple sclerosis
Monocytes
79
May contain phagocytized RBCs appearing as empty vacuoles or ghost cells, hemosiderin granules and hematoidin crystals
Macrophages
80
Disseminated lymphomas Resemble lymphocytes with cleft nuclei
Lymphoma cells
81
Diagnostic procedures Seen in clusters with distinct nuclei and distinct cell walls
Ependymal, choroidal, spindleshaped cells
82
Metastatic carcinomas Primary CNS carcinoma Seen in clusters with fusing of cell borders and nuclei
Malignant cells
83
The most frequently performed chemical test on CSF
Csf proteins
84
Primary protein fraction (same as serum)
Albumin
85
Second most prevalent (distinctive to CSF)
Pre albumin
86
- Haptoglobin - Ceruloplasmin
Alpha globulins
87
- Transferrin (Major) - Tau – carbohydrate deficient variant of transferrin (unique to CSF)
Beta Globulin
88
- IgG (primarily) - IgA (small amount)
Gamma globulin
89
True or false “IgM, Fibrinogen, and Beta lipoprotein are normally found in CSF”
False because it is NOT SEEN IN CSF
90
- CSF leakage/trauma - Recent puncture - Rapid CSF production - Water intoxication
Decreased Results
91
- Meningitis - Hemorrhage - Primary CNS tumors - Multiple sclerosis - Guillain-Barré syndrome - Neurosyphilis - Polyneuritis - Cushing disease - Polyneuritis - Diabetes - Uremia - Connective tissue disease - Myxedema
Elevated Results in
92
• Proteins that were artificially introduced into the CSF by traumatic tap
Artificially induced proteins
93
more preferred, it can precipitate both albumin and globulin
. TCA (Trichloroacetic acid)
94
precipitates only albumin
SSA (Sulfosalicylic acid
95
Method whereas TCA AND SSA IS UNDER
Turbidimetry
96
Red + Protein = Blue (read photometrically
DYE BINDING a. CBB (Coomasie Brilliant Blue
97
for Globulin Rgt: Ammonium sulfate (+) turbidity or grayish white ring
Rose jones test
98
for Globulin Rgt: Ammonium sulfate (+) turbidity
Nonne apelt
99
for Globulin Rgt: Saturated phenol solution (+) turbidity or bluish white cloudiness
Pandy’s
100
Albumin-Globulin ratio (increased Globulin = infection)
Lange’s colloidal gold test
101
Reagent use for rose jones method
Ammonium sulfate
102
Reagent use for nonne apelt method
Ammonium sulfate
103
Reagent used in pandy’s method
Saturated phenol solution

CLINICAL MICROSCOPY (7 decks)

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