Body Fluids Flashcards
Explain the routing of a three-tube cerebrospinal fluid collection
Tube 1: Chemistry Serology
Tube 2: Microbiology
Tube 3: Hematology (Microbiology)
Tube 4: Additional Tests
What is the clinical significance of abnormal CSF appearance?
If its ever bloody, something is wrong
What is the typical appearance of CSF from a traumatic tap?
Blood decreases as more tubes of blood are taken
What is the typical appearance of a CSF from a patient with subarachnoid hemorrhage?
All tube will be equally bloody with xanthochromia
Aspects of a CSF protein:
- fraction that is in greatest concentration
albumin
Aspects of a CSF protein:
- 4 general conditions that cause its increase
- inflammatory diseases
- intracranial tumors
- subarachnoid hemorrhage,
- cerebral infarction
Aspects of a CSF protein:
- two most common specific causes of its increase
- Damage to the blood brain barrier (meningitis and hemorrhage)
- Bacterial meningitis
Aspects of a CSF protein:
- reason for its supurious elevation
spurious elevations occur when fluid is contaminated with serum or blood cells during traumatic tap
Clinical significance of an increased CSF IgG index calculation
Multiple sclerosis (MS)
Normal proportion of CSF glucose related to concomitant blood glucose measurements
Should be 60-70% of concomitant blood glucose
Specific clinical significance of CSF lactate measurements
Increased in any condition that decreases oxygen blood flow to the brain
- >25 mg/dL indicate bacterial, tubercular, or fungal meningitis, with a better predictive value than CSF glucose
Clincal significance of CSF lactate dehydrogenase isoenzyme measurements *
LD-1 and LD-2 are found in brain tissue
LD-2 and LD-3 are found in lymphocytes
LD-4 and LD-5 are found in neutrophils
Clinical significance of CSF creatine kinase isoenzyme measurements
CK-BB
- If elevated post cardiac arrest, a poor prognosis is indicated
BACTERIAL MENINGITIS
- Clarity
- CSF cell count
- CSF protein
- CSF glucose
- Microbiological data
- Clarity: Cloudy
- CSF cell count: Mk’d increased neutrophils
- CSF protein: much greater than 45 mg/dL
- CSF glucose: (Mk’d decreased) much less than 50mg/dl
- Microbiological data: possible positive gram stain; positive bacterial culture
VIRAL MENINGITIS
- Clarity
- CSF cell count
- CSF protein
- CSF glucose
- Microbiological data
- Clarity: Clear to cloudy
- CSF cell count: Increased lymphocytes
- CSF protein: > 45 mg/dL, NOT Mk’d increased
- CSF glucose: Normal to slight decrease
- Microbiological data: negative Gram stain for organisms or polys
FUNGAL MENINGITIS
- Clarity
- CSF cell count
- CSF protein
- CSF glucose
- Microbiological data
- Clarity: Clear to cloudy
- CSF cell count: increased monocytes
- CSF protein: > 45 mg/dL
- CSF glucose: slightly decreased < 50 mg/dL
- Microbiological data: positive gram stain and fungal culture; possibly positive India Ink if organism is encapsulated
Normal formation of serous fluid
- colloid osmotic pressure
COP is the pressure caused by protein. If protein is higher on one side of semi-permeable membrane, water tends to flow there to dilute it
Normal formation of serous fluid
- hydrostatic pressure
HP exerted by the pumping heart drives fluid OUT of the capillaries into tissue spaces and the serous cavity
Normal formation of serous fluid
- Capillary permeability
refers to the normal ability of water, protein, and particular matter from the extravascular space to be absorbed by the lymphatic system
Increased or decreased will cause the formation of effusions
- colloid osmotic pressure
DECREASED
