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CLINICAL MICROSCOPY > CSF > Flashcards

CSF Flashcards

1
Q

a major fluid of the body associated to CNS

A

Cerebrospinal fluid

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2
Q

Csf is produced in the ________ of the two lumbar ventricles and the______ and ____ ventricles

A

Choroid plexus
3rd and 4th

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3
Q

Approx ________ is produced every hour in adults

A

20mL

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4
Q

Maintain the volume of ______ to _______ ml in adults

A

90-150 ml

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5
Q

Volume of csf in neonates

A

10-60 ml

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6
Q

The circulating fluid is reabsorbed back into the blood capillaries in ____________/ at rate to equal to its production

A

Arachnoid granulations

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7
Q

Are capillary networks that form the csf from plasma mechanisms of selective filtration under __________ and _________

A

hydrostatic pressure and active trans port secretion

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8
Q

Are capillary networks that form the csf from plasma mechanisms of selective filtration under hydrostatic pressure and active transport secretion

A

Choroid plexus

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9
Q

Csf specimen is collected by the ___________ between third,fourth or fifth lumbar vetebrate

A

lumbar puncture/ tap

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10
Q

The opening pressure of the CSF taken when the needle first enters the?

A

Subarachnoid space

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11
Q

More preferred site of collection
More Relax

A

Lying position

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12
Q

Less fluid is collected in this position
Higher opening pressure

A

Sitting position

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13
Q

method of puncturing the sub occipital area

A

Cysternal Technique

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14
Q

performed among neonates, FONTANEL is the site of collection

A

Ventricular technique

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15
Q

Tube 1 is for?

A

Chemistry and serology test
Freezing temp

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16
Q
  • these tests are least affected by blood or bacteria introduced as a result of the tap procedure
A

Tube 1

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17
Q

possible contaminants are flushed already in Tube 1

A

Tube 2

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18
Q

Tube 2 is for

A

Microbiology
Room temp

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19
Q

it is least likely to contain cells introduced by the spinal tap procedure

A

Tube 3

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20
Q

Tube 3 is for?

A

Hematology
Refrigrated

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21
Q

A fourth tube may be drawn for the___________ laboratory to provide better exclusion of skin contamination or for additional serologic tests

A

Microbiology lab

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22
Q

Excess fluid should not be discarded and should be _______ until there is no further use for it

A

Frozen

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23
Q

Supernatant fluid that is left over after each section has performed its tests may also be used for additional

A

Chemical or serologic tests

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24
Q

Lateral position in adult

A

90-180 mmHg

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25
Q

Opening pressure space to infants and children

A

10-100 mmHg

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26
Q

“If the opening pressure is greater than________ for a relaxed patient, NO more than should be collected

A

200 mmHg
No more than 2 mL

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27
Q

Avoid_________ because cell adhesion to the glass affects cell count and differentiation

A

Glasstubes

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28
Q

Processing time should be cellular degradation begins _______ after collection

A

quick/ 1hour

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29
Q

Refrigeration is contraindicated for culture specimens (Tube # 2) because fastidious organisms such as ?what organism cannot survived

A

Hemophilus influenza and Neisseria meningitides will not survive

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30
Q

Normally crystal clear. Standard is

A

h20 or distilled water

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31
Q

Cloudy or Turbid CSF

A

a. Presence of microorganisms

b. Increased protein

c. Increased WBC, RBC

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32
Q

a. Increased carotene

b. Intake of rifampin -ANTU-TB DRUG

c. Increased protein (>150mg/dL)

A

Xanthochromic CSF

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33
Q

a. Presence of microorganisms

b. Increased protein

c. Increased WBC, RBC

A

Cloudy or Turbid CSF

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34
Q

non-pathologic

A

Traumatic tap

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35
Q

Internal bleeding, pathologic

A

Intracranial hemorrhage

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36
Q

a. 6,000 RBC/uL

b. Traumatic tap – non-pathologic

c. Intracranial hemorrhage – Internal bleeding, pathologic

A

Grossly Bloody CSF

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37
Q

term used to describe CSF supernatant that is pink, orange, or yellow. Brought about by hemolysis

A

XANTHOCHROMIA

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38
Q

Very slight amount of oxyhemoglobin
Color?

