Body Fluids Flashcards
how many leukocytes is a normal level in adult CSF?
0-5/ uL
Give at least 7 types of body fluids that can be analyzed
Cerebrospinal, pleural, peritoneal, pericardial, synovial, seminal, amniotic, urine
Give some indications for evaluating body fluids
suspected infections, neuro disease, hemorrhage, malignancy, treatment monitoring
what are CSF tubes 1 through 3 designated for, and how stored if not used within?
tube 1: chemistry/immunology/serology- store frozen
tube 2: micro. Store room temp
tube 3: Hematology (cell counts and cytology): refrigerated
if not using immediately as it should be
how does normal CSF appear?
crystal clear and colorless
what may cause slight haziness or turbidity in CSF ?
increased WBCs, bacteria, increased protein, or lipid. Radiographic contrast may appear oily and become turbid when mixed
What may cause bloody CSF? Give 2 main causes
subarachnoid hemorrhage, or traumatic tap
what helps diff btw bloody CSF due to traumatic tap or subarachnoid hemorrhage?
successive tubes from a traumatic tap will be less and less bloody/ colored and there may be clots due to fibrinogen. In hemorrhage, there will be xanthochromia, no clots, and all tubes equally bloody.
define xanthochromia of CSF
yellowish appearance/tint due to recent subarachnoid hemorrhage/ bleeding into the space from other disorders
normal adult protein level in CSF
15 to 45 mg/ dL, less than 1% of the serum protein value
normal glucose of adult CSF
about 60-70% of the plasma glucose level, btw 40 and 80 mg/dL
common causes of elevated CSF protein levels, and of decreased?
increased: meningitis, hemorrhage, MS
decreased: leakage from CNS bc of BBB damage
Glucose levels of both CSF and blood should be taken immediately and simultaneously bc the diff btw is significant. When is CSF glucose especially decreased, (infection-related) and other causes?
bacterial meningitis bc of bacteria and cells using glucose; also in metastatic tumor and insulin shock
normal RBC count in CSF
usually, none. 0-1 is acceptable. Lumbar puncture can cause presence
How is the blood brain barrier often evaluated?
performing a CSF albumin: serum albumin ratio OR, the index (diff calculation)
what is the normal CSF/Serum albumin ratio, and the normal index
ratio 1: 230
Index: <9
how is the CSF albumin to serum ratio (1) and index (2) calculated?
- CSF alb in g/dL / serum in g/dL
2. CSF alb in mg/dL / serum in g/dL
what CSF alb/ serum albumin index indicates a complete breakdown of the blood-brain barrier (BBB)?
> 100
what cells may be present in a fungal meningitis?
lymphocytes (as in viral) and monocytes
compare levels of protein, glucose, and lactate in the 3 main types of meningitis
- bacterial: much higher protein, lower glucose, and higher lactate
- viral: higher protein but less than bacterial, normal glucose, and normal lactate
- Fungal: higher protein as in viral, normal or decreased glucose, and increased lactate
An increased CSF IgG index is associated with what pathological conditions? give 3
MS, inflammatory neuro diseases, increased intrathecal production
what cell findings in CSF can indicate a previous hemorrhage? esp over several days later, and which would be found up to 8 weeks later?
erythrophages (macrophages that have engulfed RBCs) and siderophages (macrophages with iron inclusions from cleaning up the hemoglobin)
What is the use of CSF protein electrophoresis most commonly?
to detect oligoclonal bands in the gamma region which may help diagnose MS.
ALso found in acute sclerosing panencephalitis, neurosyphilis, cryptococcal meningitis, acute necrotizing encephalitis, HIV-1, and GBS.
how does CSF protein electrophoresis differ from serum?
beta is about double that of serum, gamma about half
