AUBF Flashcards

1
Q

CSF is first recognized by ____ in ______

A

Catugno, 1764

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2
Q

Functions of CSF

A

Supply nutrient to nervous tissue

Remove metabolic waste

Cushion the brain & spinal cord against trauma

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3
Q

Normal adult volume of CSF

A

140-170

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4
Q

Normal volume of CSF neonates

A

10-60

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5
Q

Reduce the amount of CSF in the brain by draining it to the abdomen or directly into the chambers of the heart

A

Ventricular Shunt

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6
Q

helps reduce the pressure on the brain

A

Shunting of CSF

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7
Q

Hollow plastic tube that is placed in the ventricle of the brain

A

Shunt

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8
Q

Ventricular peritoneal shunt located from the

A

brain to abdomen

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9
Q

Ventricular atrial shunt is located from brain to _____

A

heart

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10
Q

Lines the brain and the spinal cord

Protective layer

A

Meninges

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11
Q

directly in contact with skull bones

outermost

A

dura mater

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12
Q

Web-like structure - middle layer of meninges

A

Arachnoid

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13
Q

space where CSF flows

A

Subarachnoid space

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14
Q

directly in contact with brain

Innermost

A

Pia Mater

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15
Q

Capillary networks that form the CSF

A

Choroid Plexus

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16
Q

light-fitting endothelial cells: separates blood tissues and brain tissue

A

Blood Brain Barrier

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17
Q

functional barrier; separates blood tissues and cerebrospinal fluid

A

Blood CSF Barrier

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18
Q

Normal volume production of CSF

A

20/mL per hour

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19
Q

Cells that help production of CSF

A

Ependymal cells

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20
Q

Specimen collection for CSF procedure:

A

Lumbar tap/Lumbar puncture between 3rd and 4th or 4th and 5th lumbar vertebrae

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21
Q

Opening pressure is measured _____ in aspiration of CSF

A

First

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22
Q

CSF collection tubes order of draw:

A

Tube 1: Chemistry or serology

Tube 2: Microbio

Tube 3: Hematology

*Tube 4 if possible: micro

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23
Q

Storage for CSF tube 1

A

Frozen (0 to frozen)

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24
Q
A
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25
Q

Storage for CSF tube 3

A

Refrigerated

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25
Q

Increase in blood CSF may indicate

A

traumatic tap

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25
Q

Storage for CSF tube 2

A

Room temperature (20 to 24 deg C)

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25
Q

Appearance of CSF: Cloudy, Milky, Turbid

A

Protein, Lipid, WBC

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26
Q

Appearance of CSF: Normal

A

Crystal Clear

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27
Q

Appearance of CSF: Bloody

A

Intracranial hemorrhage, Traumatic tap

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28
Q

Appearance of CSF: Xanthochromic

A

Hemoglobin, Bilirubin, Carotene, ↑Protein, Melanin

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29
Q

Appearance of CSF: Pink

A

Oxyhemoglobin

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30
Q

Appearance of CSF: Yellow

A

High bilirubin content

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31
Q

Appearance of CSF: Orange

A

combination of oxyhemoglobin and bilirubin

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32
Q

Appearance of CSF: Clotted

A

Clotting factors introduced by traumatic tap

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33
Q

Appearance of CSF: Pellicle

A

Tubercular meningitis, seen after overnight of refrigeration

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34
Q

Appearance of CSF: Oily

A

Radiographic Contrast Media

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35
Q

Traumatic tap indication:

A

Uneven blood distribution

Clot formation

Supernatant: Not Xanthochromic

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36
Q

Intracranial Hemorrhage indication:

A

Even distribution of blood

No clot formation
Supernatant: Xanthochromic

Additional: Erythrophagocytosis: microscopically- macrophages with ingested RBCs

(+): D-Dimer

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37
Q

Cell count that is routinely performed on CSF

A

Leukocyte/wbc count

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38
Q

When is Leukocyte/WBC count performed on CSF

A

Traumatic tap

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39
Q

_______ are usually determined only when a traumatic tap has occurred and a correction for leukocytes or protein is desired

A

RBC counts

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40
Q

RBC disintegrates within

A

1 hour

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41
Q

CSF: ↓ by 40% in WBC disintegrates after

A

2 hours

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42
Q

increase in the number of cells in CSF

A

Pleocytosis

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43
Q

Normal values of WBC in ADULT CSF

A

0-5 cells/uL

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44
Q

Predominant cells in ADULT CSF

A

lympthocytes

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45
Q

Predominant cells in neotates CSF

A

monocytes

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46
Q

Normal values of WBC in neonates

A

0-30 cells/uL

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47
Q

Manual method for counting cells in CSF

A

Neubauer Counting Chamber

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48
Q

Counting calls of CSF

A

4 larger corner squares and large center squares

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49
Q

Area of large square neubauer chamber:

