CSF and Other Body Fluids Flashcards
Enumerate the trio that signify meningeal irritation.
Stiffness, Kernig’s sign, Brudzinki’s sign
Which is/are false?
A.blood-brain barrier is made up of the choroid plexus and capillaries
B.blood-brain barrier is semi-permeable membrane
C.In Brudzinski’s sign, pain is experienced when head drawn towards chest.
D.In Kernig’s sign, pain is experienced when knees drawn towards the chest.
(C & D - baliktad.)
CSF is the secretion & filtraton of the \_\_\_ A.dura mater B.choroid plexus C.pia mater D.AOTA
B
not a function of CSF
A.Cushion the bulk of the brain
B.Provides buoyancy (allows brain to float)
C.Increases the weight of the brain
D.Carries essential nutrients and metabolites
E.Cleanses the CNS of wastes
C - decrease dapat
False about CSF collecton
A.Submit at least 3 separate tubes for analysis
B.Submit tube 2 or the most turbid tube to the microbiology laboratory
C.Abscesses are caused by aerobic organisms
(C - Anaerobic dapat. so if specimen will come from brain abscess, place aspirated material in anaerobic container)
False about CSF collection
A. Gauge 23 needle (Terrumo) is usually used for children, spinal tap needle for adults
B. Lumbar tap can be done by either lying down or sitting back
C. Lumbar tap can make the cerebellum or brainstem to move down
D. May lead to death due to decrease in intracranial pressure
D - increase dapat
A.Enumerate 3 ways on getting CSF:
B.Enumerate order of draw @ CSF:
C.most impt lab tests when considering an infection
A. subdural tap, ventricular aspirate, lumbar puncture
B. chemistry, microbiology, hematology
C.Differential count and culture
not a direct consequence of inadequate CSF volume
A.Lower specificity
B.Lower sensitivity
B.False negative result
A
CSF storage when delayed: specify for each field A. microbio B. viral C. hema D. chem
A.room temp
B. frozen, -70 deg C
C. refrigerate
D. frozen
Which is false?
A.Neutrophils lyse due to hypotonicity
B.S. pneumoni easily autolyse
C.N. meningitides is susceptible to hot temperature
C - cold dapat
A. after centrifugation, Supernatant + Sediment are examined for?
B. name 2 media for culture of CSF:
A.presence of antigens or for chemistry evaluation
B. blood agar plate, chocolate agar
Which is false?
A.newborn CSF has wider protein & glucose range than adult CSF
B.adult CSF has more monocytes than lymphocytes
C.both adult & newborn CSF - clear, colorless
B - baliktad
A. T/F Turbid CSF is only caused by presence of bacteria.
B.Three causes of xanthochromia in CSF?
C.New born CSF is often xanthrochromic.. why?
A.F - may also be caused by increased protein/lipid
B.RBC lysis, protein >= 150 mg/dL, traumatic/bloody tap
C. because of the frequent elevation of bilirubin and protein levels in this age group.
A.Clots may be secondary to 2 things
B.diff of uneven tap vs subarachnoid hemorrhage
A.meningitis, traumatic tap
B.latter: Constant bloody fluid in all tubes (even distribution)
not a cause of elevated CSF protein A.Infection B.Intracranial hemorrhages C.Spina bifida D.Multiple sclerosis
(C= sa low CSF protein ito)
not a cause of low CSF protein A.presence of RBC in traumatic tap B.Acute water intoxication C.Idiopathic intracranial hypertension D.Guillain Barré syndrome
(A=sa falsely high CSF protein ito)
turbidimetric method of choice @ CSF protein testing A. precip by sulfosalicylic acid B. precip by trichloroacetic acid C. Pandy's test D. Ross Jones Test
(B - it precip both albumin and globulin)
Coomasie brilliant blue G250 is used for dye binding tech @ CSF protein test. Which color change signifies protein presence? A. green to yellow B. red to blue C. orange to violet D. NOTA
B
Which is false?
A.CSF protein levels are affected by hypoproteinemia.
B.Acute water intoxication also causes cerebral edema
C.SSA cannot differentiate between albumin and globulin
(A - The blood brain barrier’s selective permeability allows maintenance of constant protein levels.)
A. T/F Cytocentrifugation increases the ability to detect bacteria.
B. other stains used in diagnosis of bacterial infection @ CSF (aside fr Gram and AFB)
C.Two most common organisms to cause bacterial meningitis
A.T
B.India ink, Giemsa stain, Wright stain
C.S. pneumonia, N. meningitidis
Which is false?
A.High CSF lactate may be seen in hypoxia and meningitis
B.Falsely decreased CSF lactate may be seen in hemolyzed sample
C.Bacterial meningitis:CSF has high neutrophil count
D.Viral meningitis:CSF has high lymphocyte count
(B - falsely high. RBCs have lactate)
Which is false?
A. normal glucose levels don’t rule out infection
B. examination of CSF glucose may not be delayed due to glycolysis
C. Blood glucose is taken 2-4 hours before CSF glucose because equilibrium
D. High glucose @ CSF signifies subarachnoid hemorrhage
(D- low dapat)
A. Explain principle of direct antigen detection test for CSF
B. T/F Panel latex agglutination test can replace culture
C. CSF is subjected to what test to detect neurosyphilis?
A.Microorganisms carry specific polysaccharide surface antigens that can be detected by antibody coated latex particles agglutination
B.F
C.serologic testing
A.Differentiate transudate fr exudate
B.Where do transudates usually accumulate?
