Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

analysis of urine and other body fluids > Chapter 12 - Cerebrospinal Fluid > Flashcards

Chapter 12 - Cerebrospinal Fluid Flashcards

1
Q

CSF is considered as the ____ major body fluid

A. 1st
B. 2nd
C. 3rd
D. 4th

A

C. 3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fxns of CSF

A

supply nutrients, remove metabolic waste, mechanical barrier to cushion the brain & spinal cord againts trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lines the brain& spinal cord

A

Meninges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 layers of meninges

A

Dura mater, arachnoid mater, pia mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Outer layer, lines the skull & vertebral canal

A

Dura mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Spiderweb-like, filamentous inner membrane

A

Arachnoid mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Below arachnoid, portion where CSF flows

A

Subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Innermost layer, lines the surface of brain & spinal cord

A

Pia mater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Can albumin pass through the BBB?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Can IgM pass through BBB?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Can WBCs pass through the BBB?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Produces CSF by selective filtration

A

Choroid plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Rate of CSF production by the choroid plexus

A

20 mL/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Reabsorbs CSF

A

Arachnoid villi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Protects brain from chemicals & other substances circulating in the blood that can harm the brain tissue

A

Blood Brain Barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Up to _____ (how much) CSF can be collected as spx?

A

20 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tube 1 of CSF spx is used for ____ tests and stored at _____

A

Chem/sero, freezer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tube 3 CSF spx is used for ____ tests and stored at ____

A

Hema, ref

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tube 2 of CSF spx is used for ____ tests, and stored at ____

A

Microbio, room temp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tube 4 of CSF spx is used for _____, and stored at ____

A

Microbio or sero, depends on test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which CSF spx tube is described by the ff?

  1. Usually designated for microbiology
  2. Better exclusion of skin contam or for additional tests
  3. Least likely contain cells introduced by spinal tap
  4. Least affected by blood or bacteria introduced by spinal tap
A
  1. Tube 2
  2. Tube 4
  3. Tube 3
  4. Tube 1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

True or false: left over supernatant fluid should not be used for additional chemo or sero tests

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

True or false: excess fluid should not be discarded and should be put in ref until there is no further use to it.

A

False. Dapat sa freezer ilalagay, hindi sa ref

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the correct order of tests if only 1 CSF tube was collected?

A

Micro then hema then chem/sero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CSF total vol in adults

A

90-150 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CSF total vol in neonates

A

10-60 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Determine the appearance of the ff conditions of CSF:

  1. Normal
  2. Inc WBCs & RBCs
  3. Inc Lipids and proteins
  4. Slight amt of oxyhemoglobin
  5. Heavy hemolysis
  6. Bilirubin
  7. Hgb degradation products
  8. Inc carotene
  9. Inc melanin
  10. Inc protein (>150 mg/dL)
  11. Traumatic tap
  12. Intracranial hemorrhage
  13. Inc microorganisms
  14. Inc rifampin
  15. Inc RBCs (>6000/uL)
A
  1. Crystal clear
  2. Hazy/turbid/milky/cloudy
  3. Hazy/turbid/milky/cloudy
  4. Xanthochromic (Pink)
  5. Xanthochromic (orange)
  6. Xanthochromic (yellow)
  7. Xanthochromic
  8. Xanthochromic
  9. Xanthochromic
  10. Xanthochromic
  11. Bloody
  12. Bloody
  13. Hazy/turbid/milky/cloudy
  14. Xanthochromic
  15. Bloody
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Identify whether traumatic tap or intracranial hemorrhage

  1. Uneven distribution of blood on 3 tubes
  2. Supernatant is xanthochromic
  3. Presence of erythrophages
  4. Negative D-dimer
  5. Absent erythrophages
  6. Clear supernatant
  7. Positive clot formation
  8. Negative clot formation
  9. Even distribution of blood on 3 tubes
  10. Positive D-dimer
A
  1. Traumatic tap (TT)
  2. Intracranial hemorrhage (IH)
  3. IH
  4. TT
  5. TT
  6. TT
  7. TT
  8. IH
  9. IH
  10. IH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Csf appearance for presence of radiographic contrast media

A

Oily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Csf appearance for the presence of protein & clotting factors

A

Clotted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Csf appearance for Froin syndrome

A

Clotted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Csf appearance for tubercular meningitis

A

Pellicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Csf appearance for blockage of CSF circulation

