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AUBF LEC > CSF > Flashcards

CSF Flashcards

1
Q

3 Layers of the Meninges

A

Dura mater, arachnoid mater, pia mater

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2
Q

outer layer; lines the skull and vertebral
canal

A

Dura mater

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3
Q

filamentous (spider-like) inner
membrane.

A

Arachnoid mater

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4
Q

thin membrane lining the surfaces of the
brain and spinal cord.

A

Pia mater

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5
Q

Choroid Plexuses of the 2 lumbar ventricles & the 3rd and 4th ventricles

A

site of production of CSF.

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6
Q

approximate volume of CSF produce every hour.

A

20 mL

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7
Q

tight-fitting structure of the
endothelial cells in the choroid plexuses

A

Blood-Brain-Barrier

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8
Q

method used to routinely collect CSF.

A

Puncture between the 3rd, 4th Or 5th Lumbar Vertebra

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9
Q

left over after each section has performed its tests may also be used for additional chemical or serologic tests.

A

Supernatant Fluid

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10
Q

should not be discarded and should be frozen until there is no further use for it.

A

Excess Fluid

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11
Q

usually determine whether the blood is the result of hemorrhage or a traumatic tap.

A

Three visual examinations of the collected specimens

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12
Q

routinely performed on CSF specimens

A

White Blood Cell Count (WBC)

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13
Q

usually determined only when a traumatic tap has occurred

A

Red Blood Cell Count

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14
Q

should be performed immediately.

A

Any cell count

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15
Q

routinely used for performing CSF cell counts.

A

Improved Neubauer counting chamber

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16
Q

have not been used for performing CSF cell counts.

A

Electronic cell counters

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17
Q

made with normal saline

A

Dilutions for total cell counts

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18
Q

Counted in the four corner squares and the center
square on both sides of the hemocytometer.

A

TOTAL CELL COUNT

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19
Q

Lysis of RBCs must be obtained

A

WBC COUNT

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20
Q

Counted in the four corner squares, and the center square on both sides of the hemocytometer and the number is multiplied by the dilution factor to obtain the number of WBCs per microliter.

A

WBC COUNT

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21
Q

for spinal fluid RBC and WBC counts.

A

Liquid commercial controls

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22
Q

must be soaked in a bactericidal solution for at least 15 minutes and then thoroughly rinsed with water and cleaned with isopropyl alcohol.

A

Non-disposable counting chambers

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23
Q

should be checked biweekly for contamination by examining them in a counting chamber under 400× magnification.

A

All diluents

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24
Q

Performed on a stained smear.

A

DIFFERENTIAL COUNT ON A CSF SPECIMEN

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25
Q

Methods available for specimen concentration

A

Sedimentation, Filtration,Centrifugation! Cytocentrifugation

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26
Q

removed and saved for additional tests

A

supernatant fluid

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27
Q

slides made from the suspended sediment are allowed to air dry and are stained with

A

Wright’s stain.

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28
Q

should be counted, classified, and reported in terms of percentage.

A

100 cells

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29
Q

majority of cells found in normal CSF.

A

Lymphocytes & Monocytes

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30
Q

predominance of lymphocytes to monocytes.

A

Adults

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31
Q

predominance of monocytes to lymphocytes.

A

Children

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32
Q

presence of increased number of these
normal cells; considered abnormal

A

Pleocytosis

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33
Q

Immature leukocytes, eosinophils, plasma cells,
macrophages, increased tissue cells, and malignant cells

A

abnormal

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34
Q

high CSF WBC Count – majority of
the cells (+) Neutrophils

A

Bacterial Meningitis

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35
Q

moderately elevated CSF WBC count with a high percentage of lymphocytes and monocytes.

A

Viral, fungal, tubercular or parasitic meningitis

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36
Q

Increased eosinophils are seen in the CSF in association with:

A

Parasitic Infections! Fungal Infections (Primarily Coccidioides immitis), Introduction of Foreign Material

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37
Q

most frequently seen after diagnostic procedures, Often appear in clusters, (+) Uniform Appearance

A

Nonpathologically significant cells

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38
Q

from the epithelial lining of the choroid plexus.

A

Choroidal Cells

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39
Q

are from the lining of the ventricles and neural canal

A

Ependymal Cells

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40
Q

represent lining cells from the arachnoid

A

Spindle-Shaped Cells

41
Q

Lymphoblasts, myeloblasts, and monoblasts in the CSF are frequently seen as a serious complication of acute leukemias

A

HEMATOLOGIC ORIGIN

42
Q

Metastatic carcinoma cells of nonhematologic origin are primarily from lung, breast, renal, and gastrointestinal malignancies

A

NON-HEMATOLOGIC ORIGIN

43
Q

Nucleoli are often more prominent than in blood smears.

A

HEMATOLOGIC ORIGIN

44
Q

Cells from primary CNS tumors include astrocytomas, retinoblastomas, and medulloblastomas

A

NON-HEMATOLOGIC ORIGIN

45
Q

Lymphoma cells are also seen in the CSF and indicate dissemination from the lymphoid tissue.

A

HEMATOLOGIC ORIGIN

46
Q

They usually appear in clusters and must be distinguished from normal clusters of ependymal, choroid plexus, lymphoma, and leukemia cells.

A

NON-HEMATOLOGIC ORIGIN

47
Q

They resemble large and small lymphocytes and usually appear in clusters of large, small, or mixed cells based on the classification of the lymphoma.

