CSF Protein Determination Flashcards by proustreview okay

2 types of method in Total Protein

Turbidimetric Method
Dye-Binding Method

How well did you know this?

Not at all

Perfectly

preferred method, precipitates both albumin and globulin

Trichloroacetic acid (3% TCA)

How well did you know this?

Not at all

Perfectly

precipitates albumin only
▪ To precipitate globulins, we add sodium sulfate

Sulfosalicylic acid (3% SSA)

How well did you know this?

Not at all

Perfectly

Dye-Binding Method:
Coomasie Brilliant Blue

protein binds to dye → dye turns red to blue (intense blue color = high protein present)

How well did you know this?

Not at all

Perfectly

assess the integrity of blood brain barrier

CSF/Serum Albumin index

How well did you know this?

Not at all

Perfectly

To compute:
o Normal value:
o Abnormal:

To compute: CSF Albumin (mg/dL) / Serum Albumin (g/dL)
o Normal value: <9 = intact BBB
o Abnormal: >9

How well did you know this?

Not at all

Perfectly

Slight impairment

9-14

How well did you know this?

Not at all

Perfectly

Moderate impairment

15-30

How well did you know this?

Not at all

Perfectly

Severe impairment

> 30

How well did you know this?

Not at all

Perfectly

Complete damage to BBB

100

How well did you know this?

Not at all

Perfectly

assess conditions the IgG production within the CNS (ie. Multiple sclerosis – increase plasma cells)

IgG Index

How well did you know this?

Not at all

Perfectly

IgG Index Value
Normal:
Abnormal:

Normal: <0.70
Abnormal: >0.70 (there’s an increase IgG production → Multiple sclerosis)

How well did you know this?

Not at all

Perfectly

Presence of 2 oligoclonal bands in CSF and not in serum

o Multiple sclerosis
o Neurosyphilis
o Encephalitis
o Neoplastic disorder
o Guillain-Barre syndrome

How well did you know this?

Not at all

Perfectly

Detection of oligoclonal bands in the gamma region → immunoglobulin production

CSF Electrophoresis

How well did you know this?

Not at all

Perfectly

Demyelinating disorder
Production of antibodies against myelin sheath

Multiple Sclerosis

How well did you know this?

Not at all

Perfectly

Multiple Sclerosis Findings:

o (+) anti-myelin sheath autoantibody
o (+) oligoclonal band in CSF but not in serum
o (+) Myelin Basic protein (MBP) – protein component of myelin sheath, monitors MS
o Increased IgG index

How well did you know this?

Not at all

Perfectly

CSF Glucose
Normal Value:

CSF Glucose
Normal Value:
* 60-70% of blood glucose (65%, 2/3) *accd. Strasinger
* 50-80 mg/dL *accd. Henry’s

How well did you know this?

Not at all

Perfectly

Measurement of glucose in CSF is always performed in conjunction with ____ glucose

blood

How well did you know this?

Not at all

Perfectly

Specimen for blood glucose should be collected _____ before spinal tap to allow equilibration of CSF and plasma glucose

2 hours

How well did you know this?

Not at all

Perfectly

Increased CSF Glucose

Diabetes mellitus

How well did you know this?

Not at all

Perfectly

Decreased CSF Glucose

Bacterial (Decreased CSF glucose), tubercular, and fungal meningitis
Alterations in glucose transport across BBB
Increased used of glucose by brain cells

How well did you know this?

Not at all

Perfectly

Normal CSF glucose

Viral meningitis

How well did you know this?

Not at all

Perfectly

waste product of glucose metabolism, inversely proportional with glucose

Lactate

How well did you know this?

Not at all

Perfectly

Increased CSF Lactate

Bacterial meningitis (bacteria utilized glucose → lactate >35mg/dL)
Tubercular and fungal meningitis (>25 mg/dL)
Hypoxia (tissues are destroyed causing release of lactate)

How well did you know this?

Not at all

Perfectly

CSF Lactate Normal values:

CSF Lactate Normal values: 10-24 mg/dL

Normal CSF lactate (<25 mg/dL)

Viral meningitis

A product of ammonia (NH3) and a-ketoglutarate in braincells

CSF Glutamine

Indirect test for the presence of excess NH3 in CSF

(High NH3 = High Glutamine)

CSF Glutamine Normal value:

CSF Glutamine Normal value: 8-18 mg/dL

Increased CSF Glutamine

* Disturbance of consciousness (>35 mg/dL) * Reye’s syndrome – 75% of patient with Reye’s syndrome have increased CSF glutamine

found in brain tissue

LD1 and 2

Lymphocytes

LD2 and 3

Neutrophils

LD4 and 5

Increased Creatinine Kinase

Stroke, multiple sclerosis, degenerative disorders, brain tumors, viral and bacterial meningitis, epileptic seizure

