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MT6328 > 2S [LEC]: CSF > Flashcards

2S [LEC]: CSF Flashcards

1
Q

Structure where the CSF is produced

A

Choroid plexuses

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2
Q

Rate of CSF production in adults

A

20 mL/hour or 120-150 mL/day

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3
Q

The CSF flows through which structure?

A

Subarachnoid space

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4
Q

Where is the choroid plexus located?

A

Midbrain

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5
Q

From the choroid plexus, where will the formed CSF flow next?

A

3rd ventricle

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6
Q

After passing through the 3rd ventricle, the CSF will pass through ___

A

Aqueduct of Sylvius

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7
Q

Once the CSF passes through the aqueduct, it will then go through ___

A

4th ventricle

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8
Q

Two paths of CSF after passing through the 4th ventricle

A
  1. Entire length of spinal cord
  2. Meninges (Subarachnoid space)
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9
Q

Volume of CSF in adults

A

90-150 mL

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10
Q

Volume of CSF in children/neonates

A

10-60 mL

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11
Q

To maintain the CSF volume in adults and neonates, CSF is reabsorbed back into the blood capillaries in the ___ at equal rate to its production

A

Arachnoid granulations/ villae

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12
Q

Tight-fitting junctions of the endothelial cells that is a boundary between the plasma and central nervous system

A

Blood-Brain Barrier

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13
Q

A method of testing intracranial pressure to determine if the patient has subarachnoid block

A

Queckenstedt test

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14
Q

Condition of underdeveloped skull, leading to buildup of fluid or CSF in the ventricles, causing enlarged head

A

Hydrocephalus

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15
Q

Usual location of lumbar/spinal tap

A

Between 3rd and 4th lumbar vertebra

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16
Q

Usual location of lumbar/spinal tap in pediatric patients

A

Between 4th and 5th lumbar vertebra

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17
Q

A method of CSF collection where the infants are extracted through the open fontanels

A

Ventricular puncture

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18
Q

A method of CSF collection wherein the sub-occipital region or the back of the skull is the site of extraction

A

Cisternal puncture

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19
Q

A method of CSF collection wherein the side portion of the neck region is the site of extraction

A

Lateral cervical puncture

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20
Q

Usual volume of CSF collected in adult patients

A

20 mL

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21
Q

Intracranial pressure intended or required when extracted CSF in adults

A

90-100 mmHg

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22
Q

Laboratory section where tube 1 of CSF is used

A

Chemistry/ Serology

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23
Q

Laboratory section where tube 2 of CSF is used

A

Microbiology

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24
Q

Laboratory section where tube 3 of CSF is used

A

Hematology

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25
Q

Laboratory section where tube 4 of CSF is used

A

Microbiology/ Serology

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26
Q

The 1st tube in CSF collection should be stored ___ in terms of temperature

A

Frozen

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27
Q

The 2nd tube in CSF collection should be stored ___ in terms of temperature

A

at room temperature

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28
Q

The 3rd tube in CSF collection should be stored ___ in terms of temperature

A

Refrigerated for up to 4 hours

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29
Q

The 4th tube in CSF collection should be stored ___ in terms of temperature

A

at RT/ frozen depending on the test

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30
Q

Normal color of CSF

A

Crystal clear

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31
Q

How do you describe a CSF with color?

A

Xanthochromic

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32
Q

This phenomenon is observed by placing CSF in a clear test tube and observed at 90-degree angle, where it should sparkle against the light

A

Tyndall’s effect

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33
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Radiographic contrast media

A

Oily

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34
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Traumatic tap

A

Bloody

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35
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Subarachnoid hemorrhage

A

Bloody

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36
Q

T/F: Traumatic tap is considered pathogenic

A

False

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37
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

High protein and clotting factor levels

A

Clotted, Pellicle

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38
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Methemoglobin

A

Brown

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39
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Hematoma

A

Brown

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40
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Melanin

A

Brown

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41
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

High WBC content of 200-500 wbc/mm3

A

Hazy, Cloudy, Turbid, Milky

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42
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

High RBC content of >400 rbc/uL

A

Hazy, Cloudy, Turbid, Milky

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43
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Presence of microorganisms

A

Hazy, Cloudy, Turbid, Milky

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44
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Increased protein and lipid

A

Hazy, Cloudy, Turbid, Milky

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45
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Slight hemolysis

46
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Hemolysis

A

Red/ Orange

47
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Presence of bilirubin

48
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Rifampin therapy

49
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Melanin

A

Black/ Brown

50
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Carotene

51
Q

Usually indicates presence of RBC degradation products

A

Xanthochromia

52
Q

Other possible tests to determine whether the xanthochromia is caused by traumatic tap or intracranial hemorrhage

A

D-dimer test

53
Q

Common diluent in CSF if total cell count is to be done

54
Q

Common diluent in CSF if WBC count is to be done

A

3% Glacial Acetic Acid (methylene blue is added as a stain)

55
Q

CSF tube used in total cell count

56
Q

Normal WBC count in the CSF of adults

A

0-5 WBCs/uL

57
Q

Normal count of mononuclear cells in the CSF of adults

A

0-30 mononuclear cells/uL

58
Q

Number of cells counted in the differential count of CSF

59
Q

Method most commonly used in the concentration of CSF that will be used for differential count

A

Cytocentrifugation

60
Q

Ratio of lymphocyte to monocyte in the CSF of adults

61
Q

Ratio of lymphocyte to monocyte in the CSF of pediatric patients

62
Q

Recommended method for differential counting

A

Cytocentrifugation

63
Q

Reagent that increases the cell yield and decreases cell distortion in cytocentrifugation

A

30% albumin

64
Q

The presence of increased number of the normal cells

A

Pleocytosis

65
Q

If only one tube of CSF is available, in which laboratory section must it be first tested?

