F2: CSF (Part 2: Sample Collection) Flashcards

1
Q

SAMPLE COLLECTION

Volume of CSF fluid among three test tubes

A

3-6 mL serially collected

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2
Q

SAMPLE COLLECTION

How many tubes are used?

A

Three

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3
Q

SAMPLE COLLECTION

What section of the laboratory is Tube 1 from a CSF collection used for?

A

Tube 1: Chemistry and Serology

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4
Q

SAMPLE COLLECTION

What section of the laboratory is Tube 2 from a CSF collection used for?

A

Culture and Sensitivity

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5
Q

SAMPLE COLLECTION

What section of the laboratory is Tube 3 from a CSF collection used for?

A

Hematological studies

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6
Q

SAMPLE COLLECTION

T or F

The reason why hematology is done on last sample is to ensure sample is clean

A

T

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7
Q

SAMPLE COLLECTION

What appropriate preservation method for following tube:
Tube 1

Room Temp, Refrigerate, Freeze?

IF NOT PERFORMED IMMEDIATELY

A

Freeze

Tube 1: chemistry and serology

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8
Q

SAMPLE COLLECTION

What appropriate preservation method for following tube:
Tube 2

Room Temp, Refrigerate, Freeze?

IF NOT PERFORMED IMMEDIATELY

A

Room temp

Tube 2: culture and sensitivity

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9
Q

SAMPLE COLLECTION

What appropriate preservation method for following tube:
Tube 3

Room Temp, Refrigerate, Freeze?

IF NOT PERFORMED IMMEDIATELY

A

Refrigerate

Tube 3: hematology

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10
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Chemistry (glucose, protein)
Amount needed: 1mL

A

Tube 1

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11
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Gram’s stain, AFB stain, India ink preparation, Bacterial culture (blood agar, chocolate agar), Fungal culture (Sabouraud agar), Culture for TB
Amount needed: 2mL

A

Tube 2

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12
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Total cell count, Differential count
Amount needed: 1mL

A

Tube 3

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13
Q

SAMPLE COLLECTION

Tube 1, 2, 3,4 ?

Tests done: Cytology, Immunology, Additional
Amount needed: 1mL

A

Tube 4

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14
Q

SAMPLE COLLECTION

T or F

if 4 tubes are collected in CSF, tube 1 and 2 have same procedure

A

T

Much harder to collect than the 3 tube sampling

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15
Q

SAMPLE COLLECTION

T or F

If only 1 tube is collected, cystology is the first tested

A

F (Microbiology is first)

Unless there is a special test request

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16
Q

SAMPLE COLLECTION

T or F

It is common to collect only 1 sample

A

T

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17
Q

SAMPLE COLLECTION

The longer sample is exposed, the more (blank) it will contain

A

The longer sample is exposed, the more bacteria it will contain

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18
Q

SAMPLE COLLECTION

T or F

It is not unusual for cell counts requested to be performed on both test tube 2 and 4 to check for cellular contamination by the puncture

A

F (t is not unusual for cell counts requested to be performed on both test tube 1 and 4 to check for cellular contamination by the puncture)

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19
Q

SAMPLE COLLECTION

Which tests are done in order?

Cell count, Cytology, Microbiology, Serology

A
  1. Microbiology
  2. Cytology
  3. Cell count
  4. Serology
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20
Q

CSF APPEARANCE

What CSF appearance based on description?

Clear, Watery

A

Normal

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21
Q

CSF APPEARANCE

What CSF appearance based on description?

  • due to an increase in Cells
    (RBC > 400 cell/cmm; WBC > 200 cell/cmm)
  • Protein (>150 mg/dL)
  • Bacteria
  • Fat
  • Debris
A

Hazy

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22
Q

CSF APPEARANCE

What CSF appearance based on description?

  • Supernatant that is pink, orange or yellow
  • Contains: hemoglobin, oxyhemoglobin, bilirubin, carotenoids, raframpin, serum bilirubin, increased protein concentration
  • Can manifest brown color due to melanin
A

Xanthrochromia

23
Q

CSF APPEARANCE

  • Indicates TB
  • After 24 hours of refrigeration, it floats on top of sample, indicates TB
  • When placed room temperature, this ndicates TB
A

Pellicle

24
Q

CSF APPEARANCE

What CSF appearance based on description?
* Increased fibrinogen
* Spinal block (Froin’s Syndrome), traumatic tap, TB

A

Clot formation

25
Q

CSF APPEARANCE

What RBC count causes CSF to appear hazy?

