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Hematology II > Body Fluids > Flashcards

Body Fluids Flashcards

1
Q

What three membranes cover the brain + spinal cord (out to in?)

A

Duramater
Arachnoid Mater
Pia Mater

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2
Q

Where is CSF found?

A

In the subarachnoid space, between arachnoid and pia mater

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3
Q

How is CSF formed? (Roughly…what cell and what kind of transport?)

A

formed by choroid plexus cells which turn plasma into CSF; active transport between blood + CSF (active secretion)

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4
Q

What are the volume ranges of CSF for Adults and neonates?

A

A: 90 - 150 mL
N: 10 - 60 mL

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5
Q

True or false: CSF is an ultrafiltrate

A

False, it is not an ultrafiltrate

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6
Q

True or false: CSF is reabsorbed into the blood in arachnoid granulations via one way valves

A

True

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7
Q

Compared to blood, what is the composition of CSF?

A
  • Less glucose, bicarb/urea
  • more Na+, Mg+ and Cl-
  • very little protein
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8
Q

What controls substance presence in CSF?

A

The blood brain barrier

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9
Q

Are Abx (antibiotics) and medicines included in the blood brain barrier?

A

No they are excluded

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10
Q

What are some functions of the blood brain barrier?

A
  • protecting the brain/spinal cord from traumatic pressure
  • maintain chemical environment
  • remove waste
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11
Q

What is the purpose of CSF examination?

A

Examine if you suspect infections/hemorrhage/tumor and can treat intracranial hypertension

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12
Q

What is the process of CSF collection called?

A

Lumbar puncture, between L3-L4 vertebrae

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13
Q

True or false: CSF collection usually has passive dripping, higher pressures mean faster outputs of CSF.

A

True

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14
Q

how early should you perform a cell count/slide after collection of CSF?

A

30 minutes of receipt

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15
Q

True or false: for CSF, you can perform cell counts with tubes for chemistry and hematology

A

True

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16
Q

True or false: You can only perform a diff on a CSF sample tube for hematology

A

True, it has the most accurate counts since it is the least contaminated

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17
Q

If not possible to test immediately after CSF collection, how would you store:
Hem tubes?
Chem/serology?
Micro?
Extra fluids?

A

Hem - refrigerate
Chem - frozen
Micro - RT
Extras - frozen

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18
Q

What do the progression of tubes look like in a Traumatic Tap?

A

Subsequent tubes become more clear although some blood is present

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19
Q

What do the progression of tubes look like in a Hemorrhage?

A

all tubes are equally bloody :( ew

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20
Q

Xanthochromic coloring is seen in which CSF sample tap? (traumatic or hemorrhage?)

A

Hemorrhage, it is caused by bilirubin

21
Q

True or false: Traumatic Tap does not have a clot

A

False: traumatic taps have clots; hemorrhages do not since the clot already happened

22
Q

What is erythrophagia? what does it relate to?

A

Red cells being eaten by macrophages (long live) it is related to hemorrhages

23
Q

True or false: Hemorrhages are positive for D-Dimers

A

True

24
Q

Explain the difference in appearance of low turbidity and high turbidity in CSF

A

Low turbidity is clear
high turbidity is colored (color is reported by chemistry)

25
Q

What is the reference range of protein in CSF (chemistry)?

A

15 - 45 mg/dL

26
Q

What is the equation for corrected CSF protein?

A

Correct CSF = Measured CSF protein - CSF RBC/1200

(every 1200 rbc increases the protein)

27
Q

Causes of CSF protein is >65 ?

A

Damage to blood brain barrier (meningitis/hemorrhage)
Ig production
decreased clearance
degeneration of tissues

28
Q

What causes a decrease in CSF protein?

A

leakage

29
Q

Low levels of Glucose in CSF is caused by what? high levels?

A

low - meningitis or subarachnoid hemorrhage
High levels - traumatic tap, diabetic coma

30
Q

True or false: Myelin basic protein is used to monitor MS

A

True

31
Q

What does IEF do?

A

Detects bands (Igs) and indicates if there is inflammation (oligoclonal)

32
Q

What do you use to dilute a sample with many cells in a CSF collection?

A

Dilute w/ saline

33
Q

In a CSF sample with many cells, what solution would you use to lyse RBCs? what is it composed of?

A

Turk solution, made of glacial acetic acid or methylene blue

34
Q

How many primary squares are counted for CSF cell counts?

A

9 primary squares (count entire chamber unless count is very high)

35
Q

What is the WBC reference range for CSF cell counts?

A

WBC (all less than or equal to)
Adults <5 / mm3
Child <10 / mm3
Neonate <30 /mm3

36
Q

What is the RBC ref range for CSF cell counts?

A

less than or equal to RBC <5 /mm3

37
Q

True or false: Traumatic tap does not affect cell counts

A

False, it does affect the count

38
Q

What is the equation for corrected CSF WBC?

A

Corrected = Measured CSF wbc - blood wbc * CSF rbc/blood rbc

39
Q

What must you do to a CSF sample before performing a WBC Diff?

A

Cytocentrifuge it so that it concentrates it into a monolayer

40
Q

What can you add to a CSF sample to increase the cell yield and stabilize the membrane during a WBC diff?

A

Albumin (30%) but can also produce some cellular distortion

41
Q

What are the ref ranges for cells in a WBC diff for CSF?

A

Adults approx 70% lymphs
30% monos
occasional PMN ok

Neonates
30% lymphs
70% monos

42
Q

What cell is primary in Bacterial Meningitis?

A

Neuts (duh) and they often contain phagocytized bacteria

43
Q

What cells are increased in viral/fungal TB and meningitis? HIV/AIDS?

A

Lymphs and monos
Reactive lymphs with viral meningitis
MS has 50 or less lymphs
Also seen with HIV/AIDS

44
Q

True or false: Macrophages may be seen after many taps (CSF)

A

TRUE

45
Q

What cells are seen with Bone marrow contamination?

A

nRBCs

46
Q

True or false: macrophages enter CSF during a hemorrhage within 2hr to phagocytize rbcs

A

yes true

47
Q

What are hemosiderin granules?

A

Dark granules caused by degraded RBCs (macros phagocytized them)

48
Q

True or false: Choroidal cells are epithelial lining cells of choroid plexus and can be singular or clumped

A

true

49
Q

What cells would you see in a smear of someone with Leukemia?

A

Lymphoblasts, monoblasts and myeloblasts

Hematology II (8 decks)

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