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AUBF > CSF > Flashcards

CSF Flashcards

1
Q

3rd major body fluid

A

CSF

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2
Q

Functions of CSF

A

Supply nutrients to nervous system, remove metabolic waste, cushion brain and spinal cord

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3
Q

Meninges 3 layers

A

Dura mater, Arachnoid mater, Pia mater

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4
Q

Outer layer of meninges

A

Dura mater

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5
Q

Filamentous inner membrane

A

Arachnoid mater

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6
Q

CSF flow space

A

Subarachnoid space

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7
Q

Innermost meninges layer

A

Pia mater

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8
Q

Reabsorption of CSF

A

Arachnoid villi

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9
Q

CSF production and reabsorption rate

A

20 mL/hr

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10
Q

CSF production site

A

Choroid plexus

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11
Q

Protects brain from harmful substances

A

Blood-brain barrier

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12
Q

CSF collection volume with manometer

A

20 mL

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13
Q

Normal CSF pressure

A

50-180 mmHg

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14
Q

CSF collection volume for high/low pressure

A

1-2 mL

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15
Q

CSF collection method

A

Lumbar puncture (L3-L4 adults)

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16
Q

CSF collection site in infants

A

L4-L5

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17
Q

CSF Tube 1 storage

A

Freezing temp for chemistry/serology

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18
Q

CSF Tube 2 storage

A

Room temp for microbiology

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19
Q

CSF Tube 3 storage

A

Ref temp for hematology

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20
Q

CSF Tube 4 use

A

Microbiology/Serology

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21
Q

Least affected tube by contamination

A

Tube 1

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22
Q

Tube for additional testing

A

Tube 4

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23
Q

Excess CSF handling

A

Freeze until further testing

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24
Q

Single CSF tube allocation priority

A

Micro > Hema > Chem/Sero

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25
Q

CSF total volume in adults

A

90-150 mL

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26
Q

CSF total volume in neonates

A

10-60 mL

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27
Q

Hazy/Milky/Turbid CSF indicates

A

Increased WBCs, RBCs, lipids, protein, microorganisms

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28
Q

Xanthochromic pink color

A

Slight oxyhemoglobin

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29
Q

Xanthochromic yellow color

A

Oxyhemoglobin to bilirubin

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30
Q

Xanthochromic orange color

A

Heavy hemolysis

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31
Q

Carotene, Melanin, Protein (>150 mg/dL), Rifampin causes what color in CSF

A

Xanthochromic

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32
Q

Bloody appearance of CSF is due to

A

RBCs (>6,000/uL), Traumatic tap, Intracranial hemorrhage

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33
Q

Indications of traumatic tap

A

Uneven blood distribution in tubes, Clot formation, Clear supernatant

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34
Q

Indications of intracranial hemorrhage

A

Even blood distribution, Xanthochromic, Erythrophage (hematoidin and hemosiderin), Positive D-dimer

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35
Q

Clinical significance of oily CSF

A

Radiographic contrast media

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36
Q

Clinical significance of clotted CSF

A

Protein, Clotting factors, Meningitis, Froin syndrome, CSF circulation blockage

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37
Q

Pellicle appearance in CSF

A

Tubercular meningitis

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38
Q

CSF cell count timing

A

Immediately or within 1 hour at room temperature

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39
Q

Percentage of WBCs disintegrating within 1 hour

A

0.4

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40
Q

Normal WBC count in adult CSF

A

0-5 WBCs/uL

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41
Q

Normal WBC count in neonate CSF

A

0-30 WBCs/uL

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42
Q

CSF dilution for clear fluid

A

Undiluted

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43
Q

CSF dilution for slightly hazy fluid

A

0.04861111111111116

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44
Q

CSF dilution for hazy fluid

A

0.05555555555555558

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45
Q

CSF dilution for slightly cloudy fluid

A

1:100

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46
Q

CSF dilution for cloudy/slightly bloody fluid

A

1:200

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47
Q

CSF dilution for bloody/turbid fluid

A

1:10,000

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48
Q

Formula for CSF WBC count

A

cells counted x dilution/area x depth (0.1)

