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ASCP M Mometrix > CSF > Flashcards

CSF Flashcards

1
Q

A lumbar puncture procedure consists of:

A

a needle being inserted through a patient’s back
between two lower vertebrae and moved into the space surrounding the spinal cord.

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2
Q

the space
surrounding the spinal cord is filled with:

A

cerebrospinal fluid (CSF) that will drip from the needle
once properly inserted. Fluid will then be collected into sterile containers for laboratory testing

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3
Q

CSF collection from a ventricular shunt is accomplished through:

A

the placement of a catheter
behind the ear that will drain excess spinal fluid from the brain

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4
Q

A shunt is inserted into:

A

ventricles of the brain to relieve pressure caused by an accumulation of CSF

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5
Q

Catheter tubing is
placed to:

A

divert excess CSF either outside of the body for sterile collection or to other parts of the
body, such as the pleural or peritoneal cavities, to be absorbed by blood vessels

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6
Q

A catheter may be placed into a lateral ventricle that is attached to:

A

a reservoir implanted under the
scalp for external access to a shunt system

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7
Q

The reservoir is often used to

A

deliver drugs directly to
the CSF and CNS or to aspirate CSF for testing with a syringe in a minimally invasive manner

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8
Q

Haemophilus influenzae react and present in the following ways:

A

Catalase +
Oxidase +
X factor (hemin) +
V factor (NAD) +
Beta-hemolytic on sheep blood agar −
Lactose fermentation −
Mannose fermentation −

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9
Q

Gram stain: Haemophilus influenzae

A

GNRs

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10
Q

Growth requirements: Haemophilus influenzae

A

aerobic and facultative anaerobe, grow best on chocolate agar in 5–
10% CO2 at 35–37 °C

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11
Q

Colony morphology: Haemophilus influenzae

A

o Unencapsulated strains — small, smooth, and translucent on chocolate agar
o Encapsulated strains — larger, mucoid, with a mouse nest odor on chocolate agar.

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12
Q

Neisseria meningitidis react and present in the following ways

A

Catalase +
Oxidase +
Nitrate reduction −
Maltose fermentation +
Glucose fermentation +
Lactose fermentation −

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13
Q

Gram stain: Neisseria meningitidis

A

GND

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14
Q

Growth requirements: Neisseria meningitidis

A

aerobic and facultative anaerobe, grow best in a humid, 5–10% CO2
environment at 35–37 °C

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15
Q

Colony morphology: Neisseria meningitidis

A

a green hue may be present on agar underneath colonies
o Unencapsulated strains — medium, round, smooth, gray to white, moist on chocolate
and sheep blood agar
o Encapsulated strains — more mucoid appearing.

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16
Q

Escherichia coli react and present in the following ways:

A

Indole +
Citrate −
Hydrogen sulfide (H2S) −
Lysine decarboxylase (LDC) +
Lysine deaminase (LDA) −
Urease −
Motility +
Voges–Proskauer +
Triple sugar iron (TSI) agar A/A
Gas production +

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17
Q

Gram stain: E. coli

A

GNRs

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18
Q

growth requirements of e. coli

A

aerobic and facultative anaerobe, grow best at 37 °C

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19
Q

colony morphology: e coli

A

circular, convex colonies, dull gray, smooth on sheep blood agar, pink
to red, surrounded by dark-pink precipitate on MacConkey agar, and yellow on Hektoen and
xylose lysine deoxycholate agar (XLD) agars.

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20
Q

Listeria monocytogenes react and present in the following ways:

A

Catalase +
Motility at 20–25 °C +
Esculin +
Nitrate reduction −
Christie–Atkins–Munch–Petersen (CAMP) test +
Hippurate +
Glucose fermentation +

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21
Q

gram stain: Listeria monocytogenes

A

GNRs or CB

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22
Q

growth requirements; Listeria monocytogenes

A

aerobic and facultative anaerobe, grow best at 35–37 °C in ambient
air or 5–10% CO2

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23
Q

colony morphology; Listeria monocytogenes

A

white, translucent, smooth, moist, with a narrow zone of beta-
hemolysis on sheep blood agar

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24
Q

Corynebacterium species react and present in the following ways:

A

Catalase +
Motility −
Esculin −
Mycolic acids +

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25
Q

gram stain: Corynebacterium species

A

Gram-positive bacilli, slightly curved, with rounded ends — some species are
pleomorphic, presenting a Chinese letter formation appearance

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26
Q

Growth requirements: Corynebacterium species

A

aerobic and facultative anaerobe, grow best at 35–37 °C in ambient
air or 5–10% CO2

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27
Q

Colony morphology: Corynebacterium diphtheriae:

A

varying morphology from small, gray, and translucent
to medium, white, and opaque; black or gray colonies on cystine-tellurite blood agar

28
Q

Colony morphology:
Less virulent Corynebacterium species:

A

small to medium, gray, white, or yellow,
nonhemolytic colonies

29
Q

Propionibacterium species react and present in the following ways:

A
  • Gram stain: Gram-positive bacilli, pleomorphic, diphtheroid-like, may be club shaped or in
    palisade arrangements
  • Growth requirements: anaerobic, grow best at 35–37 °C for 48 hours
  • Colony morphology: small white to gray on anaerobic blood agar. More mature colonies
    will be larger and yellow colored
30
Q

Correlating the appearance, microbiology, cell count, and chemistry testing of a CSF sample will
provide evidence for:

A

determining the presence of a meningitis infection, as well as differentiate the
causative agent.

