Body Fluids Flashcards
Site where CSF circulate
📍arachnoid space of the meninges of the brain and spinal cord
Site of reabsorption of CSF
Arachnoid granules of the brain
Blood brain barrier that protect the brain
Tight fitting endothelial cells in the choroid plexus
CSF Tube #1
Clinical Chemistry/Immunology (less affected by bacterial contamination from spinal tap)
CSF Tube #2
Microbiology
CSF Tube #3
Hematology (less cell contamination)
CSF Tube #4 (four tube distribution)
Hematology (In comparison with tube one for possible outside interference from the tap)
CSF Tube #1 (four tube distrib)
Hematology (in comparison with cell from puncture with cells in the 4th tube)
Tube #2 (four tube distrib)
Clinical Chem
Tube #3 (4TD)
Microbiology
Allowable hour/s to stand the CSF
1hr
Adult CSF WBC count for adults
0-5 /muL
T or F: Babies have slightly lower counts and less monocytes in CSF
False: Babies have slightly higher WBC count and more monocyte
CSF counting is performed by:
Using Neubauer counting chamber
Formula for CSF counting
of cells counted x dilution / # of sq. counter x vol of 1 sq.
Reagent use to lyse RBC in CSF
Percent glacial acetic acid
To ensure adequate number of cells for evaluation
Concentration by cytocentrifugation
Normal value of CSF Protein
15-45 mg/dL
Protein found ONLY in CSF
t Transferrin
Clinical significance: Elevated CSF
Damage to the bbb, multiple sclerosis
Clinical significance: Decreased CSF
CSF Leakage and trauma
Detects damage to the BBB.
CSF serum/albumin index
Formula of CSF serum/albumin
CSF Albumin (mg/dL) / Serum Albumin (mg/dL)
Normal value of CSF IgG index
0.70 or lower
Detect production of IgG within the CNS
CSF IgG index
CSF electrophoresis primary testing
Multiple sclerosis
Multiple sclerosis results in CSF electrophoresis
Two or more bands are seen in the CSF and no bands on the serum
Destruction of myelin sheath protein
Presence of myelin basic protein
Normal value CSF glucose
60-70%
Helpful in the differentiation of types of meningitis
Glucose CSF
T or F: Decrease level of CSF glucose indicate damage to transport of glucose to BBB.
True
Increased when there is tx destruction caused by lack of oxygen
CSF Lactate
CSF lactate normal value
25 mg/dL
Differentiates meningitis organisms
CSF Lactate
Normal value of CSF Glutamine
8-18 mg/dL
Increased glutamine indicates
⬆️ Ammonia
Value of __ mg/dL disrupts consciousness
35
Elevated values of CSF glutamine are seen in
Reye’s Snyndrome
Produces starburst Gram stain pattern
Crytococcus neoformans
Four components of semen
📍Spermatozoa
📍Seminal Fluid
📍Prostate fluid
📍Bulbourethral gland fluid
Germ cell
Spermatozoa
Nutrients and fructose for sperm energy
Seminal fluid
For coagulation and liquefaction
Prostate fluid
Alkaline mucus to neutralize acidity of prostate and vagina
Bulbourethral gland fluid
Days of abstinence before sperm collection
2-3 days but not more than 5 days
Temperature for sperm
Room temp
Sperm spx should be delivered to the lab within
1 hour
Normal appearance of sperm
Grayish-white, translucent
Toxic to sperm
Urine
Fresh semen
Clotted
Normal liquefaction
30-60 min
Indication of abnormal liquefaction
Prostate enzyme deficiency
Semen normal volume
2-5 mL
T or F: Normal viscosity of the sperm form discrete droplets from a pipette
True
T or F: Decreased viscosity and abrupt liquefaction impedes sperm motility
False
Normal pH of sperm
7.3-8.0
Indicates infection in sperm
⬆️ pH
Increased prostatic fluid
⬇️ pH
Normal sperm concentration
> 20 million/mL
Medium used to count sperm
Counting chamber
T or F: in performing sperm count, diluting fluid is necessary to immobilize the sperm
True
Sperm count must be corrected from microliter to
Milliliter
T or F: Spermatids and WBCs are counted together
False (separately)
1 million WBCs in sperm count indicates
Infection
Sperm count formula
No. Of sperm per mL x spx. volume
Contains the acrosome with enzymes for ovum penetration
Head
Attaches the head to the neck to the midpiece
Neck piece
Contains mitochondria to provide energy for the tail
Midpiece
Stain used in sperm smear
Eosin-nigrosin
Sperm that absorbs the stain is called
Nonviable sperm
Nonviable sperm would appear
Red
T or F: viable sperm takes the color of the stain
False
Fluid found in moveable joints
Synovial fluid
Large molecules that produces the viscosity of synovial fluid
Hyaluronic acid
Synoviocytes produce
Hyaluronic acid
Damage to the joint produces
Arthritis
Color of synovial fluid
Colorless to pale yellow
Detects and measures hyaluronic acid
Mucin clot
Reagent to confirm whether a spx is synovial fluid
Acetic acid
Synovial fluid dilliting agent
NSS
Normal WBC count in Synovial fluid
200 cells/muL
T or F: Synovial fluid is incubated with acetic acid before slide preparation
False (incubated with hyaluronidase)
Synovial fluids: Primary cells
📍Monocytes
📍Macrophage
Primary crystals in Synovial fluid
📍 Monosodium urate
📍calcium pyrophosphate dihydrate
Synovial Fluid: Monosodium urate are seen in
Gout
Synovial Fluid: calcium pyrophosphate dihydrate
Pseudogout
Synovial Fluid: needle shaped, strongly bifringent under polarized light
Monosodium urate
Color of monosodium urate crystal aligned under slow vibration of polarized light
Yellow
Color of Monosodium urate when vertical to the slow vibration
Blue
Crystal seen intracellularly in neutrophil vacuoles, rhombus shape
Calcium pyrophosphate dihydrate
Color of CPD crystals aligned under slow vibration
Blue
Color of CPD when vertical to the slow vibration
Yellow
Possible species seen in synovial fluid
📍Haemophilus sp.
