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AUBF > CEREBROSPINAL FLUID > Flashcards

CEREBROSPINAL FLUID Flashcards

1
Q

What are the main functions of CSF?

A
  • provides nutrients to nervous tissue
  • removes metabolic wastes
  • produces mechanical barrier to cushion the brain and spinal cord against trauma
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2
Q

This lines the brain and the spinal cord

A

Meninges

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3
Q

Three layers of the meninges

A

Dura mater
Arachnoid
Pia mater

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4
Q

This outermost layer of the meninges lines the skull and vertebral canal

A

Dura mater

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5
Q

Pertained to as the “hard mother”

A

Dura mater

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6
Q

This meningeal layer is a filamentous (spider-like) inner membrane.

A

Arachnoid

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7
Q

The innermost layer of the meninges lines the surfaces of the brain and spinal cord

A

Pia mater

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8
Q

This is where CSF is produced

A

Choroid plexuses of the two lumbar ventricles and the third and fourth ventricles

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9
Q

Which layer of the meninges is referred to as the “gentle mother”

A

Pia mater

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10
Q

In adults, approximately how many mL of CSF is produced every hour?

A

20 mL

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11
Q

This is a space located between the arachnoid and pia mater where the CSF flows through

A

Subarachnoid space

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12
Q

Normal volume of CSF in adults (range)

A

90-150 mL

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13
Q

Normal volume of CSF in neonates (range)

A

10-60 mL

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14
Q

How is the CSF volume maintained?

A

The circulating fluid is reabsorbed back into the blood capillaries in the arachnoid granulations/villae at a rate equal to its production.

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15
Q

The cells of the arachnoid granulations act as (one-way/two-way) valves that respond to pressure within the central nervous system (CNS) and prevent reflux of the fluid

A

One-way

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16
Q

TRUE or FALSE:

The chemical composition of the CSF does not resemble an ultrafiltrate of plasma.

A

TRUE

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17
Q

The choroid plexuses are capillary networks that form the CSF from plasma by mechanisms of ________ under hydrostatic pressure and active transport secretion.

A

Selective filtration

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18
Q

These are cells that line the capillary walls throughout the body.

A

Endothelial cells

NOTE:
Endothelial cells in the capillary walls are loosely connected to allow passage of soluble nutrients and wastes between the plasma and the tissues.

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19
Q

The tight-fitting structure of endothelial cells in the choroid plexuses is called:

A

Blood-brain barrier (BBB)

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20
Q

TRUE or FALSE:

Diseases such as meningitis and multiple sclerosis disrupt BBB

A

TRUE

Note:
This allows leukocytes, proteins, and additional chemicals to enter CSF

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21
Q

This is the procedure done to collect CSF

A

Lumbar puncture

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22
Q

Where is lumbar puncture done?

A

Between the third, fourth, or fifth lumbar vertebra

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23
Q

TRUE or FALSE:

Lumbar puncture is considered a complicated procedure.

A

FALSE

NOTE:
* Lumbar puncture is not complicated but may require certain precautions.

  • It requires measurement of intracranial pressure and technique to prevent infection or neural tissue damage
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24
Q

How many tubes are required for CSF collection?

A

Three (3)

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25
Q

In CSF collection, Tube 1 is for:

A

Chemical and serologic tests

NOTE:
These tests are least affected by blood or bacteria introduced as a result of the tap procedure.

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26
Q

In CSF collection, Tube 2 is for:

A

Microbiology

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27
Q

In CSF collection, Tube 3 is for:

A

Cell count

NOTE:
Tube 3 is the least likely to contain cells introduced by the spinal tap procedure.

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28
Q

In CSF collection, a fourth tube may be filled. This will be for what test/s?

A
  • Microbiology (to better exclude skin contamination)
  • Additional serologic tests
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29
Q

TRUE or FALSE:

Excess CSF fluid drawn may be discarded.

A

FALSE

NOTE:
Excess fluid should not be discarded and should be frozen until there is no further use for it.

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30
Q

Supernatant fluid left over after each section has performed its tests may be used for?

A

Additional chemical or serologic tests

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31
Q

At what temperature must excess CSF fluid be stored?