31
Q

The expected results of a normal CSF sample free of infection are as follows:

A

Appearance: clear and colorless
* Protein: 15–45 mg/dL
* Glucose: 60–70% plasma glucose levels
* Cell count: 0–5 WBC/µL
* Differential: 70% lymphocytes, 30% monocytes

32
Q

Abnormalities in the color and clarity of a CSF sample can be indicative of the following

A

a traumatic
tap; current, recent, or previous subarachnoid hemorrhage; and infection.

33
Q

Evidence of a traumatic
tap will show

A

blood in collection tubes, with a successive clearing in each tube, a clear supernatant
when spun, and clots from the presence of fibrinogen.

34
Q

Samples will contain blood in every
collection tube during

A

a current subarachnoid hemorrhage, appear pale-pink to pale-orange in a
recent hemorrhage, and appear yellow in a past hemorrhage. A cloudy sample, maybe due to
increased WBCs, can be indicative of an infection

35
Q

Bacterial infections can be detected and a presumptive causative organism can be

A

seen on a Gram
stain of CSF and correlated with the cell count and chemistry results.

36
Q

Bacterial CSF lab values

A

CSF protein = greatly increased
CSF glucose= decreased
CSF WBC pop= Neutrophils
Lactate = increased

37
Q

Viral CSF lab values

A

CSF protein = increased
CSF glucose = normal
CSF WBCs = lymphs

38
Q

Fungal CSF lab values

A

CSF protein = increased
CSF glucose = normal - decreased
CSF WBCs = lymphs or monos
CSF lactate = increased

39
Q

Direct detection methods for the evaluation and diagnosis of CSF infections includes

A

stains, rapid
latex antigen testing, and serological testing

40
Q

Bacterial meningitis can be detected by the presence of

A

bacteria found on a Gram stain.

41
Q

India ink and acid-fast stain preparations allow for

A

the direct
detection of Cryptococcus and tuberculosis pathogens, respectively.

42
Q

Rapid latex antigen tests are
useful in the immediate detection of

A

classic meningitis causing bacteria such as S. pneumoniae, H.
influenzae, group B strep, E. coli, Neisseria meningitides, and Cryptococcus neoformans.

43
Q

Latex beads
coated with

A

ensitized monoclonal IgG antibodies for each bacterium are added to a test card with a
CSF sample, mixed, and mechanically rotated for 5 minutes

44
Q

Agglutination of the latex determines

A

the presence of bacterial antigens, thus indicating a bacterial infection

45
Q

Serological methods are also
used in

A

determining syphilis infections of the CNS

46
Q

The fluorescent treponemal antibody absorption
test

A

very sensitive but less specific in CSF samples than serum

47
Q

Molecular methods aid in

A

detecting pathogens that do not grow on routine media or in patients who have already had
antibiotic treatments.

48
Q

PCR testing is available for the detection and amplification of

A

nucleic acids in
the RNA or DNA of various CSF pathogens including bacteria, virus, fungi, and parasites.

49
Q

COMMON MENINGITIS-CAUSING PATHOGENS

A

S. pneumoniae, H. influenzae, and N. meningitidis, E. coli and L. monocytogenes, Streptococcus agalactiae

50
Q

Bacterial meningitis is caused by

A

opportunistic bacteria that enter the bloodstream, are carried
across the blood–brain barrier to the meninges, and spread throughout the spinal fluid

51
Q

S. pneumoniae, H. influenzae, and N. meningitidis are

A

normal flora of the upper respiratory tract
and are spread from person to person by respiratory droplets.

52
Q

The most susceptible population of meningitis are

A

children younger than 5 years of age, and pneumonia or bacteremia are commonly the initial
infection in a host prior to meningitis.

53
Q

S. pneumoniae in meningitis

A

Pneumolysin: antiphagocytic capsular protein
o Several adhesion factors and immunogenic cell wall membrane

54
Q

H. influenzae and N. meningitidis in meningitis

A

Encapsulated strains: resistant to phagocytosis and complement-mediated lysis

55
Q

H. influenzae: in meningitis

A

B strain, most likely to cause meningitis

56
Q

N. meningitidis: in meningitis

A

most common meningitis causing strains: A, B, C, Y, W.

57
Q

E. coli and L. monocytogenes are transmitted via the: in meningitis

A

ingestion of contaminated food.

58
Q

E. coli and L. monocytogenes, Streptococcus agalactiae: in meningitis

A

are common pathogens of neonatal meningitis due to transmission
from mother to baby at birth

59
Q

S. agalactiae (group B strep): in meningitis

A

Polysaccharide capsule: prevents phagocytosis
Pore-forming toxins: promote entry into host cells and facilitate organism survival

60
Q

E. coli: in meningitis

A

K1 strain: inhibits phagocytosis and resists bactericidal activity of serum antibodies

61
Q

L. monocytogenes: in meningitis

A

Escape phagocytic vacuoles due to listeriolysin O, phospholipase A, and phospholipase
B.

62
Q

COMMON PATHOGENS OF CSF SHUNT INFECTIONS

A

Coagulase-negative Staphylococcus
Corynebacterium
Propionibacterium

63
Q

Contamination of the
shunt can occur

A

during surgery to implant the device or during the aftercare and maintenance of
the shunt.

64
Q

Coagulase-negative Staphylococcus in CSF shunt infections

A

Encapsulated serotypes: resistant to phagocytosis
Several adhesion factors and biofilm producing the cell wall membrane

65
Q

Corynebacterium in CSF shunt infections

A

Toxigenic strains are lysogenic due to exotoxin production

66
Q

Propionibacterium in CSF shunt infections

A

Acquired resistance to the following antibiotic classes:
❖ Macrolides: erythromycin and azithromycin
❖ Lincosamides: clindamycin
❖ Tetracyclines: doxycycline and minocycline

67
Q
A

ASCP M Mometrix (18 decks)

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