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Clinical Pathology > 15: CSF Analysis > Flashcards

15: CSF Analysis Flashcards

1
Q

What makes up the BBB?

A

Choroid plexus

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2
Q

What makes up the blood-CSF barrier?

A

Arachnoid

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3
Q

What makes up the CSF-brain barrier?

A

Ependyma and pia

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4
Q

Why is CSF low cellularity?

A

Plasma ultrafiltrate and membrane secretion

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5
Q

Why should you not collect CSF if increased intracranial pressure?

A

Causes brain herniation

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6
Q

What do you use for cell count and cytology?

A

EDTA

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7
Q

What do you use for protein albumin and serology?

A

Protein albumin and serology

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8
Q

What time after collection is CSF analysis best?

A

Within 30 mins

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9
Q

If keeping longer than 30 mins, what do you need to add to CSF?

A

Serum/albumin or cells were burst

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10
Q

Why do you need hemocytomer for CSF analysis?

A

Cell numbers too low for automated count

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11
Q

What stain do you use for CSF?

A

None

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12
Q

How do you concentrate cells from CSF?

A

Centrifuge, membrane filter selection, gravity sedimentation, then air dry and count

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13
Q

How do you measure CSF protein?

A

Urine dipstick

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14
Q

What does high CSF protein suggest?

A

Inflammation or tumour

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15
Q

WHat does an Ig index do?

A

Compares CSF to serum Ig numbers

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16
Q

What else do you measure in CSF?

A

Albumin, Igs, virus specific Ag, PCR

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17
Q

How much RBC and WBC should there be in CSF?

A

No RBC, very little WBC

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18
Q

How can RBCs enter the CSF?

A

Contamination, haemorrhage, iatrogenic

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19
Q

How can WBCs enter the CSF?

A

Inflammation or blood contamination

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20
Q

How do you correct for blood contamination in CSF?

A

Remove 1 WBC for every 500 RBC

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21
Q

What will be present in the CSF if haemorrhage is fresh?

A

Platelets

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22
Q

Which contrast agents do you use for CAT and MRI scans?

A

Iodine

23
Q

Why do you take cell count before injecting contrast agents?

A

Affects cells counts - neutrophils and macrophages will increase within 24 hours

24
Q

How long can cell changes last after contrast contrast agent use?

A

5-10 days

25
Q

Which cells are in normal CSF?

A

Mononuclear cells, choroid/ependymal cells, rare neutrophils and eosinophils

26
Q

What kind of macrophages are abnormal in CSF?

A

Foamy/reactive

27
Q

What colour can CSF be in bacterial meningitis?

A

Clear to turbid

28
Q

What parameters are increased in bacterial meningitis?

A

Cells, proteins, IgG index

29
Q

What % neutrophils do you see in bacterial meningitis?

A

over 75% degenerate

30
Q

What kind of animals especially get bacterial meningitis?

A

Young

31
Q

Which cells/parameters do you see increased in fungal meningitis?

A

Mixed cell pleocytosis, increased protein, sometimes eosinophils

32
Q

How common is fungal meningitis?

A

Rare

33
Q

What is correlation between CSF and blood eosinophils?

A

None

34
Q

What does eosinophils in CSF indicate?

A

The meningitis is fungal or immune mediated

35
Q

What are two forms of parasitic meningitis?

A

Common protozoal myelitis or verminous encephalomyelitis

36
Q

What species gets verminous encephalomyelitis?

A

Horse

37
Q

Which other parasites can cause meningitis?

A

Neospora or toxoplasma

38
Q

Which cell changes do you see in parasitic meningitis?

A

Mixed pleocytosis

39
Q

Which kind of meningoencephalomyelitis does parasitic meningitis cause?

A

Multifocal granulomatous

40
Q

What kind of inflammation do you see in viral disease?

A

Non-suppurative

41
Q

What cell/parameter changes do you see in viral disease?

A

Increased cell numbers, protein and IgG index, xanthochromia, mononuclear pleocytosis

42
Q

What cell/parameter changes does herpes give?

A

Increased IgG and IgA, increased pleocytotic lymphocytes

43
Q

What can CSF be like in rabies?

A

Normal

44
Q

Should you collect CSF if rabies is suspected?

A

No

45
Q

What colour is CSF in immune-mediated disease?

A

Clear to hazy

46
Q

What is a symptom of immune-mediated disease?

A

headache

47
Q

In which species is immune-mediated disease common?

A

Dogs

48
Q

Which cell/parameter changes do you see in immune-mediated disease?

A

Increased cells and proteins, pleocytosis of any cell types

49
Q

What may you see in CSF following intervertebral disc disease?

A

Cartilaginous emboli

50
Q

What can CSF be like in intervertebral disc disease?

A

Normal

51
Q

What are two different CSF changes you may see in IVDD?

A

Mild mononuclear pleocytosis, foamy macrophages, increased protein OR pleocytosis, normal protein, albumin and IgG

52
Q

What can CSF be like in neoplasia?

A

Normal, but commonly there is increased protein and albumin and pleocytosis with abnormal cells

53
Q

What is the usual neoplasia causing CSF changes?

A

Lymphoma, or meningioma or choroid plexus tumour

Clinical Pathology (30 decks)

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