C.What does pleural effusion indicate?
A.transudate - non-inflammatory origin
exudate - inflammatory origin
B.serous cavities
C.Indicator of a pathologic process that may be of primary pulmonary origin or an origin related to another organ system or to systemic disease
not a reason for transudate accumulation A.Infection B.Venous obstruction C.Cardiac failure D.Disturbance in circulation with passive congestion
A
Which is false? A.Transudates are colorless. B.Transudates have putrid odor. C.Exudates have acidic pH reaction. D.Exudates coagulate.
(B - sa exudates ito. transudates: no odor)
Which is false? A.Transudates have lower protein content. B.Exudates have higher specific gravity. C.Exudate have higher glucose. D.Transudates have less cellular matter.
(C - transudates have higher glucose)
Which is false?
A.If fluid is transudate, further tests no longer necessary
B.Mucin is present in transudates
C.Pleura comes in 2 types: parietal and visceral
D.Pleural fluid is slightly acidic
(B - mucin @ exudates)
true about pleural fluid
A.Glucose content similar to interstitial fluid
B.Sodium, potassium and calcium concentration similar to that of plasma
C.Provides a frictionless surface between the two pleurae in response to changes in lung volume with respiration
C : baliktad ang A and B
Identify mechanism of pleural effusion:
A. hypoalbuminemia - reduced intravasc oncotic pressure
B. congestive heart failure - Increased capillary hydrostatic pressure
A. hypoalbuminemia - reduced intravasc oncotic pressure
B. congestive heart failure - Increased capillary hydrostatic pressure
identify mechanism of pleural effusion:
A. mesothelioma - lung unable to expand
B. piercing of pleura - latrogenic cause
A. mesothelioma - lung unable to expand
B. piercing of pleura - latrogenic cause
enumerate Light’s criteria for pleural fluids
- Pleural fluid protein/serum protein ratio > 0.5
- Pleural fluid LDH/serum LDH ratio > 0.6
- Pleural fluid LDH > 2/3 the upper limits of normal serum LDH
Which is true?
A. If all of Light’s criteria apply to sample, it’s an exudate
B. If all of Light’s criteria apply to sample, it’s a transudate
C. If none of Light’s criteria apply to sample, it’s an exudate
D. If none of Light’s criteria apply to sample, it’s a transudate
(D)
if pleural fluid is put in red top tube, it will be examined for any except A.protein B.amylase C.lactate dehydrogenaase D.culture
D
If pleural fluid is purulent
A. malignancy
B. infection
C. empyema
C
If pleural fluid is yellow-turbid, indicative of A. malignancy B. infection C. empyema D. chyle
D
If pleural fluid is turbid, it is indicative of A.infection B.lipid content C.empyema D.A or B E.B or C
d
If pleural fluid is bloody & there is no trauma, patient has
A. malignancy
B. infection
C. empyema
A
Which is false?
A.TB infection - transudate
B.Significant eosinophilia @ pleural fluid bc of chyle @ pleural space
C.Lymphocyte domination @ pleural fluid – chronic effusion
(B - air or blood dapat)
A. identify best indicator of pleural inflammation
B. if amylase is elevated @ pleural fluid, their ratio is greater than __
A.lactate dehydrogenase
B.1
A. if pH of pleural fluid
A.empyema
B.low
Does not secrete gastric fluid A. Cells of the gastric mucosa B. Epithelial cells C. Various glands of the GI tract D. Acinar cells
D
Four most common uses for gastric fluid analysis
- Detect gastrin secreting tumors
- Detect recurrent peptic ulcer disease
- Evaluating hyperacidity
- Diagnosis of achlorydia
A.Differentiate Basal acid output from Maximal acid output
B.When gastric fluid has coffee ground color, what does this mean?
A.Basal acid output – one hour collection of gastric secretion (15 min sample)
Maximal acid output – one hour collection of gastric secretion after stimulation
B.Large amount of blood which has remained in the stomach for a period of time
Enumerate three qualitative tests for HCl presence @ gastric fluid, as well as their positive colors :)
Dimethylaminoazobenzole: Cherry red
Gunzberg: Purplish red
Boas Test: rose red
enumerate three tests that detect presence of lactic acid @ gastric fluid
- Uffelman’s test
- Kelling’s test
- Strauss
presence of lactic acid @ gastric fluid indicates:
A. gastric cancer
B. ulcer
C. gall bladder disease
A
presence of RBC @ gastric fluid indicates:
A. gastric cancer
B. ulcer
C. gall bladder disease
B
presence of columnar epithelial cell @ gastric fluid indicates:
A. gastric cancer
B. ulcer
C. gall bladder diseas
C
False about basal gastric secretion?
A. Acid secretion without external stimulation
B. No need for fasting state
C. Patient must be removed from environmental situation evoking untoward psychological reactions
B – fasting state dapat
[Gastric Fluid]
Which is false?
A.Maximal Stimulation Test result in an output of HCl that cannot be increased with additional stimulation
B.Insulin is a potent inhibitor for gastric acid secretion
C.BOTA
B : stimulator dapat