A

> 400 cell/cmm

26
Q

CSF APPEARANCE

What WBC count causes CSF to appear hazy?

A

> 200 cell/cmm

27
Q

CSF APPEARANCE

What protein volume causes CSF to appear hazy?

A

> 150mg/dL

28
Q

CSF APPEARANCE

Most common form of xanthochromia?

XANTHOCHROMIA

A

Hemoglobin

29
Q

CSF APPEARANCE

Color indicates heavy hemolysis

XANTHOCHROMIA

A

Orange

30
Q

CSF APPEARANCE

Color indicates slight amount of oxyhemoglobin

XANTHOCHROMIA

A

Pink

31
Q

CSF APPEARANCE

Color indicates conversion of oxyhemoglobiin to unconjugated bilirubin

XANTHOCHROMIA

A

Yellow

32
Q

CSF APPEARANCE

Color indicates melanin (melanoma)

XANTHOCHROMIA

A

Brown

33
Q

CSF APPEARANCE

T or F

Pellicle formation after 24 hours of refrigeration and in room temperature both indicates TB

Pellicle

A

T

34
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: none
Major significance: Normal

TABLE

A

CRYSTAL CLEAR

35
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: WBCs
Major significance: Meningitis

A

HAZY/ TURBID/ MILKY/ CLOUDY

36
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Microorganisms
Major significance: Meningitis

A

HAZY/ TURBID/ MILKY/ CLOUDY

37
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Protein
Major significance: Disorders affecting BBB Production of IgG within the CNS

A

HAZY/ TURBID/ MILKY/ CLOUDY, XANTOCHROMIC, CLOTTED, PELLICLE

pwede siya sa 4

38
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Radiographic contrast media
Major significance: None

A

OILY

39
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: RBCs
Major significance: Hemorrhage Traumatic tap

A

BLOODY

40
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Hemoglobin
Major significance: Old hemorrhage, Lysed cells from traumatic tap

A

XANTOCHROMIC

41
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Bilirubin
Major significance: RBC degradation, Elevated serum levels

A

XANTOCHROMIC

42
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Carotene
Major significance: Increased serum levels

A

XANTOCHROMIC

43
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Clotting factors
Major significance: Introduced by traumatic tap

A

CLOTTED

44
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

What appearance based on cause and major significance

Cause: Clotting factors
Major significance: Tubercular meningitis

A

PELLICLE

45
Q

CLINICAL SIGNIFICANCE OF CSF APPEARANCE

Determine if Trauma or Subarachnoid Hemorrhage

Clearing: (+)
Xanthochromia: (-)
Eryhtophagocytosis: (-)
Hemosiderin: (-)
D dimer: (-)

A

Trauma

46
Q

Determine if Trauma or Subarachnoid Hemorrhage

Clearing: (-)
Xanthochromia: (+)
Eryhtophagocytosis: (+)
Hemosiderin: (+)
D dimer: (+)

A

Subarachnoid Hemorrhage

47
Q

T or F

If CSF is very red viscous, it indicates SAH

A

F (indicates Traumatic lumbar puncture; Internal brain bleeding)

48
Q

What are the (5) characteristics involved in differentiating trauma or blood (hemorrhage)

A
  • Clearing
  • Xanthochromia
  • Eryhtrophagocytosis
  • Hemosiderin
  • D dimer
49
Q

(5) characteristics involved in differentiating trauma or blood

Positive or Negative result for clearing?

  • First tube will have the most blood and 4th tube having least to no blood
  • Traumatic tap
A

Positive

50
Q

(5) characteristics involved in differentiating trauma or blood

Positive or Negative result for clearing?

  • First tube is same color to the rest
  • SAH/Subarachnoid hemorrhage
A

Negative

51
Q

(5) characteristics involved in differentiating trauma or blood

Characteristic that refers to breakdown of RBC releasing hemoglobin, bilirubin,….

A

Xanthochromia

52
Q

(5) characteristics involved in differentiating trauma or blood

Characteristic that involves erythrophagia (macrophage eating RBCs)

A

Eryhtrophagocytosis

53
Q

(5) characteristics involved in differentiating trauma or blood

  • Characteristic that is involved with coagulation
  • Phagocytic system
  • Fibrinolytic system is activated and breaks down fibrin into different fragments, one of which is this
A

D dimer

54
Q

This means macrophage eating rbc

A

Erythrophagia