CSF Flashcards
3rd major body fluid
CSF
CSF is produced by CHOROID PLEXUS by
selective filtration, at a rate of _____
20ml/hr
_______________ - where CSF flows
Subarachnoid space
Method of Collection
Lumbar Puncture
Lumbar puncture Sites
Common:
Adult:
Children
Lumbar puncture Sites
Common: L3, L4, L5; Common - L4
Adult: L3, L4
Children: L4, L5
CSF Order of Collection
Tube 1:
Tube 2:
Tube 3:
Tube 4:
CSF Order of Collection
Tube 1: Chem/Sero
Tube 2: Microbio
Tube 3: Hematology
Tube 4: Serology
CSF Tubes Temperature Requirement
Tube 1:
Tube 2:
Tube 3:
CSF Tubes Temperature Requirement
Tube 1: Frozen - -15C to -30C
Tube 2: Room Temperature - 19C to 22C
Tube 3: Refrigerator - 2C to 8C
Order in 1 CSF Tube ONLY
MicroBio > Hema > Chemistry
Normal CSF Appearance
Crystal Clear
CSF Appearance
Normal: Xanthochromia Pink Yellow Orange Yellow Green Brown Bloody:
CSF Appearance
Normal: Crystal Clear Xanthochromia Pink - Slight amount of OHb Yellow - Bilirubin Orange - Heavy hemolysis Yellow Green - Biliverdin Brown - Meningeal Metastatic Melanoma Bloody: Traumatic Tap or Intracranial Hemorrhage
Traumatic Tap
Distribution of Blood: Clot formation: Supernatant: Xanthochromia: D-dimer:
Traumatic Tap
Distribution of Blood: Uneven - 1 > 2 > 3 Clot formation: Positive Supernatant: Clear Xanthochromia: Negative D-dimer: Negative
Intracranial Hemorrhage
Distribution of Blood: Clot formation: Supernatant: Xanthochromia: D-dimer:
Intracranial Hemorrhage
Distribution of Blood: Even - 1 = 2 = 3 Clot formation: Negative Supernatant: Xanthocromic Xanthochromia:Positive D-dimer: Positive
Present in Clotted Pellicle
Proteins and Clotting Factors
Cells in CSF
Normal:
Bacterial Meningitis:
Bone Marrow contamination:
RBCs in CSF:
Cells in CSF
Normal: Lymphocytes
Bacterial Meningitis: Neutrophils
Bone Marrow contamination: NRBCs
RBCs in CSF: Macrophages
CSF Dilutions
Clear Slightly Hazy Hazy Slightly Cloudy *Cloudy/Slightly Bloody Bloody/Turbid
CSF Dilutions
Clear: UNDILUTED 1:1 Slightly Hazy - 1:10 Hazy - 1:20 Slightly Cloudy - 1:100 *Cloudy/Slightly Bloody - 1:200 Bloody/Turbid - 1:10,000
Cloudy CSF
1:200
Predominant Cells in CSF
70% - ________
30% - ________
Predominant Cells in CSF
70% - LYMPHOcytes
30% - MONOcytes
PLEOCYTOSIS
INCREASD number of NORMAL cells in the CSF
CSF Proteins
§ MAJOR CSF Protein: _____________
§ 2nd most prevalent: _______________
§ Protein ONLY found in CSF: _________
CSF Proteins
§ MAJOR CSF Protein: Albumin
§ 2nd most prevalent: Transthyretin
§ Protein ONLY found in CSF: B2 Globulin - Transferrin
ONLY protein found in CSF
B2 Globulin: Transferrin
CHO-deficient transferrin
TAU Protein
Proteins NOT Normally found in CSF
Fibrinogen
IgM
B-lipoprotein
Predominant Cell Type - Bacterial Meningitis
Neutrophils
CSF Glucose and Lactate is ______ in Viral Meningitis
NORMAL
CSF Glucose is DECREASED in:
1.
2.
3.
CSF Glucose is decreased in:
- Bacterial
- Fungal
- Tubercular
CSF Lactate is INCREASED in:
1.
2.
3.
CSF Lactate is INCREASED in:
- Bacterial
- Fungal
- Tubercular
Predominant Cell in Bacterial Meningitis
Neutrophils
Predominant Cell in Viral Meningitis
Lymphocytes
In Fungal and Tubercular Meningitis, ___________ and ___________ are the predominant cell type.
Lymphocyte
Monocyte
CSF - web-like clot or pellicle is formed
Tubercular (M. tuberculosis) Meningitis
Findings:
(+) India ink preparations and microbial antigen tests
(+) Classic Starbust Pattern
Fungal Meningitis - C. neoformans
Findings:
(+) Limulus Lysate test
(+) Culture
(+) Gram Stain - Gram Negative
Bacterial Meningitis
Indirect Measure of Ammonia and used in the Diagnosis of Reyes Syndrome
CSF Glutamine
