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AUBF 2 CSF/ AMNIOTIC (FINALS) > CSF Protein Determination > Flashcards

CSF Protein Determination Flashcards

1
Q

2 types of method in Total Protein

A

Turbidimetric Method
Dye-Binding Method

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2
Q

preferred method, precipitates both albumin and globulin

A

Trichloroacetic acid (3% TCA)

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3
Q

precipitates albumin only
▪ To precipitate globulins, we add sodium sulfate

A

Sulfosalicylic acid (3% SSA)

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4
Q

Dye-Binding Method:
Coomasie Brilliant Blue

A

protein binds to dye → dye turns red to blue (intense blue color = high protein present)

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5
Q

assess the integrity of blood brain barrier

A

CSF/Serum Albumin index

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6
Q

To compute:
o Normal value:
o Abnormal:

A

To compute: CSF Albumin (mg/dL) / Serum Albumin (g/dL)
o Normal value: <9 = intact BBB
o Abnormal: >9

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7
Q

Slight impairment

A

9-14

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8
Q

Moderate impairment

A

15-30

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9
Q

Severe impairment

A

> 30

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10
Q

Complete damage to BBB

A

100

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11
Q

assess conditions the IgG production within the CNS (ie. Multiple sclerosis – increase plasma cells)

A

IgG Index

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12
Q

IgG Index Value
Normal:
Abnormal:

A

Normal: <0.70
Abnormal: >0.70 (there’s an increase IgG production → Multiple sclerosis)

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13
Q

Presence of 2 oligoclonal bands in CSF and not in serum

A

o Multiple sclerosis
o Neurosyphilis
o Encephalitis
o Neoplastic disorder
o Guillain-Barre syndrome

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14
Q

Detection of oligoclonal bands in the gamma region → immunoglobulin production

A

CSF Electrophoresis

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15
Q
  • Demyelinating disorder
  • Production of antibodies against myelin sheath
A

Multiple Sclerosis

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16
Q

Multiple Sclerosis Findings:

A

o (+) anti-myelin sheath autoantibody
o (+) oligoclonal band in CSF but not in serum
o (+) Myelin Basic protein (MBP) – protein component of myelin sheath, monitors MS
o Increased IgG index

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17
Q

CSF Glucose
Normal Value:

A

CSF Glucose
Normal Value:
* 60-70% of blood glucose (65%, 2/3) *accd. Strasinger
* 50-80 mg/dL *accd. Henry’s

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18
Q

Measurement of glucose in CSF is always performed in conjunction with ____ glucose

A

blood

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19
Q

Specimen for blood glucose should be collected _____ before spinal tap to allow equilibration of CSF and plasma glucose

A

2 hours

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20
Q

Increased CSF Glucose

A

Diabetes mellitus

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21
Q

Decreased CSF Glucose

A
  • Bacterial (Decreased CSF glucose), tubercular, and fungal meningitis
  • Alterations in glucose transport across BBB
  • Increased used of glucose by brain cells
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22
Q

Normal CSF glucose

A

Viral meningitis

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23
Q

waste product of glucose metabolism, inversely proportional with glucose

A

Lactate

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24
Q

Increased CSF Lactate

A
  • Bacterial meningitis (bacteria utilized glucose → lactate >35mg/dL)
  • Tubercular and fungal meningitis (>25 mg/dL)
  • Hypoxia (tissues are destroyed causing release of lactate)
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25
Q

CSF Lactate
Normal values:

A

CSF Lactate
Normal values: 10-24 mg/dL

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26
Q

Normal CSF lactate (<25 mg/dL)

A

Viral meningitis

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27
Q

A product of ammonia (NH3) and a-ketoglutarate in braincells

A

CSF Glutamine

28
Q

Indirect test for the presence of excess NH3 in CSF

A

(High NH3 = High Glutamine)

29
Q

CSF Glutamine
Normal value:

A

CSF Glutamine
Normal value: 8-18 mg/dL

30
Q

Increased CSF Glutamine

A
  • Disturbance of consciousness (>35 mg/dL)
  • Reye’s syndrome – 75% of patient with Reye’s syndrome have increased CSF glutamine
31
Q

found in brain tissue

A

LD1 and 2

32
Q

Lymphocytes

A

LD2 and 3

33
Q

Neutrophils

A

LD4 and 5

34
Q

Increased Creatinine Kinase

A

Stroke, multiple sclerosis, degenerative disorders, brain tumors, viral and bacterial meningitis, epileptic seizure

35
Q

Increased Aspartate Aminotransferase

A

Intracerebral and subarachnoid hemorrhage, bacterial meningitis

36
Q

bacterial meningitis → high neutrophils

A

5>4>3>2>1

37
Q

If the distribution of LD enzyme in serum is seen on CSF (predominant LD2)

A

neurologic abnormality

38
Q

Normal distribution of LD enzyme in serum

A

LD2>LD1>LD3>LD4>LD5

39
Q

Normal distribution of LD enzyme in CSF

A

LD1>LD2>LD3>LD4>LD5

40
Q

If the distribution of LD enzyme in CSF is seen on serum (predominant LD1) → flipped pattern