A

Clotted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Any cell count should be performed IMMEDIATELY. This is because WBCs & RBCs begin to lyse within ____ (how long), and ____% WBCs disintegrate within ____ (how long)

A

1 hr; 40%; 2 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

True or false: WBC count is not routinely performed on CSF

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Normal values for CSF WBC ct for adults

A

0-5 wbcs / uL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Normal values for CSF WBC ct for neonates

A

0-30 WBC/uL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

CSF dilution for WBC ct:

  1. Clear
  2. Hazy
  3. Bloody/turbid
  4. Slightly cloudy
  5. Cloudy/slightly bloody
  6. Slightly hazy
A
  1. Undiluted
  2. 1:20
  3. 1:10000
  4. 1:100
  5. 1:200
  6. 1:10
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Formula for CSF WBC ct:

A

WBC ct (/uL) = (# of cells counted x dilution) / (area x depth factor [0.1])

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Area of each WBC square

A

1 mm^2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Area of each RBC square

A

0.04 mm^2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

CSF WBC count diluting fluid

A

Acetic acid w/ methylene blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

RBC count is done only in cases of ____

A

Traumatic tap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

To correct for WBC count & total protein conc:

_______ WBC for every 700 RBCs seen

A

-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

To correct for WBC count & total protein conc:

______ Total protein conc for every 1,200 RBCs/uL

A

-1 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

To correct for WBC count & total protein conc:

_____ total protein conc for every 10,000 RBCs/uL

A

-8 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

CSF diff count is performed on ____

A

Stained smear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Regarding CSF diff count, spn should be concentrated before smearing by using the ff methods:

A

Cytocentrifugation, centrifugation, sedimentation, filtration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Regarding cytocentri, cells are forced into a monolayer within a ____ diameter circle on the slide

A

6 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Regarding cytocentri, ______ is added to increase cell yield or recovery and to decrease cellular distortion

A

30% albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Predominant cells in CSF

A

Lympho & mono

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Adult mono to lympho ratio

A

30:70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Neonates CSF normal cell value

A

Up to 80% mono

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Abnormal condition, increased # of normal cells in the CSF

A

Pleocytosis

55
Q

Identify the type/s of cell that may be present in CSF given the ff descriptions:

  1. Multiple sclerosis
  2. Bacterial meningitis
  3. Acute leukemia
  4. Viral
  5. Metastatic carcinomas
  6. Diagnostic procedures
  7. Disseminated lymphoma
  8. Cerebral hemorrhage
  9. Contrast media
  10. RBCs in spinal fluid
  11. Fungal meningitis
A
  1. Lympho, mono, plasma cells
  2. Neutro
  3. Blast forms
  4. Lympho, mono
  5. Malignant cells
  6. Ependymal, choroidal, spindle-shaped cells
  7. Lymphoma cells
  8. Neutro
  9. Macrophage
  10. Macrophage
  11. Lympho, mono, neutro
56
Q

Normal value for adult CSF protein

A

15-45 mg/dL

57
Q

Normal value for infant CSF protein

A

150 mg/dL

58
Q

Most common cause of increased CSF protein

A

Damage to BBB

59
Q

Identify whether CSF protein is increased or decreased in the ff:

  1. CSF leakage / trauma
  2. Recent puncture
  3. Meningitis
  4. Multiple sclerosis
  5. Rapid CSF production
  6. Water intoxication
  7. Neural tissue degeneration
  8. Decreased normal protein clearance from the fluid
  9. Hemorrhage
A
  1. Dec
  2. Dec
  3. Inc
  4. Inc
  5. Dec
  6. Dec
  7. Inc
  8. Inc
  9. Inc
60
Q

Major CSF protein

A

Albumin

61
Q

2nd most prevalent CSF protein

A

Prealbumin

62
Q

2 alpha globulins found in CSF

A

Haptoglobin, ceruloplasmin

63
Q

A beta globulin, carbohydrate-deficient transferrin, found in CSF but not in serum

A

Beta2-transferrin (tau)

64
Q

How many transferrins are present in CSF

A

2 namely beta 1 and beta 2 transferrins

65
Q

Name 3 biochemical substances not normally found in CSF but normally found in serum

A

IgM, fibrinogen, lipids

66
Q

Identify whether the ff tests for total protein or protein fractions:

  1. IgG index
  2. Tubidimetric
  3. Dye-binding
  4. CSF/serum albumin index
A
  1. Protein fractions
  2. Total protein
  3. Total protein
  4. Protein fractions
67
Q

Preferred turbidimetric method that precipitates both albumin and globulins

A

3% trichloroacetic acid (tca)

68
Q

Dye used in the dye binding technique for CSF

A

Coomassie blue

69
Q

Color result for increased proteins in CSF dye binding technique

A

Dye turns from red to Blue (using Coomassie blue)

70
Q

Test used to assess the integrity of BBB

A

CSF/Serum albumin index

71
Q

In the formula:

CSF/serum albumin index = CSF albumin / serum albumin

In what unit/s should CSF albumin and serum albumin be in order to use the formula?

