Cerebrospinal Fluid

Question 1

When taking CSF glucose simultaneous serum glucose should be taken when? 
A. 2 to 4 hours before lumbar puncture
B. 2 to 4 hours after lumbar puncture 
C. 10 hours before lumbar puncture
D. 10 hours after lumbar puncture

Answer 1

A. 2 to 4 hours before lumbar puncture

Question 2

The following is true regarding CSF, except.
A. If the intracranial pressure is between 90 to 180 mmHg, 20 ml of fluid can be removed.
B. The normal range for infants and children is 10 to 100 mmHg
C. Intracranial pressure may be as high as 250 mmHg in obese patients
D. If the intracranial pressure is greater than 200 mmHg in a relaxed patient, no more than 4 ml should be withdraw

Answer 2

D. It should be only 2ml

Question 3

Which of the following is true regarding intracranial hemorrhage in csf? 
A. Subsequent clearing of tubes 
B. Clear supernatant 
C. Presence of clots 
D. Increased lactate dehydrogenase

Answer 3

D.
Remarks: traumatic tap from intracranial hemorrhage does not significantly elevate LD level as compared to intracranial hemorrhage.

Question 4

Leukemic involvement of the meninges is more frequent in what type of leukemia?

Answer 4

Acute lymphoblastic leukemia (ALL)

Question 5

What is the most common abnormality of the CSF?

Answer 5

High protein in csf.
Remarks: normal protein 15 to 45 mg/dL
Term infants have higher mean protein levels of 90 mg/dL.

Question 6

With regards to protein electrophoresis of the csf, what are the proteins unique to the csf?

Answer 6

1. Prominent transthyretin (prealbumin) - due to dual synthesis of the liver and choroid plexus
2. Two transferrin bands
3. Beta 2 transferrin - unique to csf

Question 7

What is the normal csf albumin/serum albumin ratio?

Answer 7

1:230

Question 8

Which of the following pairing of csf protein to disease/disorder is incorrect?
A. Protein 14-3-3 : Creutzfeldt- Jacob disease
B. Transferrin : CSF leak
C. Myelin basic protein : Multiple sclerosis
D. Methemoglobin : Alzheimer’s disease

Answer 8

D. Is incorrect.

Remarks: Beta amyloid : Alzheimer’s disease is correct

Question 9

What is the etiology of a patient with the following csf lab results: opening pressing of 170 mmHg, cell differentials is mainly lymphocytes, protein 45 mg/dL, glucose 60 mg/dL, csf to serum glucose ratio 0.4.

Answer 9

Viral