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49
Q

CSF diluting fluid

A

3% acetic acid with methylene blue

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50
Q

Cleaning nondisposable chamber for CSF counting

A

Soak in bactericidal solution 15 mins; rinse with water; clean with isopropyl alcohol

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51
Q

WBC correction for every 700 RBCs

A

Subtract 1 WBC

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52
Q

Total protein correction for every 10,000 RBCs/uL

A

Subtract 8 mg/dL

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53
Q

Total protein correction for every 1,200 RBCs/uL

A

Subtract 1 mg/dL

54
Q

CSF smear preparation

A

Concentrate specimen before smearing

55
Q

Methods for CSF differential count

A

Cytocentrifugation, Centrifugation, Sedimentation, Filtration

56
Q

Monolayer cell diameter during CSF cytocentrifuge

A

6 mm

57
Q

CSF additive for cell yield/recovery

A

30% albumin

58
Q

Predominant cells in CSF

A

Lymphocytes and monocytes

59
Q

Adult lymphocyte-to-monocyte ratio in CSF

A

70% lymph, 30% mono

60
Q

Neonate cell ratio in CSF

A

80% monocytes, 20% lymphocytes

61
Q

Increased number of normal cells in CSF

A

Pleocytosis

62
Q

Significance of lymphocytes and monocytes in CSF

A

Normal, Viral/TB/Fungal meningitis, Multiple sclerosis

63
Q

Significance of neutrophils in CSF

A

Bacterial meningitis, Early viral/TB/fungal meningitis, Cerebral hemorrhage

64
Q

Significance of eosinophils in CSF

A

Parasitic/fungal infections, Coccidioidal meningitis, Medications, Shunts

65
Q

Significance of macrophages in CSF

A

RBCs in spinal fluid, Contrast media

66
Q

Blast forms in CSF indicates

A

Acute leukemia

67
Q

Plasma cells in CSF clinical significance

A

Multiple sclerosis

68
Q

Ependymal, choroidal, spindle-shaped cells clinical significance for CSF

A

Diagnostic contamination

69
Q

Malignant cells in CSF indicates

A

Carcinoma or leukemia

70
Q

Normal values of CSF protein in adults

A

15-45 mg/dL

71
Q

Normal values of CSF protein in infants

A

<150 mg/dL

72
Q

Normal values of CSF protein in immature

A

<500 mg/dL

73
Q

Protein is increased in CSF during

A

Meningitis, hemorrhage, trauma, multiple sclerosis

74
Q

Decreased protein in CSF indicates

A

Increased CSF flow or leakage

75
Q

Major CSF protein

A

Albumin

76
Q

Second most prevalent protein in CSF

A

Prealbumin

77
Q

Alpha-globulins in CSF

A

Haptoglobin, ceruloplasmin

78
Q

Beta-globulins in CSF

A

Transferrin

79
Q

Gamma-globulin in CSF

A

IgG

80
Q

Not normally found in CSF

A

Fibrinogen

81
Q

Preferred method for CSF total protein

A

Turbidimetric (Coomassie Brilliant Blue)

82
Q

To precipitate globulins, add

A

Ammonium sulfate

83
Q

Coomassie Brilliant Blue positive reaction indicates

A

Protein presence

84
Q

CSF/Serum albumin index is used for

A

Assessing blood-brain barrier integrity

85
Q

CSF/Serum albumin index formula

A

CSF albumin (mg/dL) / Serum albumin (g/dL)