A

Pink

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39
Q

Heavy hemolysis

A

Orange

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40
Q

conversion of oxyhemoglobin to unconjugated bilirubin

A

Yellow

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41
Q

*RBC à Lyse à releasing Hgb causing?

A

xanthochromic hemolysis

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42
Q

is caused by bilirubin due to immature liver function is also commonly seen in infants, particularly in those who are premature

A

Xanthochromia

43
Q

Disorders affecting bloodbrain barrier Tubular meningitis

A

Pellicle

44
Q

Disorders affecting bloodbrain barrier Traumatic tap

A

Clotted

45
Q

Old hemorrhage Lysed cells RBC degradation Elevated bilirubin Increased serum level Disorders affecting bloodbrain barrier Meningeal melanosarcoma

A

Xanthochromic

46
Q

Turbidity and Cloudiness begins to appear with:

  • CSF WBC count Turbidity and Cloudiness begins to appear with:
  • CSF WBC counts >200 cells/uL or
  • CSF RBC counts >400 cells/uL
A

> 200 cells/uL or >400 cells/uL

47
Q

CSF with cell counts of <50 cells/uL when direct sunlight is directed to the tube at 90 degree angle from the observer appear __________

A

Sparkling or snowy

48
Q

CSF with cell counts of <50 cells/uL when direct sunlight is directed to the tube at 90 degree angle from the observer appear “sparkling” or “snowy”

A

TYNDALL EFFECF

49
Q

when CSF clots without presence of blood, there is damage in blood brain barrier

A

Froin syndrome

50
Q

Grossly bloody CSF can be an indication of intracranial hemorrhage, but it may also be due to the puncture of a blood vessel during the spinal tap procedure

A

Traumatic tap

51
Q

Uneven distribution of blood?

A

Traumatic tap

52
Q

Equal redness

A

Intracranial hemorrhage

53
Q

1 st tube is much red and color diminish

A

Traumatic tap

54
Q

Introduction of plasma fibrinogen into the specimen

A

Clot formation

55
Q

Bloody CSF caused by ________does not contain enough fibrinogen to clot

A

Intracranial hemorrhage

56
Q

RBC contains fibrinogen which is a clotting factor, fresh blood introduced due to

A

Traumatic tap

57
Q

Diseases in which damage to the blood-brain barrier allows increased filtration of protein and coagulation factors also cause clot formation but do not usually produce a bloody fluid

A

Meningitis
Froin syndrome
Blockage of csf

58
Q

A classic web-like pellicle is associated with

A

Tubular meningitis

59
Q

RBCs must usually remain in the CSF for approximately 2 hours before noticeable hemolysis begins

A

Xanthochromic supernatant

60
Q

RBCs concentrated at the bottom

A

Traumatic tap

61
Q

Bloody all throughout

A

Intracranial hemorrhage

62
Q

1>2>3
Positive (plasma fibrinogen)
Clear supernatant
Negative to erythrophages

A

Traumatic tap

63
Q

1=2=3

Negative (fibrinogen is absent

Xanthochromic

Positive to erythrophages

A

Intracranial hemorrhage

64
Q
  • Subtract ___WBC for every 700 RBC
  • Subtract___ mg/dL Protein for every 10,000 RBC/uL
A

1 WBC
8 mg/dl

65
Q

The microscopic finding of macrophages containing ingested RBCs or hemosiderin granules is indicative of

A

Intracranial hemorrhage

66
Q

are usually determined only when a traumatic tap has occurred and a correction for leukocytes or protein is desired

A

Rbc count

67
Q

Routinely done

A

Wbc count

68
Q

Diluent in wbc count

A

3% acetic acid + Methylene blue

69
Q

increased number of normal cells in csf

A

Pleocytosis

70
Q

•70% Lymphocytes is for?

