F2: CSF (Part 3: Tests - TUBE 1) Flashcards
Tube 1 includes what tests?
Chemistry and Serology
What analytes are measured in chemistry?
- Protein
- Sugar
- Lactic acid
- Enzymes
- Glutamine
Chemistry - Protein
Percentage and volume of protein in plasma
< 1% of plasma level
< 45 mg/dl
Chemistry - Protein
Protein increases with these conditions
a. Inflammation, increased permeability of BBB
b. Disintegrated cells and bacteria
c. Antibodies produced by nervous tissue
d. Obstruction of CSF flow
e. ALL
f. NOTA
e. ALL
Chemistry - Protein
What are the (4) methods of measuring protein?
- Antiquated
- Turbidimetric
- Colorimetric
- Immuno-chem
(4) methods of measuring protein
What are the 2 tests under Antiquated method of measurement of protein
- Colloidal gold
- Pandy’s
(4) methods of measuring protein
- Not done anymore
- Expensive - uses real gold
- Qualitative test
Antiquated test
Colloidal gold
(4) methods of measuring protein
- Only measures globulin
- Produced in the brain → CSF
- Does not pass brain barrier
Antiquated test
Chemistry - Protein
Pandy’s
(4) methods of measuring protein
Tests under this method is:
* TriChlorAceticacid (TCA)
* SSA
Chemistry - Protein
Turbidimetric
(4) methods of measuring protein
Tests under this method is:
* Lowry
* CBB
* Ponceau
* modified biuret
Chemistry - Protein
Colorimetric
(4) methods of measuring protein
- This method uses the most automated analyzers
Chemistry - Protein
Immuno-chem
Chemistry - Protein
(4) methods of measuring protein
Colorimetric biuret method positive and negative results?
(+) Purple
(-) Blue
Blue to purple
Chemistry - Protein
If sample is contaminated with blood….Protein level will be too high, what action must be done
Protein correction
Chemistry - Protein
In protein correction, one must subtract (blank) for (blank)
subtract 1mg/dL of protein for every 1000 RBC counted
T or F
Protein correction formula should only be used if HCT and blood protein levels are normal
T
Other CSF Proteins
What are the other (3) CSF proteins
- Alpha 2 macroglobulin (A2M)
- Fibronectin
- Transferrin (tau)
AFT AFT AFT AHUH AHUH
Other (3) CSF proteins
- Indicates Subdural hemorrhage
- Breakdown of BBB
- Not done anymore
Alpha 2 macroglobulin (A2M)
Other (3) CSF proteins
Alpha 2 macroglobulin (A2M) is now replaced by what technology?
Alpha 2 macroglobulin (A2M)
CT scan/MRI are now used
Other (3) CSF proteins
- Indicates poor prognosis in Acute Lymphoblastic Leukemia (ALL)
- No lumbar puncture done anymore
Fibronectin
Other (3) CSF proteins
- Unique to CSF
- CSF leakage
- Rhinorrhea /Otorrhea
- Used to differentiate CSF from serum
Transferrin (tau)
Chemistry – Protein Fractions
Familiarize the protein fractions
- Albumin
- Pre albumin (second most abundant in CSF)
- transferrin (tau)
- IgG (second most abundant in serum)
- IgA
- ceruloplasmin
- haptoglobin
Chemistry – Protein Fractions
↑ albumin and globulin indicates
a. BBB damage
b. CNS
c. ALL
d. NOTA
a. BBB damage
Chemistry – Protein Fractions
↑ globulin only
a. BBB damage
b. CNS
c. ALL
d. NOTA
b. CNS
Chemistry - Protein Indices
What are the (3) protein indices
- CSF/Serum albumin index
- CSF/Serum IgG index
- CSF IgG/albumin