A

1 mm^2

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50
Q

Total Cell Count:

A

Cell counted x Dilution / Area x Depth

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51
Q

Needed for the correction of WBC Count & CSF Protein Results

A

RBC Count

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52
Q

Diluent for CSF RBC count

A

NSS

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53
Q

Diluent for WBC count CSF:

A

3% Glacial Acetic Acid

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54
Q

Can be added to diluting fluid of WBC count

A

Methylene Blue

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55
Q

Correction for Contamination of CSF

A

WBC added = WBC Blood x RBC CSF
RBC Blood

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56
Q

Subtract 1 WBC for every ____ RBCs present in the CSF

A

700

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57
Q

CSF Electrophoresis primary purpose:

A

detection of OLIGOCLONAL bands

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58
Q

Can determine if a fluid is indeed CSF

A

CSF Electrophoresis

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59
Q

Most Common Method of CSF electrophoresis

A

Agarose Gel Electrophoresis

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60
Q

Indicates immunoglobulin production

A

Oligoclonal Bands

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61
Q

Oligoclonal bands are located in the ____ region of the protein electrophoresis

A

GAMMA

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62
Q

Oligoclonal bands in CSF only

A

Multiple Sclerosis; Neurologic Disorder, Encephalitis, Neurosyphilis, Guillain Barre Syndrome

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63
Q

Oligoclonal Bands in CSF and Serum

A

HIV infection

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64
Q

Oligoclonal bands in Serum only; CSF banding because of BBB leakage or blood contamination during lumbar tap.

A

Leukemia, Lymphoma, Viral Infections

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65
Q

Indicates recent destruction of the myelin sheath that protects the axon of the neurons

A

Myelin Basic Protein

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66
Q

Myelin Basic Protein can be used to monitor ________-

A

Multiple sclerosis

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67
Q

Myelin Basic Protein theorized that the inflammatory response in multiple sclerosis is triggered by ________

A

molecular mimicry

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68
Q

Normal volume of CSF Glucose:

A

60-70% of plasma glucose

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69
Q

Blood glucose should be drawn ________ prior to lumbar tap (CSF)

A

2 hours

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70
Q

Can be used to determine the cause of meningitis

A

CSF glucose

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71
Q

Increased levels of CSF glucose is always a result of

A

plasma elevations

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72
Q

Decreased levels of CSF glucose

A

caused by alteration in transport in BBB ↑ used by braincells

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73
Q

Destruction of tissue within the CNS due to hypoxia causes the production of

A

Increased CSF lactate

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74
Q

Aid in the diagnosis and management of meningitis cases

A

CSF Lactate

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75
Q

Elevation of CSF lactate is consistent with:

A

Bacterial, Tubercular, and Fungal Meningitis

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76
Q

Level of CSF lactate when treatment is successful

A

declines rapidly

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77
Q

Used to monitor severe head injuries

A

CSF Lactate

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78
Q

Falsely elevated CSF lactate is due to

A

xanthochromic or hemolyzed samples

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79
Q

Preferred over direct measurement of CSF ammonia

A

CSF Glutamine

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80
Q

CSF Glutamine normal values

A

8-18 mg/dL

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81
Q

Elevated levels of CSF glutamine is associated with

A

liver disorder that result in blood and CSF ammonia

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82
Q

CSF glutamine is produced from ____ and ____ by the brain cell

A

Ammonia & α-ketoglutarate

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83
Q

______ is an indirect test for the presence of excess ammonia in CSF

A

Glutamine

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84
Q

Frequently requested procedure for patients with coma of unknown origin

A

CSF Glutamine

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85
Q

CSF glutamine is ↑ in approximately 75% of children with

A

Reye Syndrome

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86
Q

Bacterial meningitis is recovered after ____

A

24 hours

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87
Q

Tubercular meningitis is recovered after ___

A

6 weeks

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88
Q

CSF centrifuged at _____ for ___ minutes

A

1500 g for 15 minutes

89
Q

used for slides and culture of CSF

A

sediments

90
Q

Confirmatory rather than Diagnostic Procedure

A

CSF Culture

91
Q

Microbiology laboratory test for a preliminary diagnosis of CSF

A

Gram Stain
Acid Fast Stain
India Ink Preparation
Latex Agglutination Test

92
Q

Predominant cell in bacterial meningitis

A

Neutrophil

93
Q

Predominant cell in Viral meningitis

A

Lymphocyte

94
Q

Predominant cell in Tubercular

A

Lymphocyte, Monocyte

95
Q

Predominant cell in Fungal meningitis (LEM)

