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F2: CSF (Part 2: Sample Collection) Flashcards

1
Q

SAMPLE COLLECTION

Volume of CSF fluid among three test tubes

A

3-6 mL serially collected

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2
Q

SAMPLE COLLECTION

How many tubes are used?

A

Three

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3
Q

SAMPLE COLLECTION

What section of the laboratory is Tube 1 from a CSF collection used for?

A

Tube 1: Chemistry and Serology

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4
Q

SAMPLE COLLECTION

What section of the laboratory is Tube 2 from a CSF collection used for?

A

Culture and Sensitivity

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5
Q

SAMPLE COLLECTION

What section of the laboratory is Tube 3 from a CSF collection used for?

A

Hematological studies

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6
Q

SAMPLE COLLECTION

T or F

The reason why hematology is done on last sample is to ensure sample is clean

A

T

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7
Q

SAMPLE COLLECTION

What appropriate preservation method for following tube:
Tube 1

Room Temp, Refrigerate, Freeze?

IF NOT PERFORMED IMMEDIATELY

A

Freeze

Tube 1: chemistry and serology

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8
Q

SAMPLE COLLECTION

What appropriate preservation method for following tube:
Tube 2

Room Temp, Refrigerate, Freeze?

IF NOT PERFORMED IMMEDIATELY

A

Room temp

Tube 2: culture and sensitivity

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9
Q

SAMPLE COLLECTION

What appropriate preservation method for following tube:
Tube 3

Room Temp, Refrigerate, Freeze?

IF NOT PERFORMED IMMEDIATELY

A

Refrigerate

Tube 3: hematology

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10
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Chemistry (glucose, protein)
Amount needed: 1mL

A

Tube 1

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11
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Gram’s stain, AFB stain, India ink preparation, Bacterial culture (blood agar, chocolate agar), Fungal culture (Sabouraud agar), Culture for TB
Amount needed: 2mL

A

Tube 2

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12
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Total cell count, Differential count
Amount needed: 1mL

A

Tube 3

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13
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Cytology, Immunology, Additional
Amount needed: 1mL

A

Tube 4

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14
Q

SAMPLE COLLECTION

T or F

if 4 tubes are collected in CSF, tube 1 and 2 have same procedure

A

T

Much harder to collect than the 3 tube sampling

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15
Q

SAMPLE COLLECTION

T or F

If only 1 tube is collected, cystology is the first tested

A

F (Microbiology is first)

Unless there is a special test request

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16
Q

SAMPLE COLLECTION

T or F

It is common to collect only 1 sample

A

T

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17
Q

SAMPLE COLLECTION

The longer sample is exposed, the more (blank) it will contain

A

The longer sample is exposed, the more bacteria it will contain

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18
Q

SAMPLE COLLECTION

T or F

It is not unusual for cell counts requested to be performed on both test tube 2 and 4 to check for cellular contamination by the puncture

A

F (t is not unusual for cell counts requested to be performed on both test tube 1 and 4 to check for cellular contamination by the puncture)

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19
Q

SAMPLE COLLECTION

Which tests are done in order?

Cell count, Cytology, Microbiology, Serology

A
  1. Microbiology
  2. Cytology
  3. Cell count
  4. Serology
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20
Q

CSF APPEARANCE

What CSF appearance based on description?

Clear, Watery

A

Normal

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21
Q

CSF APPEARANCE

What CSF appearance based on description?

  • due to an increase in Cells
    (RBC > 400 cell/cmm; WBC > 200 cell/cmm)
  • Protein (>150 mg/dL)
  • Bacteria
  • Fat
  • Debris
A

Hazy

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22
Q

CSF APPEARANCE

What CSF appearance based on description?