A

CSF albumin should be in mg/dL

Serum albumin should be in g/dL

72
Q

A turbidimetric technique that precipitates albumin only

A

3% sulfosalicylic acid (ssa)

73
Q

In the turbidimetric 3% SSA, to precipitate globulins, add _____

A

Sodium sulfate (Na2SO4)

74
Q

Normal value for csf/serum albumin index

A

<9

75
Q

Identify the qualitative interpretation of the ff csf/serum albumin index results:

  1. 20
  2. 30
  3. 105
  4. 40
  5. 9
  6. 14
  7. 16
A
  1. Mod impairment
  2. Mod impairment
  3. Complete dmg to BBB
  4. Severe impairment
  5. Slight impairment
  6. Slight impairment
  7. Moderate impairment
76
Q

Test used to assess conditions w/ IgG production w/in the CNS (e.g. multiple sclerosis)

A

IgG index

77
Q

IgG index formula

A

IgG index = (csf IgG in mg/dL / serum IgG in g/dL) / (csf albumin in mg/dL / serum albumin in g/dL)

78
Q

Normal IgG index value

A

<0.77

79
Q

An IgG index of 0.80 is indicative of?

A

IgG production within the CNS like in multiple sclerosis

80
Q

Csf electrophoresis is done to detect for ____

A

Oligoclonal bands

81
Q

In which region can you find oligoclonal bands

A

Gamma region

82
Q

Oligoclonal bands indicates?

A

Immunoglobulin production

83
Q

Csf electrophoresis is done in conjunction with ____ to ensure that banding is due to neurologic inflammation

A

Serum electrophoresis

84
Q

How many oligoclonal bands should be present in the CSF but not in serum is valuable for diagnosing?

A

2 or more

85
Q

Presence of 2 or more okiclonal bands in csf but not in serum is valuable for the diagnosis of ___

A

Multiple sclerosis

86
Q

Matching type:

A. Oligoclonal banding in csf but not in serum
B. Oligoclonal banding in serum but not in csf
C. Oligoclonal banding in serum and csf

  1. Leukemia
  2. Lymphoma
  3. Encephalitis
  4. Guillain-Barre syndrome
  5. BBB leakage
  6. HIV
  7. Neoplastic disorders
  8. Traumatic tap
  9. Persistent multiple sclerosis
  10. Viral infxn
  11. Neurosyphilis
A
  1. B
  2. B
  3. A
  4. A
  5. B
  6. C
  7. A
  8. B
  9. A
  10. B
  11. A
87
Q

Demyelinating disorder

A

MS

88
Q

Protein component of the lipid-protein complex that insulate the nerve fibers

A

MBP

89
Q

Presence of MBP in CSF indicates?

A

MS / destruction of myelin sheath

90
Q

Used to monitor the course of multiple sclerosis

A

MBP

91
Q

Which test for protein fractions is ised to detect MS

A

IgG index

92
Q

Autoantibody present in MS

A

Anti-myelin sheath autoantibody

93
Q

Spx for blood glucose (when comparing it with CSF glucose) should be drawn ____ prior to spinal tap

A

2 hrs

94
Q

Normal csf glucose value

A

60-70% of blood glucose (50-80 mg/dL)

95
Q

Determine whether glucose is inc or dec in the ff:

  1. Viral meningitis
  2. Increased plasma glucose
  3. Tubercular meningitis
  4. Fungal meningitis
  5. Bacterial meningitis
  6. Alteration in mechanism of BBB
  7. Inc use of glu by brain cells
A
  1. Normal
  2. Inc
  3. Dec
  4. Dec
  5. Dec
  6. Dec
  7. Dec
96
Q

Which csf substance is inversely proportional to glucose and a sensitive method for evaluating the effectiveness of antibiotic therapy?

