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Urinalysis & Body Fluids > Cerebrospinal fluid analysis > Flashcards

Cerebrospinal fluid analysis Flashcards

1
Q

Dura mater

A

outer membrane of brain

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2
Q

arachnoid mater

A

middle membrane of brain

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3
Q

pia mater

A

inner membrane

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4
Q

choroid plexus cells

A

in the center of the brain area

produces cerebrospinal fluid

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5
Q

composition of cerebrospinal fluid

A

selective secretion from plasma NOT an ultrafiltrate

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6
Q

collection

A

3+ sterile tubes

1: chemical & immunological testing
2: microbiology
3: cell count & cytology
4: optional, micro

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7
Q

crystal clear color

A

normal cerebrospinal fluid

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8
Q

cloud or turbid color

A

wbcs, increased protein or lipid concentration

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9
Q

milky color

A

wbcs, increased protein or lipid concentration

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10
Q

xanthrochromic color

A 
pink to orange color
rbcs degradation
increased serum bilirubin
carotene
markedly increased protein
melanoma pigment
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11
Q

hemolyzed/bloody color

A

intracranial hemorrhage or traumatic tap

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12
Q

traumatic tap

A

greatest amount of blood in tube 1 & least in tube 3
after centrifugation , colorless supernatant
may see clots present in tubes bc of fibrinogen

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13
Q

hemorrhage

A

consistent amount of blood in all three tubes
after centrifuge, xanthochromic supernatant
macrophages with phagocytized RBcs

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14
Q

routine tests on CSF

A

cell count & differential
protein
glucose

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15
Q

temps for tube storages

A

1: can be frozen if needed
2: micro- room temp
3: refrigerated for cell counts

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16
Q

traumatic tap & wbcs

A

correct for contamination

17
Q

D-dimer for hemorrhage & traumatic tap

A

hemorrhage: positive D-dimer

traumatic tap: negative D-dimer

18
Q

range for RBCs in CSF

A

0 rbcs/ul for all ages

19
Q

cytospin

A

pro: good cellular recovery & preservation; rapid & simple
con: production of some aberrant cells

20
Q

cytocentrifugation

A

particle sedimentation speed increases w/ the rotational speed of the centrifuge; it is faster for large or dense particles & slower for small or light particles

21
Q

2 categories of cytocentrifugation

A
  1. remove the suspension fluid during cell sedimentation

2. retain the suspension fluid during cell sedimentation

22
Q

normal adult CSF differential

A

lymphs & monos = 70:30
few neutrophils
few lining cells & macrophages

23
Q

normal children CSF differential

A

monos > lymphs

ependymal cells & macrophage

24
Q

neutrophilia

A

bacterial meningitis

25
Q

macrophages present

A

recent hemorrhage usually

appear 2-4 hours after RBC introduction

26
Q

protein

A

usually determined to assess the integrity of the blood-brain barrier
also used to indicate CNS pathology
15-45 mg/dl

27
Q

increased protein

A

decreased reabsorption into the venous blood
increased synthesis of immunoglobulin
contamination w/ blood during tap

28
Q

decreased protein

A

increased reabsorption by the arachnoid villi due to increased intracranial pressure
fluid leaking !!

29
Q

CSF/ serum albumin index

A

used to evaluate the integrity of blood-brain barrier

30
Q

CSF IgG index

A

used to measure IgG synthesis w/in the CNS

multiple sclerosis >0.70

31
Q

protein electrophoresis

A

4 bands: tranthyretin (TTR), albumin, two transferrin bands

tau transferrin migrates in beta 2 region & in synthesized almost exclusively in CNS

32
Q

oligoclonal banding in the y region

A

presence in CSF & absence in serum is highly indicative of multiple sclerosis

33
Q

glucose

A

60-70% of plasma concentration

decreased: bacterial meningitis or defective glucose transport

34
Q

bacterial meningitis picture

A

up WBCs, up neutrophil

down glucose

35
Q

lactate

A

increased levels - anaerobic metabolism
>35 mg/dl found in bacterial meningitis
25-30 mg/dl in viral

36
Q

increased CSF lactate correlates with what?

A

low CSF glucose levels

better diagnostic indicator of bacterial meningitis than either parameter alone

37
Q

Glutamine

A

produced in the CNS by brain cells from ammonia & alpha-ketoglutarate
indirect measurement of excess ammonia in CSF

38
Q

elevated glutamine

A

seen w/ liver disorders that have increased blood & CSF ammonia

Urinalysis & Body Fluids (8 decks)

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