Body Fluids

Question 1

how many leukocytes is a normal level in adult CSF?

Answer 1

0-5/ uL

Question 2

Give at least 7 types of body fluids that can be analyzed

Answer 2

Cerebrospinal, pleural, peritoneal, pericardial, synovial, seminal, amniotic, urine

Question 3

Give some indications for evaluating body fluids

Answer 3

suspected infections, neuro disease, hemorrhage, malignancy, treatment monitoring

Question 4

what are CSF tubes 1 through 3 designated for, and how stored if not used within?

Answer 4

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

Question 5

how does normal CSF appear?

Answer 5

crystal clear and colorless

Question 6

what may cause slight haziness or turbidity in CSF ?

Answer 6

increased WBCs, bacteria, increased protein, or lipid. Radiographic contrast may appear oily and become turbid when mixed

Question 7

What may cause bloody CSF? Give 2 main causes

Answer 7

subarachnoid hemorrhage, or traumatic tap

Question 8

what helps diff btw bloody CSF due to traumatic tap or subarachnoid hemorrhage?

Answer 8

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.

Question 9

define xanthochromia of CSF

Answer 9

yellowish appearance/tint due to recent subarachnoid hemorrhage/ bleeding into the space from other disorders

Question 10

normal adult protein level in CSF

Answer 10

15 to 45 mg/ dL, less than 1% of the serum protein value

Question 11

normal glucose of adult CSF

Answer 11

about 60-70% of the plasma glucose level, btw 40 and 80 mg/dL

Question 12

common causes of elevated CSF protein levels, and of decreased?

Answer 12

increased: meningitis, hemorrhage, MS
decreased: leakage from CNS bc of BBB damage

Question 13

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?

Answer 13

bacterial meningitis bc of bacteria and cells using glucose; also in metastatic tumor and insulin shock

Question 14

normal RBC count in CSF

Answer 14

usually, none. 0-1 is acceptable. Lumbar puncture can cause presence

Question 15

How is the blood brain barrier often evaluated?

Answer 15

performing a CSF albumin: serum albumin ratio OR, the index (diff calculation)

Question 16

what is the normal CSF/Serum albumin ratio, and the normal index

Answer 16

ratio 1: 230

Index: <9

Question 17

how is the CSF albumin to serum ratio (1) and index (2) calculated?

Answer 17

1. CSF alb in g/dL / serum in g/dL

2. CSF alb in mg/dL / serum in g/dL

Question 18

what CSF alb/ serum albumin index indicates a complete breakdown of the blood-brain barrier (BBB)?

Answer 18

> 100

Question 19

what cells may be present in a fungal meningitis?

Answer 19

lymphocytes (as in viral) and monocytes

Question 20

compare levels of protein, glucose, and lactate in the 3 main types of meningitis

Answer 20

1. bacterial: much higher protein, lower glucose, and higher lactate
2. viral: higher protein but less than bacterial, normal glucose, and normal lactate
3. Fungal: higher protein as in viral, normal or decreased glucose, and increased lactate

Question 21

An increased CSF IgG index is associated with what pathological conditions? give 3

Answer 21

MS, inflammatory neuro diseases, increased intrathecal production

Question 22

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?

Answer 22

erythrophages (macrophages that have engulfed RBCs) and siderophages (macrophages with iron inclusions from cleaning up the hemoglobin)

Question 23

What is the use of CSF protein electrophoresis most commonly?

Answer 23

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.

Question 24

how does CSF protein electrophoresis differ from serum?

Answer 24

beta is about double that of serum, gamma about half