CSF PROTEIN DETERMINATION Flashcards
Preferred method for CSF Protein determination
Turbidimetric
T/F.
Turbidimetric precipitates only albumin
FALSE.
Turbidimetric precipitates both albumin and globulin
It precipitates albumin only:
sulfosalicylic acid
To precipitate globulins, add
sodium sulfate
Dye binding uses
Coomassie Brilliant Blue
assess the integrity of the blood brain barrier
CSF /Serum Albumin Index
CSF /Serum Albumin Index
Normal value:
Abnormal value:
Normal value: <9
Abnormal value: >9
Index of 100:
complete damage to BBB
assess condition with IgG production within the CNS (Multiple Sclerosis)
IgG Index
indicative of IgG production within the CNS
IgG index
IgG Index
Normal value:
Abnormal value:
Normal value: <0.70
Abnormal value: >0.70
Done in conjunction with serum electrophoresis
CSF electrophoresis
For the detection of oligoclonal bands
CSF electrophoresis
The presence of 2 or more oligoclonal bands in CSF but not in serum is valuable for the diagnosis of:
Multiple sclerosis
Neoplastic disorders
Encephalitis
Guillain-Barre’ syndrome
Protein component of the lipid-protein complex that insulate the nerve fibers
Myelin Basic Protein
presence of MBP in CSF indicates destruction of
myelin sheath
Used to monitor course of multiple sclerosis
Myelin Basic Protein
____ techniques are used for measurement
Immunoassay
Done in conjunction with blood glucose.
CSF Glucose
Specimen for blood glucose should be drawn ____ to spinal tap
2 hours prior
CSF Glucose Normal values
60-70% of the plasma glucose
CSF Glucose is increased
Due to increase plasma glucose (not
significant)
CSF Glucose is decreased in
Bacterial, Fungal, and Tubercular Meningitis
CSF glucose is normal in
Viral Meningitis
CSF lactate levels can be a valuable aid in diagnosing and managing ____
meningitis
CSF lactate normal values
Normal value: 10-22 mg/dl (1.1 to 2.4 mmol/L)
T/F.
CSF Lactate is directly proportional to glucose
CSF lactate is inversely proportional to glucose
Frequently CSF lactate levels are used to monitor patients with
severe head injuries
RBCs contain high concentrations of lactate, and results that are falsely elevated may be obtained on
Xanthochromic or hemolyzed fluid
CSF Lactate Values:
Bacterial meningitis
Fungal and tubercular meningitis
Viral meningitis
Bacterial meningitis - Increased (>35mg/dl)
Fungal and tubercular meningitis - Increased (>25mg/dl)
Viral meningitis - Normal (remains lower than 25mg/dl)
Product of ammonia and alpha-ketoglutarate
CSF Glutamine
Indirect test for the presence of excess ammonia in CSF
CSF Glutamine
Why CSF Glutamine is preferred over direct measurement of CSF ammonia?
because the glutamine concentration remains more stable than the volatile
CSF Glutamine Normal value
8 to 18 mg/dl
CSF Glutamine is increased in
Reye’s syndrome, Disturbance of
consciousness/coma (more than 35 mg/dl)
CSF Enzyme for Brain tissue LD
LD 1 and 2
CSF Enzyme for Lymphocytes LD
LD 2 and 3
CSF Enzyme for Neutrophils LD
LD 4 and 5
Serum LDH
Normal =
Flipped pattern =
Normal = LDH 2>1>3>4>5
Flipped pattern = LD 1>2>3>4>5 (AMI)
CSF LDH
Normal =
Neurological abnormalities=
Bacterial meningitis=
Normal = LDH 2>3>1>4>5
Neurological abnormalities= LDH 1>2>3>4>5
Bacterial meningitis= LDH 5>4>3>2>1
Detects gram-negative bacterial endotoxin
Limulus Lysate Test
Limulus Lysate Test Reagent
Blood of horseshoe crab
Positive result for Limulus Lysate Test
Clumping or clot formation