86
Q

Normal value of CSF/Serum albumin index

A

<9

87
Q

CSF/Serum albumin index: 9-14

A

Mild impairment

88
Q

CSF/Serum albumin index: 15-100

A

Moderate impairment

89
Q

CSF/Serum albumin index: >100

A

Severe impairment

90
Q

CSF/Serum albumin index: Complete damage to BBB

A

> 100

91
Q

IgG index is used for CSF

A

Detecting IgG production within CNS

92
Q

Normal value of IgG index

A

0.3-0.7

93
Q

Abnormal IgG index

A

> 0.7

94
Q

Detection of oligoclonal bands in gamma region indicates

A

Immunoglobulin production

95
Q

Valuable for the diagnosis of Multiple Sclerosis

A

CSF electrophoresis

96
Q

Better resolution in CSF electrophoresis is obtained using

A

Immunofixation or isoelectric focusing

97
Q

Oligoclonal banding in CSF but NOT in serum

A

Multiple sclerosis

98
Q

Oligoclonal banding in serum but NOT in CSF

A

Systemic infection or inflammation

99
Q

Oligoclonal banding in both serum and CSF

A

CNS infection

100
Q

Protein component of lipid-protein complex insulating nerve fibers

A

Myelin basic protein (MBP)

101
Q

Presence of MBP in CSF indicates

A

Destruction of myelin sheath, Multiple sclerosis

102
Q

Method for MBP detection

A

Immunoassay

103
Q

Demyelinating disorder findings

A

Increased MBP, IgG index, oligoclonal bands

104
Q

Specimen for blood glucose should be drawn

A

Simultaneously with CSF sample

105
Q

Normal values of CSF glucose

A

50-80 mg/dL or 60-70% of plasma glucose

106
Q

Decreased CSF glucose is seen in

A

Bacterial, fungal, or tubercular meningitis

107
Q

Viral meningitis plasma glucose and CSF lactate levels

A

Normal glucose, lactate <25 mg/dL

108
Q

CSF lactate is ___ to glucose

A

Independent

109
Q

Sensitive method for evaluating antibiotic therapy

A

CSF lactate measurement

110
Q

Normal values of CSF lactate

A

10-22 mg/dL

111
Q

Increased CSF lactate is seen in

A

Bacterial, fungal, tubercular meningitis, cerebral ischemia

112
Q

Product of ammonia and alpha-ketoglutarate

A

Glutamine

113
Q

Normal value of CSF glutamine

A

8-18 mg/dL

114
Q

Indirect test for excess ammonia in CSF

A

Glutamine measurement

115
Q

Increased CSF glutamine is seen in

A

Reye syndrome, hepatic encephalopathy

116
Q

CSF enzymes

A

LDH, AST, ALT, CK

117
Q

LDH isoenzymes in CSF

A

LDH1 and LDH2

118
Q

CSF LDH pattern for bacterial meningitis

A

Increased LDH1 and LDH2

119
Q

CSF detection of bacterial antigens

A

Latex agglutination, immunoassays

120
Q

Recommended by CDC for neurosyphilis detection

A

VDRL test

121
Q

Predominant WBC in bacterial meningitis

A

Neutrophils

122
Q

Protein and lactate increased in CSF indicates

A

Bacterial or fungal meningitis

123
Q

Predominant cells in viral meningitis

A

Lymphocytes

124
Q

Increased protein in CSF indicates

A

Bacterial, fungal, tubercular meningitis

125
Q

Tubercular and fungal meningitis predominant WBC in CSF

A

Lymphocytes and monocytes

126
Q

Classic starburst pattern in CSF

A

Cryptococcus neoformans

127
Q

Agents of viral meningitis

A

Enterovirus, Herpes simplex, Mumps virus

128
Q

Detection of Gram-negative endotoxin in fluids/instruments

A

Limulus amoebocyte lysate test

129
Q

Reagent for Limulus amoebocyte lysate

A

Amebocyte extract

130
Q

Principle of Limulus amoebocyte lysate

A

Gel-clot formation in presence of endotoxin

AUBF (26 decks)

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