  • Supernatant that is pink, orange or yellow
  • Contains: hemoglobin, oxyhemoglobin, bilirubin, carotenoids, raframpin, serum bilirubin, increased protein concentration
  • Can manifest brown color due to melanin
A

Xanthrochromia

23
Q

CSF APPEARANCE

  • Indicates TB
  • After 24 hours of refrigeration, it floats on top of sample, indicates TB
  • When placed room temperature, this ndicates TB
24
Q

CSF APPEARANCE

What CSF appearance based on description?
* Increased fibrinogen
* Spinal block (Froin’s Syndrome), traumatic tap, TB

A

Clot formation

25
# CSF APPEARANCE **What RBC count** causes CSF to appear hazy?
> 400 cell/cmm
26
# CSF APPEARANCE **What WBC count** causes CSF to appear hazy?
> 200 cell/cmm
27
# CSF APPEARANCE What protein volume causes CSF to appear hazy?
>150mg/dL
28
# CSF APPEARANCE Most common form of xanthochromia? | XANTHOCHROMIA
Hemoglobin
29
# CSF APPEARANCE Color indicates heavy hemolysis | XANTHOCHROMIA
Orange
30
# CSF APPEARANCE Color indicates slight amount of oxyhemoglobin | XANTHOCHROMIA
Pink
31
# CSF APPEARANCE Color indicates conversion of oxyhemoglobiin to unconjugated bilirubin | XANTHOCHROMIA
Yellow
32
# CSF APPEARANCE Color indicates melanin (melanoma) | XANTHOCHROMIA
Brown
33
# CSF APPEARANCE T or F Pellicle formation after 24 hours of refrigeration and in room temperature both indicates TB | Pellicle
T
34
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: none Major significance: Normal ## Footnote TABLE
CRYSTAL CLEAR
35
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: WBCs Major significance: Meningitis
HAZY/ TURBID/ MILKY/ CLOUDY
36
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Microorganisms Major significance: Meningitis
HAZY/ TURBID/ MILKY/ CLOUDY
37
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Protein Major significance: Disorders affecting BBB Production of IgG within the CNS
HAZY/ TURBID/ MILKY/ CLOUDY, XANTOCHROMIC, CLOTTED, PELLICLE | pwede siya sa 4
38
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Radiographic contrast media Major significance: None
OILY
39
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: RBCs Major significance: Hemorrhage Traumatic tap
BLOODY
40
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Hemoglobin Major significance: Old hemorrhage, Lysed cells from traumatic tap
XANTOCHROMIC
41
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Bilirubin Major significance: RBC degradation, Elevated serum levels
XANTOCHROMIC
42
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Carotene Major significance: Increased serum levels
XANTOCHROMIC
43
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Clotting factors Major significance: Introduced by traumatic tap
CLOTTED
44
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE What appearance based on cause and major significance Cause: Clotting factors Major significance: Tubercular meningitis
PELLICLE
45
# CLINICAL SIGNIFICANCE OF CSF APPEARANCE Determine if Trauma or Subarachnoid Hemorrhage Clearing: (+) Xanthochromia: (-) Eryhtophagocytosis: (-) Hemosiderin: (-) D dimer: (-)
Trauma
46
Determine if Trauma or Subarachnoid Hemorrhage Clearing: (-) Xanthochromia: (+) Eryhtophagocytosis: (+) Hemosiderin: (+) D dimer: (+)
Subarachnoid Hemorrhage
47
T or F If CSF is very red viscous, it indicates SAH
F (indicates Traumatic lumbar puncture; Internal brain bleeding)
48
What are the (5) characteristics involved in differentiating trauma or blood (hemorrhage)
* Clearing * Xanthochromia * Eryhtrophagocytosis * Hemosiderin * D dimer
49
# (5) characteristics involved in differentiating trauma or blood **Positive or Negative result for clearing?** * First tube will have the most blood and 4th tube having least to no blood * Traumatic tap
Positive
50
# (5) characteristics involved in differentiating trauma or blood **Positive or Negative result for clearing?** * First tube is same color to the rest * SAH/Subarachnoid hemorrhage
Negative
51
# (5) characteristics involved in differentiating trauma or blood Characteristic that refers to breakdown of RBC releasing hemoglobin, bilirubin,....
Xanthochromia
52
# (5) characteristics involved in differentiating trauma or blood Characteristic that involves erythrophagia (macrophage eating RBCs)
Eryhtrophagocytosis
53
# (5) characteristics involved in differentiating trauma or blood * Characteristic that is involved with coagulation * Phagocytic system * Fibrinolytic system is activated and breaks down fibrin into different fragments, one of which is this
D dimer
54
This means macrophage eating rbc
Erythrophagia

AUBF (45 decks)

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