A

Lymphocytes, Monocytes, Eosinophil

96
Q

↑ Protein: Marked
Glucose: Markedly ↓

A

Bacterial meningitis

97
Q

Increased protein: Moderate
Glucose: Normal

A

Viral meningitis

98
Q

↑ Protein: moderate to marked
Glucose: decreased

A

Tubercular meningitis

99
Q

↑ Protein: moderate to marked
Glucose: normal to ↓

A

Fungal meningitis

100
Q

Lactate: > 35 mg/dL

A

Bacterial meningitis

101
Q

Lactate: normal

A

Viral meningitis

102
Q

Lactate: >25 mg/dL

A

Tubercular or Fungal meningitis

103
Q

Routinely performed on CSF from all suspected cases of meningitis

A

Gram stain

104
Q

CSF specimen uses _______ that provides highly concentrated specimens

A

Cytocentrifuge

105
Q

Common causes of bacterial meningitis for infants

A

S.agalactiae

E. Coli K1 strain,

L. monocytogenes

106
Q

Common causes of bacterial meningitis for adolescent/adults

A

N. meningitides
H. Influenza type B,
S. pneumoniae

107
Q

Common causes of bacterial meningitis for elderly

A

S. pneumoniae
N. Meningitides
L. monocytogenes

108
Q

one the frequently occuring complications of AIDS

A

Cryptococcal meningitis

109
Q

Cryptococcus neoformans india ink result:

A

Thick encapsulated organism

110
Q

Cryptococcus neoformans gram stain result:

A

Starburst pattern (may be seen more often than a positive india ink)

111
Q

Cryptococcus neoformans is associated with increased _______

A

eosinophils

112
Q

Diagnosis of meningitis caused by Gram negative bacteria

A

Limulus lysate test

113
Q

reacts with bacterial endotoxin of Gram (-) bacteria

A

Limulus amebocyte

114
Q

Reagent for limulus lysate test

A

blood cells of horseshoe crab (limulus polyphemus)

115
Q

(+) Result of limulus lysate test

A

Coagulation within 1 hour of incubation at 37 deg C

116
Q

Rapid Test for CSF:

A

Latex

ELISA method

Bacterial Antigen Test

117
Q

Performed to detect the presence of neurosyphilis

A

Serologic Testing

118
Q

Procedure recommended by the CDC to diagnose Neurosyphillis

A

Venereal Disease Research Laboratories (VDRL)

119
Q

More sensitive than VDRL

A

Fluorescent Treponemal Antibody-Absroption (FTA-ABS) Test

120
Q

Prevent contamination with blood because the FTA-ABS remains —— in the serum of treated cases of syphilis (Treponema pallidum)

A

positive

121
Q

Semen - composed of four fractions that are contributed by the: (TSPB)

A

Testes (Epididymis)

Seminal vesicles

Prostate gland

Bulbourethral gland

122
Q

paired glands in the scrotum that contain the seminiferous tubules

A

Testes

123
Q

production of spermatozoa takes place

A

seminiferous tubules

124
Q

storage of sperm

A

epididymis

125
Q

Seminal Vesicles produces most fluid present in the semen (percentage)

A

60-70%

126
Q

Seminal fluid contains high concentration of

A

fructose

127
Q

use by sperm for energy needed for motility

A

fructose

128
Q

responsible for gray appearance color of the sperm

A

flavin

129
Q

aids in propelling the sperm through the urethra by contractions during ejaculation

A

Prostate Gland

130
Q

percentage of acidic fluid produced by the prostate gland

A

20-30%

131
Q

Milky acidic fluid from prostate gland contains:

It is also responsible for both coagulation and liquefaction of semen following ejaculation

A

Acid phosphatase
Citric acid
Zinc
Proteolytic enzymes

132
Q

Bulbourethral gland contributes about ___ of the fluid volume

A

5%

133
Q

Sexual abstinence for semen analysis:

A

at least 2 days but nor more than 7 days

134
Q

Prolong abstinence

A

Higher volume and decreased motility

135
Q

Fertility testing according to WHO:

2 or 3 sample be collected not less than ___ or more than ___

A

7 days or more than 3 weeks

136
Q

Abnormal semen analysis result according to WHO

A

2 abnormal samples are considered significant

137
Q

Specimen for semen analysis should be kept at _____ temp and delivered within ____

A

room temperature
(20-24) within 1 hour

138
Q

Specimen awaiting for semen analysis should be kept

A

37 deg C

139
Q

Container needed for semen analysis

A

only non-lubricant-containing rubber or polyurethane condoms should be used

140
Q

Ordinary condom contains:

A

spermicides

141
Q

Reference value for semen analysis: Volume

A

2-5 mL

142
Q

Reference value for semen analysis: Viscosity

A

pours in droplets

143
Q

Reference value for semen analysis: pH

A

7.2 - 8.0

144
Q

Reference value for semen analysis: Sperm concentration

A

> 20 million/mL

145
Q

Reference value for semen analysis: Sperm count

A

> 40 million/ejaculate

146
Q

Reference value for semen analysis: motility

A

> 50% within 1 hour

147
Q

Reference value for semen analysis: quality

A

> 2.0 or a,b,c

148
Q

Reference value for semen analysis: morphology (strict criteria)

A

> 14% normal forms

149
Q

Reference value for semen analysis: morphology routine

A

> 30% normal forms

150
Q

Reference value for semen analysis: round cells

A

<1.0 million/mL

151
Q

Sperm Motility Grading: 4.0

A

Rapid, straight-line motility

152
Q

Sperm Motility Grading: 3.0

A

Slower speed, some lateral movement

153
Q

Sperm Motility Grading: 2.0

A

Slow forward progression, noticeable lateral movement

154
Q

Sperm Motility Grading: 1.0

A

no forward progression

155
Q

Sperm Motility Grading: 0

A

no movement

156
Q

Alternative sperm motility grading criteria:

Progressive Motility

A

Sperm moving linearly or in a large circle

157
Q

Alternative sperm motility grading criteria:

Non-progressive (NP)

A

Sperm moving with an absence of progression

158
Q

Alternative sperm motility grading criteria:

Immotility

A

No movement

159
Q

Normal semen appearance:

A

gray-white color, appears translucent, has characteristic of musty odor/bleach like odor; opacity (due to flavin)

160
Q

Semen appearing almost clear

A

Low sperm concentration

161
Q

Increase turbidity of semen indicates

A

presence of WBCs and infection within the reproductive tract

162
Q

Useful in differentiating presence of WBC compared to immature sperm (spermatids)

A

Leukocyte esterase

163
Q

Leukocyte esterase test positive result indicates

A

WBC

164
Q

Leukocyte Esterase negative result

A

spermatids

165
Q

Red coloration of semen is due to

A

presence of RBC

166
Q

Yellow coloration of semen

A

urine contamination (toxic to sperm), prolonged abstinence, and medication

167
Q

Fresh semen specimen is clotted and liquefy within ______ after collection

A

30 to 60 minutes

168
Q

Failure of liquefaction within 60 minutes: caused by deficiency in

A

prostatic enzymes

169
Q

If after 2 hours the specimen has not liquefied: an equal volume of physiologic ______ may be added to induce liquefaction and allow the rest of the analysis to be performed

A

Dulbecco’s phosphate-buffered saline or proteolytic enzymes (alphachymotrypsin or bromelain)

170
Q

Normal semen volume

A

2-5 mL

171
Q

Increased semen volume is due to

A

prolonged abstinence

172
Q

Decreased volume of semen is associated with

A

infertility

incomplete specimen collection must be considered

173
Q

Refers to the consistency of the fluid and may be related to specimen liquefaction

A

Viscosity

174
Q

Viscosity: Incomplete liquefied specimen

A

clumped and highly viscous

175
Q

Normal viscosity of semen:

A

easily drawn into a pipette and form small discrete droplets, do not appear clumped or stingy

176
Q

Droplets that form longer than 2cm of semen

A

highly viscous, abnormal (problem with enzyme)

177
Q

Normal pH of semen

A

7.2 to 8.0 (alkaline)

178
Q

Increased pH of semen indicates:

A

infection within the reproductive tract

179
Q

Decreased pH of semen:

A

increased prostatic fluid, ejaculatory duct obstruction, poorly developed seminal vesicles

180
Q

Normal Sperm Concentration

A

greater than 20- 250 million sperm per milliliter

181
Q

Borderline Sperm Concentration

A

10-20 million sperm per milliliter

182
Q

Computation for sperm count:

A

Sperm count: Sperm concentration x Specimen Volume

183
Q

Dilution of semen to diluting fluid:

A

Dilution: 1:20

184
Q

Sperm should be capable of ______, progressive motility

A

forward

185
Q

Motility should be assessed within

A

1 hour of collection

186
Q

Head of sperm morphology:

A

oval shape approximately 5 um long and 3um wide

187
Q

enzyme containing critical to ovum penetration;

(encompasses half of the head and cover approximately two-thirds of the sperm nucleus)

A

acrosomal cap

188
Q

Enzyme present in acrosomal cap:

A

Hyaluronidase & Acrosin

189
Q

attaches the head to the tail and midpiece

A

neckpiece

190
Q

approximately 7 um long, thickest part of the tail (surrounded by mitochondrial sheath that produces energy required by tail for motility)

A

Midpiece

191
Q

inherited only from the mother. Used for patient identification.

A

mtDNA

192
Q

Tail - approximately ___ long

A

45 um

193
Q

Problem with sperm tail

A

decreased motility

194
Q

Problem with sperm head

A

ovum penetration

195
Q

stain for sperm vitality by counting the number of dead cells in 100 sperm using bright field or phase contrast microscopy

A

Eosin nigrosin

196
Q

Normal sperm concentration with markedly decreased motility

A

decreased sperm vitality

197
Q

remains bluish white in eosin nigrosin stain for sperm

A

living cells

198
Q

stain red against purple background in eosin nigrosin stain for sperm

A

dead cells

199
Q

Normal Vitality for sperm

A

50% or more living cells

200
Q

Normal seminal fluid fructose

A

≥13 umol per ejaculate

201
Q

Low seminal fluid fructose indicates:

A

abnormalities of the seminal vesicle

bilateral congenital absence of the vas deferens

obstruction of the ejaculatory duct

partial retrograde ejaculation and androgen deficiency

202
Q

Seminal fluid fructose should be tested within ___ or ___ to prevent fructolysis

A

2 hours or frozen to prevent fructolysis

203
Q

present in both men and women

A

Anti-sperm antibodies

204
Q

anti-sperm antibodies can be detected through:

A

semen, cervical mucosa or serum

205
Q

detects the presence of IgG antibodies of anti-sperm antibodies

A

Mixed agglutination reaction test

206
Q

more specific procedure that detects IgG, IgM, and IgA antibodies of anti-sperm antibodies

A

Immunobead test

207
Q

(semen analysis) Microbial and Chemical Testing: indication of infection is detected through the presence of

A

> 1.0 million/mL (leukocytes)

208
Q

Microbial testing for semen analysis involves routine aerobic and anaerobic cultures and tests that usually detects:

A

chlamydia tracomatis
mycoplasma hominis
and ureaplasma urealyticum

209
Q

Reference value of chemical testing for semen analysis:

Neutral-a-glucosidase

A

> =20 uml/ejaculate

210
Q

Reference value of chemical testing for semen analysis: Zinc

A

> = 2.4 umol/ejaculate

211
Q

Reference value of chemical testing for semen analysis: Citric acid

A

> = 52 umol/ejaculate

212
Q

Reference value of chemical testing for semen analysis:

Acid ejaculate

Glutamyl Transpeptidase

A

≥ 200 units/ ejaculate

213
Q

Reference value of chemical testing for semen analysis:

Fructose

A

≥ 13 umol/ejaculate

214
Q

Indication (↓ levels) of chemical testing for semen analysis:

Neutral-a-glucosidase

Glycerophosphocoline

L-carnitine

A

Disorder of epididymis

215
Q

Indication (↓ levels) of chemical testing for semen analysis:

Zinc

Citric Acid

Acid phosphatase

Glutamyl transpeptidase

A

Lack of prostatic fluid

216
Q

Indication (↓ levels) of chemical testing for semen analysis:

Fructose

A

lack of seminal fluid

217
Q

Cutting of vas deferens

A

vasectomy

218
Q

Post Vasectomy Semen Analysis detects:

A

presence or absence of spermatozoa

219
Q

Sperm function test

A

Hamster Egg Penetration

Cervical Mucus Penetration

Hypo-Osmotic Swelling

In Vitro Acrosome Reaction

220
Q

Sperm are incubated with species nonspecific hamster eggs and penetration is observed microscopically

A

Hamster egg penetration

221
Q

Observation of sperm’s ability to penetrate partner’s midcycle cervical mucus

A

Cervical Mucus Penetration

222
Q

Sperm exposed to low sodium concentrations are evaluated for membrane integrity and sperm viability

A

Hypo-osmotic Swelling

223
Q

Hypoosmotic swelling indication of normal cell morphology

A

Swelling = normal

224
Q

Evaluation of Acrosomoe to produce enzymes essential for ovum penetration

A

In Vitro Acrosome Reaction