•80% Monocytes is for?

A

Adult
Neonate

71
Q

Normal in CSF

  • If increased – seen in viral, fungal and tubercular metastasis
A

Lymphocyte

72
Q

Normal in CSF

  • If increased – seen in fungal and tubercular meningitis
A

Monocyte

73
Q
  • Not normal
  • Indicative of bacterial meningitis
  • Found in early cases of viral, fungal, and tubercular meningitis
A

Neutrophil

74
Q
  • Macrophages with ingested RBC
  • Seen in intracranial hemorrhage
A

Erythrophages

75
Q

Seen in multiple sclerosis – can lead to paralysis

A

Plasma cells

76
Q

Seen in leukemia

A

Blast cells

77
Q

RBC in spinal fluid Contrast media

A

Macrophages

78
Q

Normal Viral, tubercular, and fungal meningitis Multiple sclerosis

A

Monocytes

79
Q

May contain phagocytized RBCs appearing as empty vacuoles or ghost cells, hemosiderin granules and hematoidin crystals

A

Macrophages

80
Q

Disseminated lymphomas

Resemble lymphocytes with cleft nuclei

A

Lymphoma cells

81
Q

Diagnostic procedures

Seen in clusters with distinct nuclei and distinct cell walls

A

Ependymal, choroidal, spindleshaped cells

82
Q

Metastatic carcinomas Primary CNS carcinoma

Seen in clusters with fusing of cell borders and nuclei

A

Malignant cells

83
Q

The most frequently performed chemical test on CSF

A

Csf proteins

84
Q

Primary protein fraction (same as serum)

A

Albumin

85
Q

Second most prevalent (distinctive to CSF)

A

Pre albumin

86
Q
  • Haptoglobin
  • Ceruloplasmin
A

Alpha globulins

87
Q
  • Transferrin (Major)
  • Tau – carbohydrate deficient variant of transferrin (unique to CSF)
A

Beta Globulin

88
Q
  • IgG (primarily)
  • IgA (small amount)
A

Gamma globulin

89
Q

True or false

“IgM, Fibrinogen, and Beta lipoprotein are normally found in CSF”

A

False because it is NOT SEEN IN CSF

90
Q
  • CSF leakage/trauma
  • Recent puncture
  • Rapid CSF production
  • Water intoxication
A

Decreased Results

91
Q
  • Meningitis
  • Hemorrhage
  • Primary CNS tumors
  • Multiple sclerosis
  • Guillain-Barré syndrome
  • Neurosyphilis
  • Polyneuritis
  • Cushing disease
  • Polyneuritis
  • Diabetes
  • Uremia
  • Connective tissue disease
  • Myxedema
A

Elevated Results in

92
Q

• Proteins that were artificially introduced into the CSF by traumatic tap

A

Artificially induced proteins

93
Q

more preferred, it can precipitate both albumin and globulin

A

. TCA (Trichloroacetic acid)

94
Q

precipitates only albumin

A

SSA (Sulfosalicylic acid

95
Q

Method whereas TCA AND SSA IS UNDER

A

Turbidimetry

96
Q

Red + Protein = Blue (read photometrically

A

DYE BINDING
a. CBB (Coomasie Brilliant Blue

97
Q

for Globulin Rgt: Ammonium sulfate (+) turbidity or grayish white ring

A

Rose jones test

98
Q

for Globulin Rgt: Ammonium sulfate (+) turbidity

A

Nonne apelt

99
Q

for Globulin Rgt: Saturated phenol solution (+) turbidity or bluish white cloudiness

A

Pandy’s

100
Q

Albumin-Globulin ratio (increased Globulin = infection)

A

Lange’s colloidal gold test

101
Q

Reagent use for rose jones method

A

Ammonium sulfate

102
Q

Reagent use for nonne apelt method

A

Ammonium sulfate

103
Q

Reagent used in pandy’s method

A

Saturated phenol solution

CLINICAL MICROSCOPY (7 decks)

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