A. Room temp
B. Refrigerated
C. Frozen

A

C. Frozen

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32
Q

TRUE or FALSE:

CSF testing is ideally performed on a STAT basis.

A

TRUE

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33
Q

Storage condition of hematology tubes?

A

Refrigerated

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34
Q

Storage condition of microbiology tubes?

A

Room temperature

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35
Q

Storage condition of chemistry and serology tubes?

A

Frozen

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36
Q

If only one tube can be filled with CSF, what test must go first?

A

Microbiology

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37
Q

What tubes can be used to perform cell counts to check for cellular contamination by puncture?

A

Tubes 1 & 4

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38
Q

Appearance of normal CSF

A

Crystal-clear

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39
Q

CSF appearance that may be a result of an increased protein or lipid concentration, but may also be indicative of infection

A

Cloudy/Turbid/Milky

NOTE:
The cloudiness is mainly caused by the presence of WBCs

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40
Q

Term used when CSF supernatant is pink, orange, or yellow.

A

Xanthochromia

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41
Q

Most common cause of xanthochromia

A

Presence of RBC degradation products

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42
Q

CSF color that would indicate that there is a very slight amount of oxyhemoglobin

A

Pink

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43
Q

CSF color that would indicate heavy hemolysis

A

Orange

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44
Q

CSF color that would indicate conversion of oxyhemoglobin to unconjugated bilirubin

A

Yellow

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45
Q

Other causes of xanthochromia aside from presence of RBC degradation products:

A
  • Elevated serum bilirubin
  • Presence of pigment carotene
  • Markedly increased protein concentrations
  • Melanoma pigment
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46
Q

TRUE or FALSE:

Xanthochromia that is caused by bilirubin due to immature liver function is also commonly seen in infants, particularly premature infants.

A

TRUE

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47
Q

Oily appearance of CSF may be caused by:

A

Radiographic contrast media

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48
Q

Causes of grossly bloody CSF

A
  • Intracranial hemorrhage
  • Puncture of a blood vessel during spinal tap procedure
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49
Q

Visual examinations of CSF that would determine whether the blood is the result of hemorrhage or a traumatic tap

A
  • Uneven blood distribution
  • Clot formation
  • Xanthochromic supernatant
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50
Q

Blood from a cerebral hemorrhage will be (evenly/unevenly) distributed throughout the three CSF specimen tubes.

A

Evenly

NOTE:
Traumatic tap will leave the heaviest concentration of blood in tube 1, and gradually diminishing amounts in tubes 2 and 3.

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51
Q

TRUE or FALSE:

Fluid collected from a traumatic tap may form clots owing to the introduction of plasma fibrinogen into the specimen.

A

TRUE

NOTE:
Bloody CSF caused by intracranial hemorrhage does not contain enough fibrinogen to clot.

Diseases that damage the BBB also cause clot formation but do not usually produce a bloody fluid.

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52
Q

A classic web-like pellicles is associated with what disease?

A

Tubercular meningitis

NOTE:
Pellicles can be seen after overnight refrigeration of the fluid

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53
Q

RBCs must usually remain in the CSF for approximately ____ hours before noticeable hemolysis begins.

A

2 hours

NOTE:
A xanthochromic supernatant would be the result of blood that has been present longer than that introduced by the traumatic tap.

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54
Q

A recent hemorrhage would produce what appearance of CSF supernatant

A

Clear

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55
Q

How to examine a bloody fluid for the presence of xanthochromia?

A

Fluid is centrifuged in a microhematocrit tube and the supernatant is examined against a white background

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56
Q

Additional tests used to differentiate bloody CSF due to intracranial hemorrhage from bloody CSF due to traumatic tap

A

Microscopic Examination
* presence of ingested RBCs (erythrophagocytosis) or hemosiderin granules = intracranial hemorrhage

D-dimer Test
* detection of fibrin degradation product D-dimer by latex agglutination immunoassay indicates fibrin formation at a hemorrhage site

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57
Q

Type of cell count routinely performed on CSF specimens

A

Leukocyte (WBC) count

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58
Q

In CSF analysis, cell count must be performed immediately. WBCs (particularly granulocytes) and RBCs begin to lyse within ______, and leukocytes disintegrate after ____ hours.