Increased Aspartate Aminotransferase

Intracerebral and subarachnoid hemorrhage, bacterial meningitis

bacterial meningitis → high neutrophils

5>4>3>2>1

If the distribution of LD enzyme in serum is seen on CSF (predominant LD2)

neurologic abnormality

Normal distribution of LD enzyme in serum

LD2>LD1>LD3>LD4>LD5

Normal distribution of LD enzyme in CSF

LD1>LD2>LD3>LD4>LD5

If the distribution of LD enzyme in CSF is seen on serum (predominant LD1) → flipped pattern

Acute Myocardial Infarction or Hemolytic anemia

Common agents: Group B streptococci

Neonates

Common agents: E. coli and other gram negative bacilli

Newborn to 1 month

Common agents: Neisseria meningitis

Children (>3 months )

Common agents: Streptococcus pneumoniae

Children (>3 months )

Common agents: Haemophilus influenzae

3 month to 18 years old

Common agents: Listeria monocytogenes

Newborns, Adults, alcoholics, immunocompromised

Laboratory Findings: * WBC – * Protein – * Glucose – * Lactate - * Others o (?) Gram stain o (?) Culture o (?) Limulus Lysate test

Laboratory Findings: * WBC – Increased neutrophils * Protein – Increased * Glucose – Decreased * Lactate - Increased * Others o (+) Gram stain o (+) Culture o (+) Limulus Lysate test

Detects gram negative bacterial endotoxin in body fluids and surgical instruments

Limulus Lysate test

Limulus Lysate test Reagent:

Blood of horseshoe crabs (Limulus polyhemus) Blue in color because of hemocyanin that contains copper

Endotoxin → Amoebocyte → release lysate →

Positive reaction: Clot formation

Blood also contains WBCS called

amoebocyte

Spirochetal Meningitis Neurosyphilis – caused by Neuroborreliosis – caused by

Neurosyphilis – caused by T. pallidum Neuroborreliosis – caused by B. burgdorfer

Spirochetal Meningitis Diagnosis:

Diagnosis: * Nontreponemal tests (VDRL, FTA-Abs) * ELISA * Western blot

recommended test of CDC for neurosyphilis

VDRL

Tubercular Meningitis Agent:

Tubercular Meningitis Agent: Mycobacterium tuberculosis

Tubercular Meningitis Laboratory findings: * WBC – * Protein – * Glucose – * Lactate – * (?) AFB stain * (?) Pellicle/web-like clot formation after stored/stand 12-24 hours in refrigerator

Tubercular Meningitis Laboratory findings: * WBC – Increased lymphocyte and monocyte * Protein – increased * Glucose – Decreased * Lactate – Increased * (+) AFB stain * (+) Pellicle/web-like clot formation after stored/stand 12-24 hours in refrigerator

Fungal Meningitis Agent:

Fungal Meningitis Agent: Cryptococcus neoformans *most frequently isolated pathogen in the CSF

Fungal Meningitis Laboratory findings: * WBC – * Protein – * Glucose – * Lactate – * (?) Gram stain – starburst pattern * (?) India Ink (Negative/Indirect stain – background only) * (?) Latex agglutinations test – detects the presence of antigen of C. neoformans

Fungal Meningitis Laboratory findings: * WBC – Increase lymphocyte and monocyte * Protein – Increased * Glucose – Decreased * Lactate – Increased * (+) Gram stain – starburst pattern * (+) India Ink (Negative/Indirect stain – background only) * (+) Latex agglutinations test – detects the presence of antigen of C. neoformans

Amoebic Meningoencephalitis Agents: * Naegleria fowleri – * Acanthamoeba species and Balamuthia mandrillaris –

Amoebic Meningoencephalitis Agents: * Naegleria fowleri – Primary amoebic meningoencephalitis * Acanthamoeba species and Balamuthia mandrillaris – causes Granulomatous amoebic encephalitis

Amoebic Meningoencephalitis Laboratory Findings: * WBC – * Protein – * Glucose - * Lactate – * (?) RBCs * (?) Acridine orange stain

Laboratory Findings: * WBC – Increased neutrophils * Protein – Increased * Glucose - Decreased * Lactate – Increased * (+) RBCs * (+) Acridine orange stain

agents can be identified with Wright-stained smear but macrophage can be mistakenly identified as protozoa

Acridine orange stain

Amoeba

brick red

Viral Meningitis Agents:

Viral Meningitis Agents: Enteroviruses (Coxsackievirus, Echovirus, Poliovirus), Arbovirus

WBC

bright green

Viral Meningitis Laboratory Findings: * WBC – * Protein - * Glucose - * Lactate - * RT-PCR

Viral Meningitis Laboratory Findings: * WBC – Increased lymphocytes * Protein - Increased * Glucose - Normal * Lactate - Normal * RT-PCR

gold standard for diagnosis of viral meningitis

RT-PCR

CSF Protein Determination Flashcards

(66 cards)