A

HEMATOLOGIC ORIGIN

48
Q

Fusing of cell walls and nuclear irregularities hyperchromatic nucleoli are seen in clusters of malignant cells.

A

NON-HEMATOLOGIC ORIGIN

49
Q

Nuclei may appear cleaved, and prominent nucleoli are present.

A

HEMATOLOGIC ORIGIN

50
Q

not the same as the plasma values.

A

Reference values for CSF chemicals

51
Q

result from alterations in the permeability of the blood–brain barrier or increased production or metabolism

A

Abnormal values

52
Q

most frequently performed chemical test on CSF

A

Protein Determination

53
Q

Reference values for total CSF protein

A

15 to 45 mg/dL

54
Q

makes up the most of the CSF protein

A

ALBUMIN

55
Q

2ND most prevalent fraction in CSF

A

Pre-Albumin

56
Q

include primary haptoglobin &
ceruloplasmin

A

Alpha Globulins

57
Q

major beta globulin present

A

Transferrin

58
Q

separate carbohydrate-deficient transferrin fraction, seen in CSF; NOT in serum

A

TAU

59
Q

primarily immunoglobulin G(IgG)

A

CSF gamma globulin

60
Q

with only a small amount of immunoglobulin A(IgA)

A

CSF gamma globulin

61
Q

not found in normal CSF.

A

Immunoglobulin M (IgM), fibrinogen, and beta
lipoprotein

62
Q

calculated after determining the concentration of CSF albumin in milligrams per deciliter and the serum concentration in grams per deciliter

A

CSF/serum albumin index

63
Q

represents an intact blood-brain- barrier

A

Index value less than 9

64
Q

a comparison of the CSF/serum albumin index with the CSF/serum IgG index, compensates for any IgG entering the CSF via the blood–brain barrier. performed by dividing the CSF/serum IgG index by the CSF/serum albumin index

A

Calculation of an IgG index

65
Q

indicate IgG production within the CNS

A

Values greater than 0.70

66
Q

primary purpose for performing CSF protein electrophoresis

A

To detect oligoclonal bands (represents inflammation within the CNS)

67
Q

indicates immunoglobulin production

A

Oligoclonal Bands

68
Q

must be performed
simultaneously.

A

Serum electrophoresis

69
Q

valuable tool in diagnosing multiple sclerosis when accompanied by an increased IgG index

A

Presence of two or more oligoclonal bands in the CSF
that are not present in the serum

70
Q

method of choice when determining whether a fluid is actually CSF

A

CSF immunofixation electrophoresis (IFE) and isoelectric focusing (IEF) followed by silver staining

71
Q

approximately 60-70% that of the plasma glucose

A

Reference Value of CSF GLUCOSE

72
Q

must be run for comparison for an accurate evaluation of CSF glucose

A

Blood Glucose Test

73
Q

should be drawn about 2 hours before the spinal tap to allow time for equilibration between the blood and fluid

A

Sample for blood glucose

74
Q

Specimens should be tested immediately

A

CSF GLUCOSE

75
Q

provides more reliable information when the initial diagnosis is difficult

A

CSF lactate levels greater than 25 mg/dL

76
Q

levels greater than 35 mg/dL

A

Bacterial Meningitis

77
Q

lower than 25 mg/dL.

A

Viral Meningitis

78
Q

may be obtained on xanthochromic or hemolyzed fluid

A

Falsely elevated results

79
Q

can result from any condition that decreases oxygen flow to the tissues

A

Elevated CSF Lactate: not limited to meningitis

80
Q

frequently used to monitor severe head injuries

A

CSF lactate levels

81
Q

Normal Concentration: 8 to 18 mg/dL

A

CSF GULATAMINE

82
Q

result in increased blood and CSF ammonia.

A

Elevated levels are associated with liver disorders

83
Q

provides an indirect test for
the presence of excess ammonia in the CSF

A

Determining CSF glutamine

84
Q

almost always seen when glutamine levels are more than 35 mg/dL

A

Some Disturbance of Consciousness

85
Q

have elevated CSF glutamine levels

A

75% of children with Reye syndrome

86
Q

routinely performed on CSF from all suspected cases of meningitis, although its value lies in detecting bacterial and fungal organisms

A

Gram Stain

87
Q

should be performed on concentrated specimens

A

All smears and cultures

88
Q

should be centrifuged at 1500 g for 15 minutes

A

CSF

89
Q

should be prepared from the sediment

A

slides and cultures

90
Q

Blood cultures should be taken

A

CSF ANALYSIS: MICROBIOLOGY TEST

91
Q

Organisms most frequently encountered

A

Streptococcus pneumoniae (gram-positive cocci), Haemophilus influenzae (pleomorphic gram-negative rods), Escherichia coli (gram- negative rods), and Neisseria meningitidis (gram-negative cocci)

92
Q

not routinely performed

A

Acid-fast or fluorescent antibody stains

93
Q

performed to detect the presence of thickly encapsulated Cryptococcus neoformans

A

India Ink Preparation

94
Q

seen more often than a positive India ink

A

Gram stain for the classic starburst pattern (produced by Cryptococcus)

95
Q

performed to detect the presence of neurosyphilis

A

Serologic testing of the CSF

96
Q

procedure recommended by CDC to diagnose neurosyphilis

A

Venereal Disease Research Laboratories (VDRL)

97
Q

not recommended because it is less sensitive than the VDRL

A

Rapid plasma reagin (RPR) test

98
Q

care must be taken to prevent contamination with blood

A

the FTA-ABS is used

AUBF LEC (3 decks)

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