A

1 hour; 2 hours

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59
Q

What percentage of leukocytes in the CSF begin to disintegrate after 2 hours?

A

40%

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60
Q

TRUE or FALSE:

Specimens that cannot be analyzed immediately should be frozen.

A

FALSE

NOTE:
Only refrigerated

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61
Q

Normal WBC count in normal adult CSF

A

0-5 WBCs/uL

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62
Q

TRUE or FALSE:

The number of leukocytes present in children is higher as compared to that of adults

A

TRUE

NOTE:
30 mononuclear cells/uL is still considered normal in newborns

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63
Q

TRUE or FALSE:

Specimens that contain up to 200 WBCs or 400 RBCs/uL may still appear clear

A

TRUE

NOTE:
This is why microscopic examination of specimens is necessary

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64
Q

This is routinely used in performing CSF cell counts

A

Improved Neubauer Counting Chamber

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65
Q

This tool has not been used in performing CSF cell counts due to high background counts and poor reproducibility of low counts.

A

Electronic cell counters

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66
Q

TRUE or FALSE:

The standard Neubauer calculation formula used for blood cell counts is also applied to CSF cell counts to determine the number of cells per microliter.

A

TRUE

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67
Q

CSF Cell Count Formula

A

(# of cells counted x dilution) / (# of cells counted x volume of 1 square) = cells/uL

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68
Q

TRUE or FALSE:

The CSF cell count formula may be used for both diluted and undiluted specimens

A

TRUE

NOTE:
The formula also offers flexibility in the number and size of the squares counted.

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69
Q

TRUE or FALSE:

Clear specimens may be counted undiluted, provided no overlapping of cells is seen during the microscopic examination.

A

TRUE

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70
Q

This is used to dilute total cell counts

A

Normal saline

NOTE:
After the addition of normal saline, the sample is mixed by inversion, and loaded into the hemocytometer with a Pasteur pipette.

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71
Q

What parts of the hemocytometer are cells counted for CSF analysis?

A

4 corner squares and center square on both sides of the hemocytometer

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72
Q

TRUE or FALSE:

Lysis of RBCs must be obtained before performing the WBC count on either diluted or undiluted specimens.

A

TRUE

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73
Q

This is the reagent used to lyse RBCs prior to WBC count

A

3% glacial acetic acid

74
Q

This is used to stain white blood cells to provide better differentiation between neutrophils and mononuclear cells.

A

Methylene blue

75
Q

How often must diluents used in CSF analysis be checked for contamination?

A

Biweekly

76
Q

Diluents used in CSF analysis are checked for contamination by examining them in a counting chamber under what magnification?

A

400x

77
Q

How often must the cytocentrifuge be checked?

A

Monthly

78
Q

This is used to check the speed of the cytocentrifuge

A

Tachometer + Timer

79
Q

If non disposable counting chambers are used for CSF cell count, they must be soaked in a bactericidal solution for how long?

A

At least 15 minutes

NOTE:
After this, they must be thoroughly rinsed with water and cleaned with isopropyl alcohol after each use.

80
Q

Differential count on a CSF specimen is performed:

(a) on a stained smear
(b) via counting chamber

A

a. on a stained smear

NOTE:

There is poor visualization of cells in the counting chamber which can cause overlooking of abnormal cells

81
Q

TRUE or FALSE:

In differential counting on a CSF specimen, to ensure that the maximum number of cells is available for examination, the specimen should be concentrated before preparing the smear.

A

TRUE

82
Q

Methods used for specimen concentration (CSF)

A
  • Sedimentation
  • Filtration
  • Centrifugation
  • Cytocentrifugation
83
Q

Specimen concentration method/s that are not routinely used in the clinical laboratory but produce/s less cellular distortion

A

Sedimentation and filtration

84
Q

This is a specimen concentration method performed when there is no cytocentrifuge available

A

Centrifugation

85
Q

In concentrating CSF specimens via centrifugation, how long must be the specimen centrifuged?

A

5-10 minutes

86
Q

How many cells must be counted in performing differential count?