A

Csf lactate

97
Q

Normal csf lactate value

A

10-22 mg/dL

98
Q

Identify whether lactate is inc or dec in the ff

  1. Bacterial meningitis
  2. Hypoxia
  3. Viral meningitis
  4. Fungal meningitis
  5. Tubercular meningitis
A
  1. Inc
  2. Inc
  3. Normal
  4. Inc
  5. Inc
99
Q

Product of ammonia and alphaketoglutarate; an indirect test for the presence of excess ammonia in the csf

A

Csf glutamine

100
Q

Normal csf glutamine value

A

8-18 mg/dL

101
Q

Csf glutamine in inc or dec in the ff conditions:

  1. Reye’s syndrome
  2. Disturbance of consciousness
A
  1. Inc

2. Inc

102
Q

Test to detect coma of unknown origin

A

Csf glutamine caused by ammonia

103
Q

Arrange the ff LDH based on highest to lowest quantity in normal serum

A

2>1>3>4>5

104
Q

Arrange the ff LDH if AMI is present in serum

A

1>2 (flipped pattern)

105
Q

Arrange the ff CSF LDH in normal csf from highest to lowest quanti

A

1>2>3>4>5

106
Q

Arrange the ff CSF LDH in a csf w/ neurological abnormalities from highest to lowest quanti

A

2 > 1

107
Q

Arrange the ff CSF LDH in a csf w/ bacterial meningitis from highest to lowest quanti

A

5>4>3>2>1

108
Q

Csf LDH isoenzymes in brain tissue

A

1 and 2

109
Q

LDH isoenzyme in lympho

A

2 and 3

110
Q

LDH isoenzyme in neutro

A

4 and 5

111
Q

CSF enzyme increased in stroke, degenerative disorders, brain tumors, viral and bacterial meningitis, seizures

A

CK

112
Q

Csf enzyme increased in intracerebral and subarachnoid hemorrhage, bacterial meningitis

A

AST

113
Q

Recommended by CDC for the detection of neurosyphilis

A

VDRL

114
Q

Sero tests for csf to detect bacterial antigen

A

Latex agglutination test and ELISA

115
Q

Detects gram-neg endotoxin in body fluids & surgical instrument

A

Limulus lysate test

116
Q

Reagent for limulus lysate test

A

Blood of horseshoe crab

117
Q

Principle of limulus lysate test: in the presence of endotoxin, the ____ will release ____

A

Amoebocytes (WBCs) ; lysate (protein)

118
Q

Positive result for limulus lysate test

A

Clumping / clot formation

119
Q

Predominant wbc isotype in bacterial meningitis

A

Neutro

120
Q

Identify wheter the ff are inc or dec during bacterial meningitis

  1. Neutro
  2. Protein
  3. Glucose
  4. Lactate
A
  1. Inc
  2. Inc
  3. Dec
  4. Inc
121
Q

Predominant wbc in viral meningitis

A

Lympho

122
Q

Identify whether inc or dec during viral meningitis

  1. Protein
  2. Glucose
  3. Lactate
A
  1. Inc
  2. Normal
  3. Normal
123
Q

Identify whether the ff are inc or dec in tubercular meningitis

  1. Protein
  2. Glucose
  3. Lactate
A
  1. Inc
  2. Dec
  3. Inc
124
Q

Predominant wbc in tubercular meningitis

A

Lympho and mono

125
Q

Predominant wbc in fungal meningitis

A

Lympho and mono

126
Q

Identify whether the ff are inc or dec in fungal meningitis

  1. Protein
  2. Glucose
  3. Lactate
A
  1. Inc
  2. Dec
  3. Inc
127
Q

Agents of viral meningitis

A

Enteroviruses (poliovirus, echovirus, coxsackievirus)

128
Q

Positive pellicle/weblike clot formation after 12-24 hr refrigeration

A

Tubercular meningitis

129
Q

Agent of tubercular meningitis

A

M. tuberculosis

130
Q

Agent of fungal meningitis

A

Cryptococcus neoformans

131
Q

Gram stain pattern assoc w/ cryptococcus neoformans

A

Classic starburst pattern in gram stain

132
Q

It is not unusual for cell counts performed in tubes ____ and ____ to check for cellular contam by puncture

A

1 and 4

133
Q

______ represent further degradation of hemosiderin granules. They are iron-free, consisting hgb and unconjugated bilirubin

A

Yellow hematoidin crystals

134
Q

______ meningitis is now commonly encountered in the clin lab

A

Cryptococcal

analysis of urine and other body fluids (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions