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Chem I > Body Fluid > Flashcards

Body Fluid Flashcards

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1
Q

CSF

A

Liquid that surrounds the brain and spinal cord and flows in the subarachnoid space

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2
Q

Functions of CSF

A

1) Physical support and protection
2) Provision of controlled chemical environment to supply nutrients and removal of wastes
3) Intracerebral and extracerebral transport

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3
Q

Lumbar puncture is performed where?

A

L3/L4 and lower

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4
Q

CSF Tube order

A

Tube 1: Chemistry and serology
Tube 2: Microbiology
Tube 3: Hematology
Tube 4: extra or send out tests/cytology

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5
Q

Why do we collect a lumbar puncture and perform an investigation of CSF?

A
  • for suspected CNS infection
  • Demylinating disease
  • Malignancy
  • hemorrhage into CNS
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6
Q

Appearance of CSF

A

Color: colorless
Clarity: clear

NOTE

Cloudy: cellular particles and debris
Yellow: xanthochromia (blood is gone—older bleed)
Brown: old blood
Red: fresh blood
Traumatic tap gets clearer as tubes progress

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7
Q

What are the 4 main biochemical markers in CSF?

A
  • Glucose
  • Protein (total and specific)
  • Lactate
  • Glutamine
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8
Q

When should you collect a blood glucose when comparing glucose levels in CSF?

A

2-4 hours prior

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9
Q

T/F:

Increased CSF glucose levels are clinically significant

A

FALSE: it just confirms that there is hyperglycemia

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10
Q

What are the causes for decreased CSF glucose levels (hypoglycorrhachia)?

A
  • Disorder in carrier-mediated transport of glucose into CSF
  • Active metabolism of glucose by cells or organisms
  • Increased metabolism by the CNS
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11
Q

___ in the CSF reflect selective ultrafiltration of the CSF BBB

A

Protein levels

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12
Q

T/F:

All proteins found in blood is found in CSF

A

TRUE, just in much lower levels

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13
Q

Total protein in CSF is ___-___% of plasma

A

0.5-1%

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14
Q

What are causes of decreased protein levels in CSF?

A
  • Decreased dialysis of proteins from the plasma
  • Increased protein loss (removal of excessive volumes of CSF)
  • Leakage from a tear in the dura, CSF otorrhea (ear), or CSF rinorrhea (nose)
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15
Q

What are causes of increased levels of protein in CSF?

A
  • Lysis of contaminant blood from traumatic tap
  • Increased permeability of the epithelial membrane
  • Increased production by CNS tissue
  • Obstruction
  • BBB becomes more permeable from bacterial or fungal infections
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16
Q

Albumin MUST cross the BBB because it is produced by the ___

A

Liver

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17
Q

What does a CSF serum albumin index of <9 indicate?

A

That the BBB is intact

18
Q

What is the CSF serum albumin index equation?

A

(CSF albumin (mg/dL))/(Serum albumin (mg/dL))

19
Q

T/F: IgG must cross the BBB to enter the CSF

A

FALSE: IgG can be produced by local synthesis from plasma cells within the CSF

20
Q

What is the normal value of CSF IgG index?

A

<0.73

21
Q

What does the IgG index aid in?

A
  • Aids in the diagnosing demyelinating diseases - MS, SSPE
  • MS is most common inflammatory demyelinating disease
22
Q

What is the significance of seeing an oligoclonal band pattern in a CSF ELP

A

The presence of an oligoclonal band pattern supersede the report of normal protein levels and there is a cause for concern in the serum doesn’t show the same pattern.

Oligoclonal banding in the gamma region, involving a small number of IgG clones, are usually seen with MS or SSPE

23
Q

What does testing for lactate tell us?

A

It is an indicator of anaerobic metabolism. Time critical and ideally collected in a NaFl tube

24
Q

What does testing for Glutamine tell us?

A

Glutamine levels correlate to NH3 in the CNS and is elevated in patients with hepatic encephalopathy

25
Q

What are serous fluids?

A

The fluid between two serous membranes:

pleural, pericardial, peritoneal

26
Q

What is effusion?

A

The accumulation of serous fluid

27
Q

What is transudate?

A

when there is a systemic disorder that disrupts fluid filtration, fluid reabsorption, or both

28
Q

What is exudate?

A

Occurs during an inflammatory process that results in damage to blood vessel walls, body cavity membrane, or decreased re absorption by the lymphatic system.

29
Q

What is thoracentesis?

A

The fluid that is removed when retrieving pleural fluid

30
Q

When would retrieval of pericardial fluid be necessary?

A

Necessary if cultures are needed for infection or cytology for suspected malignancy

31
Q

What is ascites?

A

Excess peritoneal fluid. Indicates disease

32
Q

What is amniotic fluid?

A

Fluid that surrounds the fetus during gestation. There is ablance between production, clearance, fetal urination, and swallowing

33
Q

What is amniocentesis?

A

An amniotic sac puncture to retrieve amniotic fluid. The process is ultrasound guided.

34
Q

Why is amniotic fluid analyzed?

A

To look for congenital diseases, neural tube defects, hemolytic disease of the fetus, fetal pulmonary development

35
Q

What are the two reasons for the development of hemolytic desease of the fetus and newborn?

A
  • incompatibility between maternal and fetal blood
  • maternal ab to fetal RBCs that cause a hemolytic reaction (bilirubin may appear in AF)
36
Q

Neural tube defects are screened by looking for ___

A

AFP

37
Q

What is the main reason to test amniotic fluid?

A

To asses fetal lung maturity and determine if there is sufficient phospholipids reflected in the AF to prevent alveolar collapse if the fetus was delivered.

38
Q

What is sweat in babies goof to test for?

A

ONLY for cystic fibrosis, an autosomal recessive diroder that affects exocrine glands and causes electrolyte and mucus secretion abnormalities

39
Q

What is the function of synovial fluid?

A

Lubricant for joints and transport medium for delivery of nutrients and removal of cell wastes

40
Q

What needs to be done to synovial fluid before it is tested on?

A

Add hyaluronidase to break down the mucoprotein matrix

41
Q

What tests are performed on synovial fluid?

A

TP (inflammation), glucose (infectious disorders dec glucose), uric acid (gout), Lactic Acid (septic arthritis)

42
Q

What are the classifications of synovial fluid?

A

Normal

I (noninflammatory)

II (inflammatory)

III (septic)

IV (crystal induced)

V (hemorrahagic)

Chem I (14 decks)

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