A

100

87
Q

In performing CSF cell count, if the cell count is low and finding 100 cells is not possible, what must be the manner of reporting?

A

Report only the numbers of the cell types seen

88
Q

In cytocentrifugation, what volume of CSF is used to combine with 1 drop of 30% albumin to produce adequate cell yield?

A

0.1 mL

89
Q

What is the purpose of adding albumin in the process of cytocentrifugation?

A

increases cell yield and decreases cellular distortion frequently seen on cytocentrifuged specimen

90
Q

In cytocentrifugation, a daily control slide for bacteria is prepared using what reagents?

A

0.2 mL saline
Two drops of 30% albumin

91
Q

Primary cells found in normal CSF

A

Lymphocytes
Monocytes

92
Q

Ratio of lymphocytes to monocytes in adult CSF

A

70:30

NOTE:
Ratio is reversed in children.

93
Q

Term used to describe an increased cell count (white blood cells) in body fluids such as CSF

A

Pleocytosis

94
Q

TRUE or FALSE:

Pleocytosis is normal.

A

FALSE

95
Q

A high CSF WBC count with primarily neutrophils is indicative of what condition/s?

A

Bacterial meningitis

96
Q

A moderately elevated CSF WBC count with a high percentage of lymphocytes and monocytes is indicative of what condition/s?

A

Viral meningitis
Tubercular meningitis
Fungal meningitis
Parasitic meningitis

97
Q

Major clinical significance when the predominant cells seen in CSF are LYMPHOCYTES.

A
  • Normal
  • Viral, tubercular, fungal meningitis
  • Multiple sclerosis
98
Q

Major clinical significance when the predominant cells seen in CSF are NEUTROPHILS.

A
  • Bacterial meningitis
  • Early cases of viral, tubercular, and fungal meningitis
  • Cerebral hemorrhage
99
Q

Major clinical significance when the predominant cells seen in CSF are MONOCYTES.

A
  • Normal
  • Viral, tubercular, fungal meningitis
  • Multiple sclerosis
100
Q

Major clinical significance when the predominant cells seen in CSF are MACROPHAGES.

A
  • RBCs present in spinal fluid

NOTE:
Macrophages may contain phagocytized RBCs appearing as empty vacuoles or ghost cells, hemosiderin granules, and hematoidin crystals.

101
Q

Major clinical significance when the predominant cells seen in CSF are BLAST FORMS.

A

Acute leukemia

102
Q

Major clinical significance when the predominant cells seen in CSF are LYMPHOMA CELLS.

A

Disseminated lymphomas

103
Q

Major clinical significance when the predominant cells seen in CSF are PLASMA CELLS.

A
  • Multiple sclerosis
  • Lymphocyte reactions
104
Q

Major clinical significance when the predominant cells seen in CSF are EPENDYMAL, CHOROIDAL, AND SPINDLE-SHAPED CELLS.

A

Diagnostic procedures

105
Q

Major clinical significance when the predominant cells seen in CSF are MALIGNANT CELLS.

A
  • Metastatic carcinomas
  • Primary central nervous system carcinoma
106
Q

TRUE or FALSE:

Aside from bacterial meningitis, neutrophils may also be seen in CSF in early stages of viral, fungal, tubercular, and parasitic meningitis.

A

TRUE

107
Q

Appearance of neutrophils that indicate degenerating cells

A

Presence of pyknotic nuclei

NOTE:
They resemble nucleated red blood cells but usually have multiple nuclei

108
Q

A moderately elevated WBC count equates to how many WBCs/uL?

A

Less than 50

109
Q

Increased number of eosinophils in the CSF is linked to fungal infections, specifically?

A

Coccidoides immitis

110
Q

Purpose of macrophages in the CSF

A

to remove cellular debris and foreign objects such as RBCs

111
Q

Macrophages appear after how many hours after RBCs enter the CSF?

A

2-4 hours

112
Q

Degradation of phagocytized RBCs results in the appearance of dark blue or black iron-containing hemosiderin granules. What type of crystals indicate further degeneration?

A

Yellow hematoidin crystals

NOTE:
These are iron-free, consisting of hemoglobin and unconjugated bilirubin.

113
Q

Appearance of these cells in the CSF are from the epithelial lining of the choroid plexus.

A

Choroidal cells

NOTE:
These may be seen singularly and in clumps.

114
Q

Where did ependymal cells that are seen in the CSF come from?

A

From the lining of the ventricles and neural canal.

NOTE:
They have less defined cell membranes and are frequently seen in clusters. Nucleoli are also often present.

115
Q

These are cells found in CSF that represent lining cells from the arachnoid. They may be seen in clusters and with systemic malignancies.

A

Spindle-shaped cells

116
Q

Presence of these malignant cells in the CSF indicate serious complication of acute leukemias.

A

Lymphoblasts
Myeloblasts
Monoblasts

117
Q

Presence of these cells in the CSF indicate dissemination from the lymphoid tissue

A

Lymphoma cells

118
Q

Metastatic carcinoma cells of nonhematologic origin primarily come from malignancies of which organs?

A

Lungs
Breast
Kidney/Renal
GI tract

119
Q

These are cells that come from primary CNS tumors

A

Astrocytomas
Retinoblastomas
Medulloblastomas

120
Q

This is the most frequently performed chemical test on CSF.

A

Protein determination

121
Q

TRUE or FALSE:

CSF may normally contain protein.

A

TRUE

NOTE:
Normal CSF contains small amount of protein.

122
Q

Normal values of CSF protein:

A

15-45 mg/dL

NOTE:
This may be method dependent, and higher values may be present in infants and people >40 years old.

123
Q

Major protein present in both serum and CSF.

A

Albumin

124
Q

The second most prevalent fraction (protein) in CSF

A

Prealbumin

125
Q

What are the primary alpha globulins present in the CSF

A

Haptoglobin
Ceruloplasmin

126
Q

The major beta globulin present in CSF

A

Transferrin

127
Q

This is a carbohydrate-deficient transferrin fraction that is seen in CSF but not in serum

A

Tau

128
Q

The primary immunoglobulin found in CSF

A

IgG

129
Q

The second primary immunoglobulin found in CSF

A

IgA (present in small amounts)

130
Q

TRUE or FALSE:

IgM, fibrinogen, and beta lipoprotein may also be found in normal CSF.

A

Immunoglobulin M (IgM), fibrinogen, and beta lipoprotein are not found in

131
Q

Most common causes of elevated CSF protein

A

Meningitis
Hemorrhage conditions damaging BBB

132
Q

The most routinely used techniques for measuring total CSF protein utilize which top two mechanisms?

A

Turbidity production
Dye-binding ability

133
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Meningitis

A

ELEVATED

134
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Hemorrhage

A

ELEVATED

135
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Primary CNS tumors

A

ELEVATED

136
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Multiple sclerosis

A

ELEVATED

137
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Guillain-Barre syndrome

A

ELEVATED

138
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Neurosyphilis

A

ELEVATED

139
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Polyneuritis

A

ELEVATED

140
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Myxedema

A

ELEVATED

141
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Cushing disease

A

ELEVATED

142
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Connective tissue disease

A

ELEVATED

143
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Diabetes

A

ELEVATED

144
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Uremia

A

ELEVATED

145
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

CSF leakage

A

DECREASED

146
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Recent puncture

A

DECREASED

147
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Rapid CSF production

A

DECREASED

148
Q

Indicate whether the following condition causes ELEVATED or DECREASED CSF protein.

Water intoxication

A

DECREASED

149
Q

To accurately determine whether IgG is increased because it is being produced within the CNS or is elevated as the result of a defect in the BBB, comparisons between serum and CSF levels of what analytes are made?

A

Albumin
IgG

150
Q

This method is done to evaluate the integrity of the blood-brain barrier.

A

CSF/serum albumin index

151
Q

This method is done to measure IgG synthesis within the CNS

A

IgG index

152
Q

In calculating CSF/serum albumin index, an index value of less than ___ represents an intact blood-brain barrier.

A

9

153
Q

IgG index formula:

A

(CSF IgG/serum IgG) / (CSF albumin/serum albumin)

CSF IgG and CSF albumin: mg/dL
Serum IgG and serum albumin: mg/dL

154
Q

In calculating IgG index, a value greater than ______ indicate IgG production within the CNS.

A

0.70

155
Q

The primary purpose for performing CSF protein electrophoresis is to detect what?

A

Oligoclonal bands

NOTE:
This represents inflammation within the CNS.

156
Q

Presence of this protein in the CSF indicates recent destruction of myelin sheath.

A

Myelin basic protein (MBP)

157
Q

The process of destruction of myelin sheath.

A

Demyelination

158
Q

CSF glucose approximates to what percentage of the plasma glucose?

A

60%-70%

159
Q

In evaluating CSF glucose, the blood glucose must be drawn _____ hours before spinal tap.

A

About 2 hours

NOTE:
This is to allow time for equilibration between the blood and fluid.

160
Q

A markedly decreased CSF glucose level with an increased WBC count (primarily neutrophils) are indicative of what condition?

A

Bacterial meningitis

161
Q

A decreased CSF glucose with increased WBC count that are primarily lymphocytes is indicative of what condition?

A

Tubercular meningitis

162
Q

Normal CSF glucose with increased number of lymphocytes is indicative of what condition?

A

Viral meningitis

163
Q

CSF lactate levels of greater than 35 mg/dL is often observed in which type of meningitis?

A

Bacterial meningitis

164
Q

CSF lactate levels of lower than 25 mg/dL is often observed in which type of meningitis?

A

Viral meningitis

165
Q

TRUE or FALSE:
Tissue destruction within the CNS owing to oxygen deprivation (hypoxia) increases CSF lactic acid levels.

A

TRUE

166
Q

Normal concentration of CSF glutamine

A

8-18 mg/dL

167
Q

Glutamine is produced from a-ketoglutarate and ________.

A

Ammonia

168
Q

TRUE or FALSE:
As the concentration of ammonia in the CSF increases, the supply of α-ketoglutarate becomes depleted.

A

TRUE

169
Q

Normal values of CSF lactate

A

10-24 mg/dL

170
Q

CSF lactate levels of _____ mg/dL is observed in patients with some disturbance of consciousness

A

> 35 mg/dL

171
Q

CSF culture may take (duration) in cases of bacterial meningitis and (duration) in cases of tubercular meningitis.

A

24 hours; 6 weeks

172
Q

In conducting CSF culture, the CSF should first be centrifuged at _______ for ____ minutes

A

1500g; 15

173
Q

Organisms most frequently encountered in a CSF culture:

A

Streptococcus pneumoniae
Haemophilus influenzae
Escherichia coli
Neisseria meningitidis

174
Q

Organisms that may be encountered in CSF culture in newborns:

A

Streptococcus agalactiae
Listeria monocytogenes

175
Q

This is a condition considered as a frequently occurring complication of AIDS and often requires an India ink preparation aside from gram staining of the CSF.

A

Cryptococcal meningitis (caused by Cryptococcus neoformans)

176
Q

This is a pattern produced by Cryptococcus in gram-stained CSF specimens.

A

Starburst

177
Q

This test is considered more sensitive in detecting the presence of C. neoformans antigen in serum and CSF than India ink preparation.

A

Latex agglutination tests

178
Q

This is the most common cause of false-positive reactions in latex agglutination tests for CSF.

A

Rheumatoid factor (RF)

179
Q

This method helps detect C. neoformans in CSF by utilizing a reagent strip coated with monoclonal antibodies that react with the cryptococcal polysaccharide capsule.

A

Lateral Flow Assay (LFA)

180
Q

This is an opportunistic parasite capable of entering the nasal passages and migrating along the olfactory nerves to invade the brain. These are mainly found in small lakes and ponds and can be observed in a CSF wet preparation.

A

Naegleria fowleri

181
Q

This is the procedure recommended by CDC to diagnose neurosyphilis.

A

Venereal Disease Research Laboratories (VDRL)

182
Q

TRUE or FALSE:
Rapid plasma regain (RPR) test is less sensitive than the VDRL.

A

TRUE

NOTE:
Order of sensitivity of tests used to diagnose neurosyphilis:

FTA-ABS>VDRL>RPR

AUBF (5 decks)

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