A

Acute Myocardial Infarction or Hemolytic anemia

41
Q

Common agents: Group B streptococci

A

Neonates

42
Q

Common agents: E. coli and other gram negative bacilli

A

Newborn to 1 month

43
Q

Common agents: Neisseria meningitis

A

Children (>3 months )

44
Q

Common agents: Streptococcus pneumoniae

A

Children (>3 months )

45
Q

Common agents: Haemophilus influenzae

A

3 month to 18 years old

46
Q

Common agents: Listeria monocytogenes

A

Newborns, Adults, alcoholics, immunocompromised

47
Q

Laboratory Findings:
* WBC –
* Protein –
* Glucose –
* Lactate -
* Others
o (?) Gram stain
o (?) Culture
o (?) Limulus Lysate test

A

Laboratory Findings:
* WBC – Increased neutrophils
* Protein – Increased
* Glucose – Decreased
* Lactate - Increased
* Others
o (+) Gram stain
o (+) Culture
o (+) Limulus Lysate test

48
Q

Detects gram negative bacterial endotoxin in body fluids and surgical instruments

A

Limulus Lysate test

49
Q

Limulus Lysate test Reagent:

A

Blood of horseshoe crabs (Limulus polyhemus)
Blue in color because of hemocyanin that contains copper

50
Q

Endotoxin → Amoebocyte → release lysate →

A

Positive reaction: Clot formation

51
Q

Blood also contains WBCS called

A

amoebocyte

52
Q

Spirochetal Meningitis
Neurosyphilis – caused by
Neuroborreliosis – caused by

A

Neurosyphilis – caused by T. pallidum
Neuroborreliosis – caused by B. burgdorfer

53
Q

Spirochetal Meningitis
Diagnosis:

A

Diagnosis:
* Nontreponemal tests (VDRL, FTA-Abs)
* ELISA
* Western blot

54
Q

recommended test of CDC for neurosyphilis

A

VDRL

55
Q

Tubercular Meningitis
Agent:

A

Tubercular Meningitis
Agent: Mycobacterium tuberculosis

56
Q

Tubercular Meningitis
Laboratory findings:
* WBC –
* Protein –
* Glucose –
* Lactate –
* (?) AFB stain
* (?) Pellicle/web-like clot formation after stored/stand 12-24 hours in refrigerator

A

Tubercular Meningitis
Laboratory findings:
* WBC – Increased lymphocyte and monocyte
* Protein – increased
* Glucose – Decreased
* Lactate – Increased
* (+) AFB stain
* (+) Pellicle/web-like clot formation after stored/stand 12-24 hours in refrigerator

57
Q

Fungal Meningitis
Agent:

A

Fungal Meningitis
Agent: Cryptococcus neoformans *most frequently isolated pathogen in the CSF

58
Q

Fungal Meningitis
Laboratory findings:
* WBC –
* Protein –
* Glucose –
* Lactate –
* (?) Gram stain – starburst pattern
* (?) India Ink (Negative/Indirect stain – background only)
* (?) Latex agglutinations test – detects the presence of antigen of C. neoformans

A

Fungal Meningitis
Laboratory findings:
* WBC – Increase lymphocyte and monocyte
* Protein – Increased
* Glucose – Decreased
* Lactate – Increased
* (+) Gram stain – starburst pattern
* (+) India Ink (Negative/Indirect stain – background only)
* (+) Latex agglutinations test – detects the presence of antigen of C. neoformans

59
Q

Amoebic Meningoencephalitis
Agents:
* Naegleria fowleri –
* Acanthamoeba species and Balamuthia mandrillaris –

A

Amoebic Meningoencephalitis
Agents:
* Naegleria fowleri – Primary amoebic meningoencephalitis
* Acanthamoeba species and Balamuthia mandrillaris – causes Granulomatous amoebic encephalitis

60
Q

Amoebic Meningoencephalitis
Laboratory Findings:
* WBC –
* Protein –
* Glucose -
* Lactate –
* (?) RBCs
* (?) Acridine orange stain

A

Laboratory Findings:
* WBC – Increased neutrophils
* Protein – Increased
* Glucose - Decreased
* Lactate – Increased
* (+) RBCs
* (+) Acridine orange stain

61
Q

agents can be identified with Wright-stained
smear but macrophage can be mistakenly identified as protozoa

A

Acridine orange stain

62
Q

Amoeba

A

brick red

63
Q

Viral Meningitis
Agents:

A

Viral Meningitis
Agents: Enteroviruses (Coxsackievirus, Echovirus, Poliovirus), Arbovirus

64
Q

WBC

A

bright green

65
Q

Viral Meningitis
Laboratory Findings:
* WBC –
* Protein -
* Glucose -
* Lactate -
* RT-PCR

A

Viral Meningitis
Laboratory Findings:
* WBC – Increased lymphocytes
* Protein - Increased
* Glucose - Normal
* Lactate - Normal
* RT-PCR

66
Q

gold standard for diagnosis of viral meningitis

A

RT-PCR

AUBF 2 CSF/ AMNIOTIC (FINALS) (3 decks)

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