📍N. gonorrhoeae
Fluid found in between the parietal and visceral membranes
Serous fluid
Disruption of process in serous fluid Reabsorption produces
Effusion
Effusions caused by systemic disorders
Transudates
Effusion caused by membrane disorders
Exudates
Manner of collection of Pleural fluid
Thorocentesis
Thoracic duct leakage and chronic infection give a pleural fluid appearance of
Milky
Hemothorax and hemorrahgic effusion give an appearance of
Bloody
Viscous pleural fluid indicates
Malignant mesothelioma producing hyaluronic acid
Pleural fluid: ⬆️ amount of Neutrophil
Peumonia and pancreatitis
Synovial fluid: indicates presence of TB and viral infections
Lymphocytes
Synovial fluid: indicates presence of Pneumothorax
Eosinophil
Synovial fluid: it is ⬇️ with TB
Mesothelial cells
Synovial fluid: Tuberculosis
Plasma cells
pH that indicates the need for chest tube drainage
pH 7.0
pH that indicates esophageal rupture
pH 6.0
Pleural fluid cholesterol: transudate
45-60 mg/dL
Procedure done with pleural fluid in microbiology
Acid fast stain
Manner of collection of pericardial fluid
Pericardiocentesis
Pericadial fluid: indicates bacterial endocarditis
Neutrophil
Peritoneal fluid often called
Ascitic fluid
Peritoneal fluid effusion
Ascites
Causes of Effusion
📍liver disorders
📍intestinal infection
📍malignancy
Recommended method of differentiation of peritoneal fluid
Serum-ascites albumin gradient
PeritFluid: ascite albumin level of >1.1
Transudate
PeritFluid: Serum ascite albumin
Exudate
Turbid peritoneal fluid indicates
Infection
Color of Peritoneal fluid that has a gallbladder or pancreas disorder
Green
Color of Perit. Fluid that indicates trauma, infection or malignancy
Blood-streaked
Appearance of peritoneal fluid that indicates lymphatic trauma or blockage
Milky
Normal WBC count of peritoneal fluid
350/muL
Where is CSF formed
Choroid plexuses
> 250 neutrophils/uL indicates ________ in PeriF
Peritonitis
⬇️ glucose in peritoneal fluid indicates
Infection and malignancy
Elevated in peritoneal fluid in impending pancreatitis or GI perforation
Amylase
Elevated in intestinal perforation (Peritoneal fluid)
Alkaline phosphatase
Manner of collection of amniotic fluid
Amniocentesis
T or F: HDn spx must be protected from light
True
Amniotic fluid: These spx are delivered on ice
Fetal Lung Maturity
Amniotic fluid: Spx of this test is kept in room temperature
Cytogenic test
Amniotic fluid that is dark green in color indicates
Meconium
T or F: A dark red-brown appearance of Amniotic fluid indicates fetal death
True
Spectrophotometric measurement for AF of HDN
365-550 nm
Abnormal value of AF.
2x the lab median value in both serum and fluid
Time of measurement of Amniotic fluid
12-15 gestational weeks
Positive tests for Amniotic fluid followed by measuring the
Amniotic acetylcholinesterase
Causes respiratory distress syndrome
⬇️ lung surfactant
Primary lung surfactants
📍lecithin
📍sphyngomyelin
📍phosphatidylglycerol
Storage form of phospholipid in the lungs
Lamellar bodies
Optical density measurement of the lamellar bodies
650 nm of 0.150
Diarrhea that is caused bt bacterial, viral or protozoan infection
Secretory
Diarrhea caused by incomplete breakdown or reabsorption in the small intestine
Osmotic
Causes the brown color of stool
Urobilin
Causes black coloration in stool
GI bleeding, iron therapy and antacid
Color of stool that Indicates lower GI bleeding and food coloring
Red
Indicates bile obstruction or steatorrhea
Pale yellow/white
Presence if colitis, dysentry, malignancy in the stool
Blood streaked mucus
Its presence indicates the presence of non-toxin producing organisms
Fecal leukocyte
Undigested fibers seen with pancreatic insufficiency
Muscle fibers
Monitoring of malabsorption disorders
Qualitative fats
Stain easily with Sudan III in alcohol
Neutral fats
Screening for colorectal cancer
Fecal Occult Blood test
Positive result for FOBT
Blue
Indicator used in FOBT
Gum guiac
Principle of FOBT
Pseudoperoxidase
Uses antihuman hemoglobin antibodies specific for globin portion of hgb
Immnunologic FOBTS
T or F: blood from upper GI bleeding can be detected by FOBT
False (Upper GI bleeding is degraded easily)
Indicative of colorectal cancer
Lower GI Bleeding
Number of samples to confirm a (-) result in FOBT
3 samples
Sample used in FOBT
Middle of the stool
Requires collection of a timed 3 day stool spx & a maintenance of 100 g/day of fats
Quantitative fecal fats
Enzyme that differentiates pancreatic steatorrhea from non pancreatic stea.
Elastase 1
T or F: ⬆️ fecal carbs are caused by failure to reabsorb carbs or lack of digestive enzymes
True
Most common test for fecal carbs
Clinitest
Second test for fecal carbs
Intolerance test
pH indicative of carbs disorders
⬇️ 5.5
Normal pH of stool
pH 7-8
Normal value of sperm
75% normal sperm per 100 cells countes