A

Microbiology

66
Q

Give the expected appearance of the CSF based on the cause of xantochromia:

Very slight amount of oxyhemoglobin

67
Q

Appearance of pellicle in the CSF if the patient has tubercular meningitis or the sample has been stored overnight in the refrigerator

A

Classic web-like pellicle

68
Q

The microscopic finding of macrophages containing ingested RBCs (erythrophagocytosis) or hemosiderin granules are indicative of what condition?

A

Intracranial hemorrhage

69
Q

The cell count that is routinely performed on CSF specimen

70
Q

In the CSF, the RBCs begin to lyse within how many hour/s?

71
Q

In the CSF, how many percent of leukocytes will disintegrate after 2 hours?

72
Q

T/F: Electronic cell counters have been used for performing CSF cell counts

A

False (not used due to high background counts and poor reproducibility of low counts)

73
Q

Neutrophil abnormality indicating degenerating cells

A

Neutrophil with pyknotic nuclei

74
Q

Cells seen in the CSF if a patient has viral, tubercular, fungal meningitis, and multiple sclerosis

A

Lymphocytes

75
Q

Reactive lymphocytes containing increased dark blue cytoplasm and clumped chromatin are frequently present in what type of infection?

A

Viral infection

76
Q

Which cell is seen to be increased in the CSF of patients with HIV infection and AIDS

A

Lymphocytes

77
Q

A moderately elevated WBC count with increased normal and reactive lymphocytes and plasma cells may indicate which condition/s?

A

Multiple sclerosis or other degenerative neurologic disorders

78
Q

Increased eosinophil in the CSF is associated with what type of infection/s?

A

Parasitic and fungal infections

79
Q

Cells that line the ventricles and neural canal

A

Ependymal cells

80
Q

Spindle-shaped cells represent lining cells from which structure?

81
Q

CSF is formed by the filtration of what substance?

82
Q

Most frequently performed chemical test on CSF

A

CSF protein

83
Q

Normal value of CSF protein

A

15-45 mg/dL

84
Q

The major beta globulin present in the CSF

A

Transferrin

85
Q

T/F: IgM is not normally found in the CSF

86
Q

Antibodies normally found in the CSF

A

IgG (large amt.), IgA (small amt.)

87
Q

Turbidimetric method of CSF protein determination that precipitates both albumin and globulin

A

Trichloroacetic acid (TCA)

88
Q

Turbidimetric method of CSF protein determination that precipitates albumin only

A

Sulfosalicylic acid (SSA)

89
Q

In SSA method of CSF protein determination, what reagent is added to precipitate globulins?

A

Sodium Sulfate (Na2SO4)

90
Q

The dye-binding method in CSF protein determination

A

Coomassie Brilliant Blue

91
Q

What is used to determine whether IgG is increased because it is being produced within the CNS or is elevated as a result of a defect in the BBB?

A

CFS/Serum Albumin Index

92
Q

A CFS/Serum Albumin Index of ___ represents an intact BBB

93
Q

Used to measure IgG synthesis within the CNS

A

CSF IgG index

94
Q

Method to detect oligoclonal bands

A

Electrophoresis

95
Q

In electrophoresis, these represent inflammation within the CNS

A

Oligoclonal bands

96
Q

Oligoclonal bands are located in what region of the protein electrophoresis

A

Gamma region

97
Q

If the oligoclonal band is present in the serum but absent in the CSF, this may be indicative of what condition?

A

Viral infection

98
Q

If the oligoclonal band is present in the serum and present in the CSF, this may be indicative of what condition

99
Q

In conditions like leukemia, encephalitis, lymphoma, neoplastic disorders, and Guillain-Barre syndrome, which oligoclonal band should be present?

100
Q

An indication of recent destruction of the myelin sheath that protects the axons of the neurons

A

Myelin basic protein (MBP)

101
Q

Approximately how many percent of CSF is glucose?

102
Q

If the plasma glucose is 100 mg/dL, what is the expected glucose level in the CSF?

103
Q

Identify the cause of meningitis based on the findings:

Markedly increased CSF glucose
Increased WBC count with large percentage of neutrophil

104
Q

Identify the cause of meningitis based on the findings:

Markedly decreased CSF glucose
Increased WBC count with large percentage of lymphocytes

A

Tubercular

105
Q

Identify the cause of meningitis based on the findings:

Normal CSF glucose
Increased WBC count with large percentage of lymphocytes

106
Q

Catalyzes the irreversible hydrolytic deamination of adenosine to produce inosine

A

Adenosine deaminase

107
Q

Been recommended in the diagnosis of pleural, peritoneal, and meningeal tuberculosis

A

Adenosine deaminase

108
Q

Stain used for Cryptococcus neoformans

109
Q

Very accurate test for the presence of endotoxin

A

Limulus Lysate Test

110
Q

Reagent used in Limulus Lysate Test

A

Horse-shoe crab (Limulus polyphemus) blood cells

111
Q

Incubation conditions used in Limulus Lysate Test

A

1 hour at 37C

MT6328 (16 decks)

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